Evidence map›Paper›PMID 37357376›Full record

ArticleNeurogastroenterology and motility2023

The integrated relaxation pressure may not be an appropriate gold standard for deglutitive relaxation due to reliance on a single intragastric reference sensor.

Ofer Z Fass, Kirsten A Regalia, Andrew J Sweatt, Monica C Nandwani, Thomas A Zikos, Nielsen Q Fernandez-Becker, Linda A Nguyen, Irene S Sonu, George Triadafilopoulos, John O Clarke

Abstract read
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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

10 authors.

Ofer Z FassDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.ORCID 0000-0003-4947-6192
Kirsten A RegaliaKaiser Permanente Antioch Medical Center, Los Angeles, California, USA.
Andrew J SweattDivision of Pulmonary, Allergy & Critical Care Medicine, Stanford University School of Medicine, Stanford, California, USA.
Monica C NandwaniDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.
Thomas A ZikosKaiser Permanente West Los Angeles Medical Center, Los Angeles, California, USA.ORCID 0000-0003-3212-2400
Nielsen Q Fernandez-BeckerDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.
Linda A NguyenDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.ORCID 0000-0002-3498-6897
Irene S SonuDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.
George TriadafilopoulosDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.ORCID 0000-0002-4233-3773
John O ClarkeDivision of Gastroenterology, Stanford University School of Medicine, Redwood City, California, USA.

Funding

TRAINING GRANT IN ACADEMIC GASTROENTEROLOGYT32DK007056 · NIDDK · STANFORD UNIVERSITY · PI Natalie J. Torok · 1986 to 2026
$6.5M
NIDDK NIH HHS T32 DK007056
6 · The paper itself

Abstract

backgroundIntegrated relaxation pressure (IRP) calculation depends on the selection of a single gastric reference sensor. Variable gastric pressure readings due to sensor selection can lead to diagnostic uncertainty. This study aimed to examine the effect of gastric reference sensor selection on IRP measurement and diagnosis.

methodsWe identified high-resolution manometry (HRM) conducted between January and November 2017 with at least six intragastric reference sensors. IRP measurements and Chicago Classification 3.0 (CCv3) diagnoses were obtained for each of six gastric reference sensors. Studies were categorized as "stable" (no change in diagnosis) or "variable" (change in diagnosis with gastric reference selection). Variable diagnoses were further divided into "variable normal/dysmotility" (≥1 normal IRP measurement and ≥1 CCv3 diagnosis), or "variable dysmotility" (≥1 CCv3 diagnosis, only elevated IRP measurements). Bland-Altman plots were used to compare IRP measurements within HRM studies. KEY

resultsThe analysis included 100 HRM studies, among which 18% had variable normal/dysmotility, and 10% had variable dysmotility. The average IRP difference between reference sensors was 6.7 mmHg for variable normal/dysmotility and 5.9 mmHg for variable dysmotility. The average difference between the proximal-most and distal-most sensors was -1.52 mmHg (lower limit of agreement -10.03 mmHg, upper limit of agreement 7.00 mmHg). CONCLUSIONS & INFERENCES: IRP values can vary greatly depending on the reference sensor used, leading to inconsistent diagnoses in 28% of HRM studies. Choosing the correct gastric reference sensor is crucial for accurate test results and avoiding misdiagnosis. Standardization of reference sensor selection or supportive testing for uncertain results should be considered.

Indexed as

Esophagogastric JunctionManometryPressureachalasiaesophagogastric junctionesophagusmanometry

Identifiers

PMID37357376
PMCPMC10906680

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.