ArticleGastroenterology2025
Diagnostic Accuracy of Timed Barium Esophagram for Achalasia.
Article in Gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Biomechanical Assessment During High-Resolution Impedance Manometry Enhances Characterization of Inconclusive Esophagogastric Junction Outflow Obstruction.Neurogastroenterology and motility · 2026Article
- Discordance Between Functional Lumen Imaging Probe and Timed Barium Esophagram in Patients With a Chicago Classification v4.0 Manometric Diagnosis of Esophagogastric Junction Outflow Obstruction.Neurogastroenterology and motility · 2026Article
- Timed Barium Esophagography in Esophagogastric Junction Outflow Obstruction: A Retrospective Radiologic Assessment.Diagnostics (Basel, Switzerland) · 2026Article
- Addressing Gaps in the Chicago Classification Version 4.0: Defining an Optimal Intrabolus Pressure Measurement on Esophageal Manometry.Neurogastroenterology and motility · 2026Article
- Paratracheal Air Stripe Sign: A Useful Chest X-Ray Finding for Diagnosis in Patients with Esophageal Achalasia.Digestion · 2026Article
- Future perspectives in esophageal manometry.World journal of gastrointestinal surgery · 2025Review
- The Predilection of Specific Diseases to Affect Different Sections of the Esophagus.Life (Basel, Switzerland) · 2025Review
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Authors and funding
9 authors.
Funding
Abstract
BACKGROUND &
aimsTimed barium esophagram (TBE) is commonly used to evaluate esophageal motor disorders, though its accuracy is limited. The lack of standardized criteria for TBE interpretation, coupled with reliance on single measurements and outdated reference standards, limits its effectiveness. This study aimed to reexamine the accuracy of TBE interpretation using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) approach and updated reference standards.
methodsAdult patients with esophageal dysphagia were prospectively enrolled from 2019 to 2022 and underwent motility testing with esophageal manometry, functional lumen imaging probe (FLIP) panometry, and TBE. TBE accuracy for predicting achalasia/FLIP+ esophagogastric junction (EGJ) outflow obstruction, as defined by Chicago Classification 4.0 and FLIP, was assessed using 2 approaches: barium column height >2 cm at 5 minutes/impacted tablet and a classification tree model.
resultsThe study included 290 participants: 121 (42%) with EGJ outflow disorders, 151 (52%) without, and 18 (6%) with inconclusive results. The optimal classification tree had 3 levels: maximum esophageal body width at the top, maximum EGJ diameter and barium height at the second level, and tablet passage at the bottom. The TBE column height and tablet approach had a sensitivity of 77.8%, specificity 86.0%, and accuracy 82.2%, whereas the classification tree model achieved a sensitivity of 84.2%, specificity 92.1%, and accuracy of 88.3%.
conclusionsTBE can accurately identify achalasia/FLIP+ EGJ outflow obstruction when using multiple metrics in a classification tree model. This provides a simple, standardized approach to TBE interpretation that is superior to traditional single-metric methods.
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