Evidence map›Paper›PMID 27723241›Full record

ArticleNeurogastroenterology and motility2017

Impact of symptom burden and health-related quality of life (HRQOL) on esophageal motor diagnoses.

C A Reddy, A Patel, C P Gyawali

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurogastroenterology and motility, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing.The American journal of gastroenterology · 2020
    Guideline
  3. Trial
  4. Trial
  5. Article
  6. Review
  7. Review
  8. Article
  9. Article
  10. The Lyon Consensus: Does It Differ From the Previous Ones?Journal of neurogastroenterology and motility · 2020
    Review
  11. Higher Esophageal Symptom Burden in Obese Subjects Results From Increased Esophageal Acid Exposure and Not From Dysmotility.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020
    Article
  12. Is Peroral Endoscopic Myotomy a Potential Therapy for Esophageal Absent Contractility?Surgical laparoscopy, endoscopy & percutaneous techniques · 2020
    Article
  13. Review
  14. Article
  15. Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease.The Medical clinics of North America · 2019
    Review
  16. Review
  17. Review
  18. Review
  19. Observational
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

C A ReddyDivision of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
A PatelDivision of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
C P GyawaliDivision of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.

Funding

CLINICAL/LABORATORY TRAINING ACADEMIC GASTROENTEROLOGYT32DK007130 · NIDDK · WASHINGTON UNIVERSITY · PI MATTHEW AARON CIORBA · 1986 to 2026
$8.3M
NIDDK NIH HHS T32 DK007130
6 · The paper itself

Abstract

backgroundHigh-resolution manometry (HRM) categorizes esophageal motor processes into specific Chicago Classification (CC) diagnoses, but the clinical impact of these motor diagnoses on symptom burden remain unclear.

methodsTwo hundred and eleven subjects (56.8±1.0 years, 66.8% F) completed symptom questionnaires (GERDQ, Mayo dysphagia questionnaire [MDQ], visceral sensitivity index, short-form 36, dominant symptom index, and global symptom severity [GSS] on a 100-mm visual analog scale) prior to HRM. Subjects were stratified according to CC v3.0 and by dominant presenting symptom; contraction wave abnormalities (CWA) were evaluated within "normal" CC. Symptom burden, impact of diagnoses, and HRQOL were compared within and between cohorts. KEY

resultsMajor motor disorders had highest global symptom burden (P=.02), "normal" had lowest (P<.01). Dysphagia (MDQ) was highest with esophageal outflow obstruction (P=.02), but reflux symptoms (GERDQ) were similar in CC cohorts (P=ns). Absent contractility aligned best with minor motor disorders. Consequently, pathophysiologic categorization into outflow obstruction, hypermotility, and hypomotility resulted in a gradient of decreasing dysphagia and increasing reflux burden (P<.05 across groups); GSS (P=.05) was highest with hypomotility and lowest with "normal" (P=.002). Within the "normal" cohort, 33.3% had CWA; this subgroup had symptom burden similar to hypermotility. Upon stratification by symptoms, symptom burden (GSS, MDQ, HRQOL) was most profound with dysphagia. CONCLUSIONS AND INFERENCES: Chicago Classification v3.0 diagnoses identify subjects with highest symptom burden, but pathophysiologic categorization may allow better stratification by symptom type and burden. Contraction wave abnormalities are clinically relevant and different from true normal motor function. Transit symptoms have highest yield for a motor diagnosis.

Indexed as

Cost of IllnessEsophageal Motility DisordersFemaleHealth SurveysHumansMaleManometryMiddle AgedQuality of LifeChicago Classificationdysphagiahigh-resolution manometrysymptom burden

Identifiers

PMID27723241
PMCPMC5367979

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Registered trials

None linked

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.