Chicago Classification Version 4.0 Improves Stratification of Ineffective Esophageal Motility Patients into Clinically Meaningful Subtypes: A Two-Center International Study

Carmel, Moshe; Cohen, Daniel L.; Hijazi, Basem; Azzam, Narges; Khoury, Tawfik; Pagliaro, Marta; Pesce, Marcella; Mari, Amir

doi:10.1007/s00455-023-10628-4

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…This is in line with a similar study by Sallette et al [15], where 24 out of 63 patients (38%) were reclassified as normal with CCv4.0. More recently, Carmel et al [16] studied 152 patients who had manometric diagnoses of IEM with CCv3.0 and found that 39 (25%) were reclassified to normal; these patients with a change in diagnoses had fewer ineffective swallows and lower acid exposure time. It was concluded that fewer patients are diagnosed with IEM with CCv4.0.…”

Section: Discussionmentioning

confidence: 99%

A Comparison between Chicago Classification Versions 3.0 and 4.0 and Their Impact on Manometric Diagnoses in Esophageal High-Resolution Manometry Cases

Low,

Wang,

et al. 2024

Diagnostics

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High-resolution manometry (HRM) facilitates the detailed evaluation of esophageal motility. In December 2020, Chicago classification (CC) version 4.0 introduced modifications to improve consistency and accuracy. We conducted this study to compare the differences in the interpretations of HRM examinations between CC 3.0 and 4.0. Consecutive HRM records at a Taiwan tertiary medical center, including wet swallows and MRS performed in both supine and sitting positions from October 2019 to May 2021, were retrospectively reviewed and analyzed using both CC versions 3.0 and 4.0. A total of 105 patients were enrolled, and 102 patients completed the exam, while three could not tolerate HRM sitting up. Refractory gastroesophageal reflux disease (GERD) symptoms (n = 65, 63.7%) and dysphagia (n = 37, 36.3%) were the main indications. A total of 18 patients (17.6%) were reclassified to new diagnoses using CC 4.0. Of the 11 patients initially diagnosed with absent contractility, 3 (27.3%) were reclassified as having Type 1 achalasia. Of the 18 patients initially diagnosed with IEM, 6 (33.3%) were reclassified as normal. The incidence of diagnosis changes was similar in both the dysphagia and refractory GERD symptoms groups (21.6% versus 15.3%, p = 0.43). The use of CC 4.0 led to changes in the diagnoses of esophageal motility disease, irrespective of examination indications. Early adoption improves the accuracy of diagnoses and affects patient management.

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Section: Discussionmentioning

confidence: 99%