Observational studyNeurogastroenterology and motility2016
GERD phenotypes from pH-impedance monitoring predict symptomatic outcomes on prospective evaluation.
Observational study in Neurogastroenterology and motility, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing.The American journal of gastroenterology · 2020Guideline
- Radiofrequency ablation reduces esophageal hypersensitivity in refractory non-erosive reflux disease.Frontiers in medicine · 2026Article
- Validation of Esophageal Global Symptom Severity as a Patient-Reported Outcome for Evaluation of Reflux Symptoms.The American journal of gastroenterology · 2025Article
- Transoral incisionless fundoplication is cost-effective for treatment of gastroesophageal reflux disease.Endoscopy international open · 2022Article
- Diagnosis and Management of Refractory Gastroesophageal Reflux Disease.Gastroenterology & hepatology · 2021Article
- Differentiating esophageal sensitivity phenotypes using pH-impedance in intensive care unit infants referred for gastroesophageal reflux symptoms.Pediatric research · 2021Article
- Esophageal Baseline Impedance From High-resolution Impedance Manometry Correlates With Mean Nocturnal Baseline Impedance From pH-impedance Monitoring.Journal of neurogastroenterology and motility · 2020Article
- Esophageal Functional Lumen Imaging Probe (FLIP): How Can FLIP Enhance Your Clinical Practice?Digestive diseases and sciences · 2020Review
- Proposed approach to the challenging management of progressive gastroesophageal reflux disease.World journal of gastrointestinal endoscopy · 2018Review
- Chronic Cough Is Associated With Long Breaks in Esophageal Peristaltic Integrity on High-resolution Manometry.Journal of neurogastroenterology and motility · 2018Article
- Genetic risk factors for perception of symptoms in GERD: an observational cohort study.Alimentary pharmacology & therapeutics · 2018Observational
- Expert consensus document: Advances in the physiological assessment and diagnosis of GERD.Nature reviews. Gastroenterology & hepatology · 2017Review
- A review of medical therapy for proton pump inhibitor nonresponsive gastroesophageal reflux disease.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2017Review
- Impairment of chemical clearance and mucosal integrity distinguishes hypersensitive esophagus from functional heartburn.Journal of gastroenterology · 2017Article
- Distal mean nocturnal baseline impedance on pH-impedance monitoring predicts reflux burden and symptomatic outcome in gastro-oesophageal reflux disease.Alimentary pharmacology & therapeutics · 2016Observational
- Prevalence, characteristics, and treatment outcomes of reflux hypersensitivity detected on pH-impedance monitoring.Neurogastroenterology and motility · 2016Article
- Critical appraisal of Rome IV criteria: hypersensitive esophagus does belong to gastroesophageal reflux disease spectrum.Annals of gastroenterologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundCombinations of reflux parameters (acid exposure time, AET; symptom association probability, SAP) on pH-impedance monitoring describe varying confidence in reflux evidence. We compared outcomes between phenotypes with distinct pre-identified reflux parameters.
methodsIn this observational cohort study, patients undergoing pH-impedance testing over a 5-year period were phenotyped by strength of reflux evidence as strong (abnormal AET, positive SAP), good (abnormal AET, negative SAP), reflux hypersensitivity (RH, normal AET, positive SAP), and equivocal evidence of reflux, and compared to two historical institutional pH monitoring cohorts. Symptom burden (dominant symptom intensity, DSI; global symptom severity, GSS) was assessed by questionnaire at baseline and on prospective follow-up and compared between phenotypes. KEY
resultsOf 94 patients tested off proton pump inhibitor (PPI) therapy, baseline symptom burden was highest with strong reflux evidence and lowest when equivocal (DSI: p = 0.01; GSS: p = 0.03 across groups). After 3.1 ± 0.2 years follow-up, symptomatic improvement with surgical or medical therapy was highest with strong or good evidence, and lowest when equivocal (DSI: p = 0.008; GSS: p = 0.005 across groups). This was most pronounced for typical symptoms (DSI: p = 0.001; GSS: 0.016 across groups), but not atypical symptoms (DSI: p = 0.6; GSS: p = 0.2). For testing on PPI therapy, only GSS followed a similar trend (GSS: p = 0.057, DSI: p = 0.3). Compared to historical cohorts with pH monitoring alone, equivocal evidence for reflux was partly replaced by RH, especially off PPI (p < 0.0001). CONCLUSIONS & INFERENCES: Phenotyping gastroesophageal reflux disease by the strength of reflux evidence on pH-impedance testing off PPI efficiently stratifies symptomatic outcome, especially for typical symptoms, and could be useful in planning management.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.