Evidence map›Paper›PMID 32606254›Full record

ReviewJournal of neurogastroenterology and motility2020

The Lyon Consensus: Does It Differ From the Previous Ones?

Matteo Ghisa, Brigida Barberio, Vincenzo Savarino, Elisa Marabotto, Mentore Ribolsi, Giorgia Bodini, Fabiana Zingone, Marzio Frazzoni, Edoardo Savarino

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of neurogastroenterology and motility, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 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, 1 synthesis or guideline pooled it.

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  14. Letter to the Editor: Relevance of a Correct GERD Patient Classification Before Anti-reflux Procedures.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022
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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

9 authors.

Matteo GhisaDivision of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.ORCID 0000-0002-6026-5639
Brigida BarberioDivision of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Vincenzo SavarinoDivision of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
Elisa MarabottoDivision of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
Mentore RibolsiUnit of Gastroenterology, Campus Bio-Medico University, Rome, Italy.
Giorgia BodiniDivision of Gastroenterology, Department of Internal Medicine, University of Genoa, Genoa, Italy.
Fabiana ZingoneDivision of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
Marzio FrazzoniPathophysiology Unit, Baggiovara Hospital, Modena, Italy.
Edoardo SavarinoDivision of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.ORCID 0000-0002-3187-2894

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Gastroesophageal reflux disease (GERD) is a complex disorder with heterogeneous symptoms and a multifaceted pathogenetic basis, which prevent a simple diagnostic algorithm or any categorical classification. Clinical history, questionnaires and response to proton pump inhibitor (PPI) therapy are insufficient tools to make a conclusive diagnosis of GERD and further investigations are frequently required. The Lyon Consensus goes beyond the previous classifications and defines endoscopic and functional parameters able to establish the presence of GERD. Evidences for reflux include high-grade erosive esophagitis, Barrett's esophagus, and peptic strictures at endoscopy as well as esophageal acid exposure time > 6% on pH-metry or combined pH-impedance monitoring. Even if a normal endoscopy does not exclude GERD, its combination with distal acid exposure time < 4% on off-PPI pH-impedance monitoring provides sufficient evidence refuting this diagnosis. Reflux-symptom association on pH-monitoring provides supportive evidence for reflux-triggered symptoms and may predict a better treatment outcome, when present. Also recommendations to perform pH-impedance "on" or "off" PPI are well depicted. When endoscopy and pH-metry or combined pH-impedance monitoring are inconclusive, adjunctive evidence from biopsy findings (eg, microscopic esophagitis), high-resolution manometry (ie, ineffective esophagogastric barrier and esophageal body hypomotility), and novel impedance metrics, such as mean nocturnal baseline impedance and post-reflux swallow-induced peristaltic wave index, can contribute to better identify patients with GERD. Definition of individual patient phenotype, based on the level of refluxate exposure, mechanism of reflux, efficacy of clearance, underlying anatomy of the esophagogastric junction, and clinical presentation, will lead to manage GERD patients with a tailored approach chosen among different types of therapy.

Indexed as

EndoscopyEsophagitisGastroesophageal refluxManometryProton pump inhibitors

Identifiers

PMID32606254
PMCPMC7329153

What OpenQuestion holds

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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.