Comparing Patients Diagnosed With Ineffective Esophageal Motility by the Chicago Classification Version 3.0 and Version 4.0 Criteria

Tuan, Alyssa; Syed, Nauroz; Panganiban, Ronaldo Paolo; Lee, Roland; Dalessio, Shannon; Pradhan, Sandeep; Zhu, Junjia; Ouyang, Ann

doi:10.14740/gr1563

Cited by 5 publications

(1 citation statement)

References 33 publications

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“…Patients with functional dysphagia often exhibit symptoms such as difficult swallowing, a sensation of food sticking in the throat, or the regurgitation of food. The dysphagia score as determined by validated questionnaires in patients with functional dysphagia can be similar to patients with identifiable esophageal motility disorders such as achalasia esophagus, distal spasm, and esophagogastric junction outflow obstruction [13,14]. The esophagus has one simple function: to transfer swallowed contents to the stomach.…”

Section: Introductionmentioning

confidence: 99%

Unraveling Functional Dysphagia: A Game-Changing Automated Machine-Learning Diagnostic Approach

Zifan,

Lin,

Peng

et al. 2023

Applied Sciences

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(1) Background: Dysphagia affects around 16% of the US population. Diagnostic tests like X-ray barium swallow and endoscopy are used initially to diagnose the cause of dysphagia, followed by high-resolution esophageal manometry (HRM). If the above tests are normal, the patient is classified as functional dysphagia (FD), suggesting esophageal sensory dysfunction. HRM records only the contraction phase of peristalsis, not the distension phase. We investigated the utilization of esophageal distension–contraction patterns for the automatic classification of FD, using artificial intelligent shallow learners. (2) Methods: Studies were performed in 30 healthy subjects and 30 patients with FD. Custom-built software (Dplots 1.0) was used to extract relevant esophageal distension–contraction features. Next, we used multiple shallow learners, namely support vector machines, random forest, K-nearest neighbors, and logistic regression, to determine which had the best performance in terms of accuracy, precision, and recall. (3) Results: In the proximal segment, LR produced the best results, with accuracy of 91.7% and precision of 92.86%, using only distension features. In the distal segment, random forest produced accuracy of 90.5% and precision of 91.1% using both pressure and distension features. (4) Conclusions: Findings emphasize the crucial role of abnormality in the distension phase of peristalsis in FD patients.

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Section: Introductionmentioning

confidence: 99%

Unraveling Functional Dysphagia: A Game-Changing Automated Machine-Learning Diagnostic Approach

Zifan,

Lin,

Peng

et al. 2023

Applied Sciences

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Ineffective esophageal motility: Characterization and outcomes across pediatric neurogastroenterology and motility centers in the United States

Davis,

Rogers,

Llanos‐Chea

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesIneffective esophageal motility (IEM) on high‐resolution manometry (HRM) is not consistently associated with specific clinical syndromes or outcomes. We evaluated the prevalence, clinical features, management, and outcomes of pediatric IEM patients across the United States.MethodsClinical and manometric characteristics of children undergoing esophageal HRM during 2021−2022 were collected from 12 pediatric motility centers. Clinical presentation, test results, management strategies, and outcomes were compared between children with IEM and normal HRM.ResultsOf 236 children (median age 15 years, 63.6% female, 79.2% Caucasian), 62 (23.6%) patients had IEM, and 174 (73.7%) patients had normal HRM, with similar demographics, medical history, clinical presentation, and median symptom duration. Reflux monitoring was performed more often for IEM patients (25.8% vs. 8.6%, p = 0.002), but other adjunctive testing was similar. Among 101 patients with follow‐up, symptomatic cohorts declined in both groups in relation to the initial presentation (p > 0.107 for each comparison) with management targeting symptoms, particularly acid suppression. Though prokinetics were used more often and behavioral therapy less often in IEM (p ≤ 0.015 for each comparison), symptom outcomes were similar between IEM and normal HRM. Despite a higher proportion with residual dysphagia on follow‐up in IEM (64.0% vs. 39.1%, p = 0.043), an alternate mechanism for dysphagia was identified more often in IEM (68.8%) compared to normal HRM (27.8%, p = 0.017).ConclusionsIEM is a descriptive manometric pattern rather than a clinical diagnosis requiring specific intervention in children. Management based on clinical presentation provides consistent symptom outcomes.

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Quality in Upper Gastrointestinal Motility Disorders

Muftah,

Cai

2024

Quality in Gastroenterology

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Comparing Patients Diagnosed With Ineffective Esophageal Motility by the Chicago Classification Version 3.0 and Version 4.0 Criteria

Cited by 5 publications

References 33 publications

Unraveling Functional Dysphagia: A Game-Changing Automated Machine-Learning Diagnostic Approach

Unraveling Functional Dysphagia: A Game-Changing Automated Machine-Learning Diagnostic Approach

Ineffective esophageal motility: Characterization and outcomes across pediatric neurogastroenterology and motility centers in the United States

Quality in Upper Gastrointestinal Motility Disorders

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