The Chicago Classification 3.0 Results in More Normal Findings and Fewer Hypotensive Findings With No Difference in Other Diagnoses
| Autor: | Arturo Meixueiro, A. Ruiz de León, Miguel A. Valdovinos, J Pérez de la Serna, R Coello, Luiz J. Abrahao, José María Remes-Troche, Ana Maria Leguizamo, Hugo Monrroy, Albis Hani, Miguel Angel Zavala, Jordi Serra, Andres Ditaranto, Ingrid Marin, Daniel Cisternas, Claudio Bilder |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Gerontology medicine.medical_specialty Adolescent Manometry MEDLINE Esophageal Diseases Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Healthy volunteers medicine Humans Esophageal Motility Disorders Medical diagnosis Young adult Aged Hepatology business.industry Gastroenterology Case-control study Middle Aged Healthy Volunteers Esophageal Spasm Diffuse Esophageal Achalasia Latin America Spain Case-Control Studies 030220 oncology & carcinogenesis Female Peristalsis 030211 gastroenterology & hepatology Esophageal spasm Esophagogastric Junction business |
| Zdroj: | American Journal of Gastroenterology r-IGTP. Repositorio Institucional de Producción Científica del Instituto de Investigación Germans Trias i Pujol instname |
| ISSN: | 0002-9270 1572-0241 |
| DOI: | 10.1038/ajg.2017.10 |
| Popis: | OBJECTIVES : High-resolution manometry (HRM) is the preferred method for the evaluation of motility disorders. Recently, an update of the diagnostic criteria (Chicago 3.0) has been published. The aim of this study was to compare the performance criteria of Chicago version 2.0 (CC2.0) vs. 3.0 (CC3.0) in a cohort of healthy volunteers and symptomatic patients. METHODS: HRM studies of asymptomatic and symptomatic individuals from several centers of Spain and Latin America were analyzed using both CC2.0 and CC3.0. The final diagnosis was grouped into hierarchical categories: obstruction (achalasia and gastro-esophageal junction obstruction), major disorders (distal esophageal spasm, absent peristalsis, and jackhammer), minor disorders (failed frequent peristalsis, weak peristalsis with small or large defects, ineffective esophageal motility, fragmented peristalsis, rapid contractile with normal latency and hypertensive peristalsis) and normal. The results were compared using McNemar's and Kappa tests. RESULTS: HRM was analyzed in 107 healthy volunteers (53.3% female; 18-69 years) and 400 symptomatic patients (58.5% female; 18-90 years). In healthy volunteers, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 7.5% and 5.6%, respectively, major disorders in 1% and 2.8%, respectively, minor disorders in 25.2% and 15%, respectively, and normal in 66.4% and 76.6%, respectively. In symptomatic individuals, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 11% and 11.3%, respectively, major disorders in 14% and 14%, respectively, minor disorders in 33.3% and 24.5%, respectively, and normal in 41.8% and 50.3%, respectively. In both groups of individuals, only an increase in normal and a decrease in minor findings using CC3.0 were statistically significant using McNemar's test. DISCUSSIONS: CC3.0 increases the number of normal studies when compared with CC2.0, essentially at the expense of fewer minor disorders, with no significant differences in major or obstructive disorders. As the relevance of minor disorders is questionable, our data suggest that CC3.0 increases the relevance of abnormal results. |
| Databáze: | OpenAIRE |
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