Evidence map›Paper›PMID 33885007›Full record

ArticleEndoscopic ultrasound

EUS and secretin endoscopic pancreatic function test predict evolution to overt structural changes of chronic pancreatitis in patients with nondiagnostic baseline imaging.

Marc Monachese, Peter J Lee, Kevin Harris, Sunguk Jang, Amit Bhatt, Prabhleen Chahal, Rocio Lopez, Tyler Stevens

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Endoscopic ultrasound. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 21% 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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Imaging of Fibrosis in Chronic Pancreatitis.Frontiers in physiology · 2021
    Review
  5. Article
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 2 institutions in 1 country.

Marc MonacheseDepartment of Internal Medicine, Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Peter J LeeDepartment of Gastroenterology, The University of Pennsylvania, Philadelphia, PA, USA.
Kevin HarrisDepartment of Internal Medicine, Medicine Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Sunguk JangDepartment of Gastroenterology, Digestive Disease Institute, The Cleveland Clinic, Cleveland, OH, USA.
Amit BhattDepartment of Gastroenterology, Digestive Disease Institute, The Cleveland Clinic, Cleveland, OH, USA.
Prabhleen ChahalDepartment of Gastroenterology, Digestive Disease Institute, The Cleveland Clinic, Cleveland, OH, USA.
Rocio LopezSection of Biostatistics and Quantitative Health Sciences, The Cleveland Clinic, Cleveland, OH, USA.
Tyler StevensDepartment of Gastroenterology, Digestive Disease Institute, The Cleveland Clinic, Cleveland, OH, USA.
Cleveland Clinic · USUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe accuracy of EUS and endoscopic pancreatic function test (ePFT) for diagnosis of early or minimal-change chronic pancreatitis (MCCP) is poorly understood. We hypothesized that the natural history of the disease may be used as a "gold standard" to assess the ability of EUS and ePFT to predict the eventual development of overt chronic pancreatitis (CP) changes on computed tomography/magnetic resonance cholangiopancreatography (CT/MRCP). The aim of the study was to determine the ability of EUS and ePFT to predict disease progression in patients with suspected MCCP who had nondiagnostic baseline imaging.

methodsA retrospective cohort study was conducted. Patients who underwent EUS and ePFT for suspected CP and who had nondiagnostic CT or MRCP were included. Patients without repeat imaging performed more than 1 year after their initial EUS/ePFT were excluded. Imaging was considered diagnostic if calcifications, main duct dilation (Cambridge Class III/IV), or severe atrophy were identified. Patients lost to follow-up were contacted to complete a survey documenting current symptoms and whether patients progressed to CP based on imaging. Univariable and multivariable analyses were performed using Cox regression.

resultsTwo hundred and thirty patients who underwent EUS/ePFT for suspected MCCP were identified between 2006 and 2012. Of these, 90 had a non-diagnostic baseline imaging test and subsequently a follow-up imaging test greater than 1 year later. These 90 patients constituted our study population. During a mean follow-up of 7 years, 19 (21%) patients developed CP by histology and imaging. Abnormal ePFT (peak bicarbonate <80 mmol) was a significant predictor of progression (hazard ratio [HR]: 4.7, confidence interval [CI]: 1.8, 12.4). Likewise, EUS Rosemont classification "suggestive/most-consistent" was a significant predictor of progression (HR: 7.3, CI: 2.4, 22.1).

conclusionsIn patients with abdominal pain of suspected pancreatic origin and with nondiagnostic cross-sectional imaging, EUS and ePFT results predict the development of classic CP structural changes over time. These results support EUS and ePFT as effective tools for predicting progression of minimal change to overt CP.

Indexed as

chronic pancreatitisendocrine pancreatic function testingEUSminimal-change chronic pancreatitis

Identifiers

PMID33885007
PMCPMC8098843
OpenAlexW3155740355

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
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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.