Are the Chicago 3.0 manometric diagnostics consistent with Chicago 4.0?
Journal
Diseases of the Esophagus
ISSN
1120-8694
1442-2050
Date Issued
2023
Author(s)
Angélica Tobón
Albis C Hani
Cristiam D Pulgarin
Andres F Ardila
Oscar M Muñoz
Julian A Sierra
Type
journal-article
Abstract
<jats:title>Summary</jats:title>
<jats:p>There is little information on the degree of concordance between the results obtained using the Chicago 3.0 (CCv3.0) and Chicago 4.0 (CCv4.0) protocols to interpret high-resolution manometry (HRM) seeking to determine the value provided by the new swallowing maneuvers included in the last protocol. This is a study of diagnostic tests, evaluating concordance by consistency between the results obtained by the CCv3.0 and CCv4.0 protocols, in patients undergoing HRM. Concordance was assessed with the kappa test. Bland–Altman scatter plots, and Lin’s correlation-concordance coefficient (CCC) were used to assess the agreement between IRP measured with swallows in the supine and seated position or with solid swallows. One hundred thirty-two patients were included (65% women, age 53 ± 17 years). The most frequent HRM indication was dysphagia (46.1%). Type I was the most common type of gastroesophageal junction. The most frequent CCv4.0 diagnoses were normal esophageal motility (68.9%), achalasia (15.5%), and ineffective esophageal motility (IEM; 5.3%). The agreement between the results was substantial (Kappa 0.77 ± 0.05), with a total agreement of 87.9%. Diagnostic reclassification occurred in 12.1%, from IEM in CCv3.0 to normal esophageal motility in CCv4.0. Similarly, there was a high level of agreement between the IRP measured in the supine compared to the seated position (CCC0.92) and with solid swallows (CCC0.96). In conclusion, the CCv4.0 protocol presents a high concordance compared to CCv3.0. In the majority of manometric diagnoses there is no reclassification of patients with provocation tests. However, the more restrictive criteria of CCv4.0 achieve a better reclassification of patients with IEM.</jats:p>
<jats:p>There is little information on the degree of concordance between the results obtained using the Chicago 3.0 (CCv3.0) and Chicago 4.0 (CCv4.0) protocols to interpret high-resolution manometry (HRM) seeking to determine the value provided by the new swallowing maneuvers included in the last protocol. This is a study of diagnostic tests, evaluating concordance by consistency between the results obtained by the CCv3.0 and CCv4.0 protocols, in patients undergoing HRM. Concordance was assessed with the kappa test. Bland–Altman scatter plots, and Lin’s correlation-concordance coefficient (CCC) were used to assess the agreement between IRP measured with swallows in the supine and seated position or with solid swallows. One hundred thirty-two patients were included (65% women, age 53 ± 17 years). The most frequent HRM indication was dysphagia (46.1%). Type I was the most common type of gastroesophageal junction. The most frequent CCv4.0 diagnoses were normal esophageal motility (68.9%), achalasia (15.5%), and ineffective esophageal motility (IEM; 5.3%). The agreement between the results was substantial (Kappa 0.77 ± 0.05), with a total agreement of 87.9%. Diagnostic reclassification occurred in 12.1%, from IEM in CCv3.0 to normal esophageal motility in CCv4.0. Similarly, there was a high level of agreement between the IRP measured in the supine compared to the seated position (CCC0.92) and with solid swallows (CCC0.96). In conclusion, the CCv4.0 protocol presents a high concordance compared to CCv3.0. In the majority of manometric diagnoses there is no reclassification of patients with provocation tests. However, the more restrictive criteria of CCv4.0 achieve a better reclassification of patients with IEM.</jats:p>
Cite this document
Tobón, A., Hani, A. C., Pulgarin, C. D., Ardila, A. F., Muñoz, O. M., Sierra, J. A., & Cisternas, D. (2024). Are the Chicago 3.0 manometric diagnostics consistent with Chicago 4.0? Diseases of the Esophagus, 37(4), doad071. https://doi.org/10.1093/dote/doad071
Subjects
chicago 3.0
;
chicago 4.0
;
concordance
;
dysphagia
;
high-resolution manometry
;
adult
;
aged
;
chicago
;
deglutition disorders
;
esophageal achalasia
;
esophageal motility disorders
;
female
;
humans
;
male
;
manometry
;
middle aged
;
barium
;
adult
;
aged
;
article
;
diagnostic value
;
dysphagia
;
esophagus achalasia
;
esophagus function disorder
;
esophagus manometry
;
esophagus motility
;
esophagus spasm
;
female
;
gastroesophageal junction
;
gastroesophageal reflux
;
human
;
illinois
;
major clinical study
;
male
;
sitting
;
supine position
;
swallowing
;
thorax pain
;
treatment indication
;
dysphagia
;
esophagus achalasia
;
illinois
;
manometry
;
middle aged
;
procedures