ArticleUnited European gastroenterology journal2024
The Milan score: A novel manometric tool for a more efficient diagnosis of gastro-esophageal reflux disease.
Article in United European gastroenterology journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05851482 (NOVEL HIGH-RESOLUTION MANOMETRY SCORE FOR THE DIAGNOSIS OF GASTRO-ESOPHAGEAL REFLUX DISEASE), which is not on this map. Cited by 21 papers.
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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.
Novel high-resolution manometry score for the diagnosis of gastro-esophageal reflux disease
Who cites it
21 citing papers in PubMed.
- Randomized Controlled Trial of Upper Esophageal Sphincter Assist Device in Laryngopharyngeal Reflux Disease.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Trial
- Editorial: The Milan Score as Supportive Evidence of Gastro-Oesophageal Reflux Disease. Authors' Reply.Alimentary pharmacology & therapeutics · 2026Article
- Editorial: The Milan Score as Supportive Evidence of Gastro-Oesophageal Reflux Disease.Alimentary pharmacology & therapeutics · 2026Article
- Inter-Observer Variability of Gerd-Related Metrics on High-Resolution Manometry and Calculation of the Milan Score.Neurogastroenterology and motility · 2026Article
- PPI-Refractory GERD in Systemic Sclerosis Is Driven by Distinct Esophageal and Gastric Motility Abnormalities.medRxiv : the preprint server for health sciences · 2026Article
- The Milan Score is an Effective Manometric Tool to Predict Gastroesophageal Reflux in Patients With Laryngopharyngeal Symptoms.Neurogastroenterology and motility · 2026Article
- Gatherings in Esophagology: Innovations and Future Directions in the Diagnosis and Management of Reflux Disease.Annals of the New York Academy of Sciences · 2026Article
- Is Mean Basal Esophagogastric Junction Pressure a Simpler and More Reliable Marker for Gastroesophageal Reflux Disease Barrier Function?Journal of neurogastroenterology and motility · 2026Article
- Mean Basal Esophagogastric Junction Pressure Is a Better High-resolution Manometry Predictor of Gastroesophageal Reflux Disease Than Esophagogastric Junction Contractile Integral.Journal of neurogastroenterology and motility · 2026Article
- The American Foregut Society endoscopic classification outperforms Hill in phenotyping the esophago-gastric junction to guide gastroesophageal reflux disease management.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2026Article
- The Milan Score Predicts Objective Gastroesophageal Reflux Disease in Patients With Type 2 Esophagogastric Junction.Neurogastroenterology and motility · 2026Article
- Pathophysiology of Gastroesophageal Reflux Disease.Digestion · 2026Review
- Creation and validation of manometry GERD score to predict positive reflux test (gastroesophageal reflux disease).Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- Assessment of Esophagogastric Junction Barrier Function With the Supine-Upright Transition of the Chicago Classification Protocol.Neurogastroenterology and motility · 2025Article
- Optimizing the Straight Leg Raise Maneuver to Improve Prediction of Conclusive Gastro-Esophageal Reflux Disease.Neurogastroenterology and motility · 2025Article
- Combined Lyon and Milan Scores Predict Gerd Management Outcome Better Than Either Score Alone or Their Individual Components.Alimentary pharmacology & therapeutics · 2025Article
- Clinical Application of Lyon Consensus 2.0 in Asia: An Overview.Gut and liver · 2025Review
- Demographic and Manometric Variables Can Independently Predict Gastroesophageal Reflux Disease: The AGES-D Score.The Korean journal of helicobacter and upper gastrointestinal research · 2025Article
- Hyaluronic acid and chondroitin sulfate-based medical devices: formulations, esophageal mucosal protection, and their place in the management of GERD.Therapeutic advances in gastroenterology · 2025Review
- High resolution manometry as a diagnostic tool for gastro-esophageal reflux: A step forward but not yet ready for clinical use.United European gastroenterology journal · 2024Article
Corrections and comments
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Authors and funding
29 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveA definitive diagnosis of gastroesophageal reflux disease (GERD) depends on endoscopic and/or pH-study criteria. However, high resolution manometry (HRM) can identify factors predicting GERD, such as ineffective esophageal motility (IEM), esophago-gastric junction contractile integral (EGJ-CI), evaluating esophagogastric junction (EGJ) type and straight leg raise (SLR) maneuver response. We aimed to build and externally validate a manometric score (Milan Score) to stratify the risk and severity of the disease in patients undergoing HRM for suspected GERD.
methodsA population of 295 consecutive patients undergoing HRM and pH-study for persistent typical or atypical GERD symptoms was prospectively enrolled to build a model and a nomogram that provides a risk score for AET > 6%. Collected HRM data included IEM, EGJ-CI, EGJ type and SLR. A supplemental cohort of patients undergoing HRM and pH-study was also prospectively enrolled in 13 high-volume esophageal function laboratories across the world in order to validate the model. Discrimination and calibration were used to assess model's accuracy. Gastroesophageal reflux disease was defined as acid exposure time >6%.
resultsOut of the analyzed variables, SLR response and EGJ subtype 3 had the highest impact on the score (odd ratio 18.20 and 3.87, respectively). The external validation cohort consisted of 233 patients. In the validation model, the corrected Harrel c-index was 0.90. The model-fitting optimism adjusted calibration slope was 0.93 and the integrated calibration index was 0.07, indicating good calibration.
conclusionsA novel HRM score for GERD diagnosis has been created and validated. The MS might be a useful screening tool to stratify the risk and the severity of GERD, allowing a more comprehensive pathophysiologic assessment of the anti-reflux barrier.
trial registrationClinicalTrials.gov (Identifier: NCT05851482).
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