Evidence map›Paper›PMID 34864928›Full record

ArticleDiseases of the esophagus : official journal of the International Society for Diseases of the Esophagus2022

Can FLIP guide therapy in idiopathic esophagogastric junction outflow obstruction?

Claire A Beveridge, Joseph R Triggs, Shivani U Thanawala, Nitin K Ahuja, Gary W Falk, Alain J Benitez, Kristle L Lynch

Open access · greenAbstract read
In one paragraph

Article in Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 14% 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

4 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Modern Achalasia: Diagnosis, Classification, and Treatment.Journal of neurogastroenterology and motility · 2023
    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

7 authors at 3 institutions in 1 country.

Claire A BeveridgeDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
Joseph R TriggsDepartment of Medicine, Division of Gastroenterology & Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Shivani U ThanawalaDepartment of Medicine, Division of Gastroenterology & Hepatology, University of Pennsylvania, Philadelphia, PA, USA.ORCID 0000-0002-1835-1381
Nitin K AhujaDepartment of Medicine, Division of Gastroenterology & Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Gary W FalkDepartment of Medicine, Division of Gastroenterology & Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Alain J BenitezDepartment of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Kristle L LynchDepartment of Medicine, Division of Gastroenterology & Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
University of Pennsylvania · USChildren's Hospital of Philadelphia · USCleveland Clinic · US

Funding

Institutional Clinical and Translational Science AwardKL2TR001879 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI MEAGHER, EMMA ANNE · 2016 to 2025
$13.7M
NRSA Training CoreTL1TR001880 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI MEAGHER, EMMA ANNE · 2016 to 2025
$10.0M
NCATS NIH HHS KL2 TR001879NCATS NIH HHS TL1 TR001880NIH HHS KL2TR001879
6 · The paper itself

Abstract

backgroundEsophagogastric junction outflow obstruction (EGJOO) has a variable disease course. Currently, barium swallow (BaS) and manometric parameters are used to characterize clinically significant EGJOO. The esophagogastric junction distensibility index (EGJ-DI) measured via functional lumen imaging probe (FLIP) can provide complementary information. Our aim was to assess symptom response in patients with EGJOO and an abnormal EGJ-DI after botulinum toxin (BT) treatment.

methodsA prospective cohort study of adults with idiopathic EGJOO was performed from September 2019 to March 2021. Patients with dysphagia underwent upper endoscopy with FLIP. If the EGJ-DI was abnormally low, BT was injected. Data examined included demographics, medical history, endoscopic and FLIP findings, BaS, manometry, and Eckardt score (ES). ES improvement was assessed via paired samples t-test. Pearson's chi-square tests were used to assess for associations.

resultsOf the 20 patients, 75% had an abnormal EGJ-DI and underwent BT injections. Mean ES for patients with abnormal EGJ-DIs significantly improved from baseline to 1, 3, and 6 month follow-up (P-values: 0.01, 0.05, and 0.02, respectively). There was a significant association between an abnormal EGJ-DI with delayed bolus transit and presence of rapid drink challenge panesophageal pressurization on manometry: P = 0.03 and P = 0.03.

conclusionThis prospective study revealed that an abnormal EGJ-DI can guide BT as assessed via symptomatic response. Additionally, abnormal EGJ-DI measurements were significantly associated with other parameters used previously to determine clinically relevant EGJOO. Larger follow-up studies are warranted to further elucidate guidance for therapy in EGJOO.

Indexed as

Botulinum ToxinsDeglutition DisordersEsophageal AchalasiaEsophageal Motility DisordersStomach DiseasesAdultEsophagogastric JunctionHumansManometryProspective StudiesBotulinum Toxinsesophageal motilityesophagogastric junctionesophagogastric junction outflow obstructionesophagusfunctional lumen imaging probepatient-reported outcomes

Identifiers

PMID34864928
PMCPMC9016893
OpenAlexW4200245038

What OpenQuestion holds

Textmetadata
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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.