Evidence map›Paper›PMID 37288617›Full record

ArticleNeurogastroenterology and motility2023

Diagnostic methods to measure spastic segment and guide tailored myotomy length in type 3 achalasia.

Eric E Low, Aws Hasan, Syed Abbas Fehmi, Michael A Chang, Wilson Kwong, Mary L Krinsky, Gobind Anand, Madeline Greytak, Alexander Kaizer, Rena Yadlapati

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

Article in Neurogastroenterology and motility, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.9field-weighted citation impact, top 15% 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

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Eric E LowDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.ORCID 0000-0003-0852-8005
Aws HasanDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Syed Abbas FehmiDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Michael A ChangDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Wilson KwongDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Mary L KrinskyDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Gobind AnandDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Madeline GreytakDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.
Alexander KaizerDepartment of Biostatistics and Informatics, University of Colorado, Denver, Colorado, USA.
Rena YadlapatiDivision of Gastroenterology, University of California, San Diego, San Diego, California, USA.ORCID 0000-0002-7872-2033
University of San Diego · USUniversity of Colorado Denver · US

Funding

Training Grant in GastroenterologyT32DK007202 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GHOSH, PRADIPTA · 1985 to 2022
$7.7M
Mechanism Guided Therapy for Laryngopharyngeal RefluxK23DK125266 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI YADLAPATI, RENA HIREN · 2021 to 2025
$963k
NIDDK NIH HHS K23 DK125266NIDDK NIH HHS T32 DK007202NIH HHS K23 DK125266
6 · The paper itself

Abstract

backgroundMyotomy length in type 3 achalasia is generally tailored based on segment of spasticity on high-resolution manometry (HRM). Potential of length of tertiary contractions on barium esophagram (BE) or length of thickened circular muscle on endoscopic ultrasound (EUS) to guide tailored myotomy is less understood. This study aimed to assess agreement between spastic segments lengths on HRM, BE, and EUS among patients with type 3 achalasia.

methodsThis retrospective study included adults with type 3 achalasia on HRM between November 2019 and August 2022 who underwent evaluation with EUS and/or BE. Spastic segments were defined as HRM-distance between proximal borders of lower esophageal sphincter and high-pressure area (isobaric contour ≥70 mmHg); EUS-length of thickened circular muscle (≥1.2 mm) from proximal border of esophagogastric junction (EGJ) to the transition to a non-thickened circular muscle; BE-distance between EGJ to proximal border of tertiary contractions. Pairwise comparisons assessed for correlation (Pearson's) and intraclass correlation classification (ICC) agreement. KEY

resultsTwenty-six patients were included: mean age 66.9 years (SD 13.8), 15 (57.7%) male. Spastic segments were positively correlated on HRM and BE with good agreement (ICC 0.751, [95% CI 0.51, 0.88]). Spastic segments were negatively correlated with poor agreement on HRM and EUS (ICC -0.04, [-0.45, 0.39]) as well as BE and EUS (ICC -0.03, [-0.47, 0.42]). CONCLUSIONS & INFERENCES: Length of spastic segment was positively correlated on HRM and BE while negatively correlated when compared to EUS, supporting the common use of HRM and highlighting the uncertain role for EUS in tailoring myotomy length for type 3 achalasia.

Indexed as

Esophageal AchalasiaMyotomyAdultAgedEsophageal Sphincter, LowerFemaleHumansMaleManometryMuscle SpasticityRetrospective StudiesTreatment OutcomedilationdysphagiaHeller Myotomyper-oral endoscopic myotomyswallowing

Identifiers

PMID37288617
PMCPMC10726676
OpenAlexW4379768559

What OpenQuestion holds

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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.