Evidence map›Paper›PMID 28194667›Full record

ArticleDigestive diseases and sciences2017

Three-Dimensional Anorectal Manometry Enhances Diagnostic Gain by Detecting Sphincter Defects and Puborectalis Pressure.

Shreya Raja, Francis C Okeke, Ellen M Stein, Sameer Dhalla, Monica Nandwani, Kristle L Lynch, C Prakash Gyawali, John O Clarke

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Article in Digestive diseases and sciences, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.4field-weighted citation impact, top 12% of its field
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

7 citing papers in PubMed, 19 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

Shreya RajaDivision of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Francis C OkekeDivision of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ellen M SteinDivision of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Sameer DhallaDivision of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Monica NandwaniDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Kristle L LynchDivision of Gastroenterology and Hepatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
C Prakash GyawaliDivision of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA.
John O ClarkeDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA. john.clarke@stanford.edu.
Johns Hopkins Medicine · USStanford University · USWashington University in St. Louis · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConstipation and fecal incontinence (FI) are common and are often evaluated with anorectal manometry. Three-dimensional high-resolution anorectal manometry (HRAM) is a promising technology; however, implementation has been limited by lack of metrics and unclear clinical utility.

aimTo investigate the diagnostic utility of 3D HRAM compared to 2D HRAM.

methodsThree-dimensional HRAM studies performed from April 2012 to October 2013 were identified and re-interpreted by two blinded investigators examining 3D function. Disagreements were resolved by a third investigator. Puborectalis (PR) visualization, focal defects, and dyssynergy were reported. Differences between groups were analyzed with Fisher's exact test. Discordance was analyzed with McNemar Chi-square test.

resultsTwo hundred and twenty-one 3D HRAM studies were identified. Mean age and BMI were 52.2 ± 17.4 and 27.1 ± 7.5 years (81% female, 74% white). Most common indications for 3D HRAM were constipation (65%) and FI (28%). PR function was visualized in 81% (rest), 97% (squeeze), and 73% (strain). PR was visualized less often at rest in FI than constipation (68 vs. 85%, p = 0.007). Defects were identified twice as often in FI than constipation (19 vs. 10%, p = 0.113). Twenty-nine defects (86% anterior) were visualized on 3D HRAM. Inter-reader agreement was moderate for PR function (κ = 0.471), but fair for focal defects (κ = 0.304).

conclusionsPR function and focal defects can be visualized on 3D-HRAM with added diagnostic benefit compared to 2D. Fair inter-reader agreement for focal defects highlights the need for quantitative metrics.

Indexed as

AdultAgedAnal CanalConstipationFecal IncontinenceFemaleHumansImaging, Three-DimensionalMaleManometryMiddle AgedRectumRetrospective StudiesAnorectal manometryConstipationDyssynergyFecal incontinence

Identifiers

PMID28194667
OpenAlexW2588711830

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Registered trials

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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.