Rachel Rosen1, Kristen Hart, Samuel Nurko. 1. Center for Motility and Functional Gastrointestinal Disorders, Children's Hospital Boston, Boston, MA 02115, USA. rachel.rosen@childrens.harvard.edu
Abstract
OBJECTIVES: Multichannel intraluminal impedance with pH (pH-MII) has become the criterion standard test for the evaluation of gastroesophageal reflux disease, but it is not clear whether the results of this test change clinical decision making. The goal of the present study was to determine the differences in clinical decision making by attending physicians based on the pH probe results versus MII results. METHODS: We conducted a prospective study in which physicians were initially given pH probe results and asked how they would change the patient's clinical management based on these results. Physicians were then given the MII results and asked how their management would change. Physicians then were asked whether they believed MII affected their clinical decision making overall. RESULTS: pH probe results changed clinical management 40% of the time and MII results changed clinical management an additional 22% of the time. Clinical decision making was not influenced by the performance of pH-MII on or off acid suppression. The escalation of acid suppression therapy was the main management change that occurred based on the pH-MII results. CONCLUSIONS: The addition of MII to the standard pH probe resulted in a change in management in approximately 25% of the patients, suggesting that there may be a role for pH-MII in clinical practice.
OBJECTIVES: Multichannel intraluminal impedance with pH (pH-MII) has become the criterion standard test for the evaluation of gastroesophageal reflux disease, but it is not clear whether the results of this test change clinical decision making. The goal of the present study was to determine the differences in clinical decision making by attending physicians based on the pH probe results versus MII results. METHODS: We conducted a prospective study in which physicians were initially given pH probe results and asked how they would change the patient's clinical management based on these results. Physicians were then given the MII results and asked how their management would change. Physicians then were asked whether they believed MII affected their clinical decision making overall. RESULTS: pH probe results changed clinical management 40% of the time and MII results changed clinical management an additional 22% of the time. Clinical decision making was not influenced by the performance of pH-MII on or off acid suppression. The escalation of acid suppression therapy was the main management change that occurred based on the pH-MII results. CONCLUSIONS: The addition of MII to the standard pH probe resulted in a change in management in approximately 25% of the patients, suggesting that there may be a role for pH-MII in clinical practice.
Authors: Steven Shay; Radu Tutuian; Daniel Sifrim; Marcelo Vela; James Wise; Nagammapudur Balaji; Xin Zhang; Talal Adhami; Joseph Murray; Jeffrey Peters; Donald Castell Journal: Am J Gastroenterol Date: 2004-06 Impact factor: 10.864
Authors: Albert J Bredenoord; Bas L A M Weusten; Robin Timmer; José M Conchillo; André J P M Smout Journal: Am J Gastroenterol Date: 2006-02-08 Impact factor: 10.864
Authors: Lindsey Gumer; Rachel Rosen; Benjamin D Gold; Eric H Chiou; Melanie Greifer; Sherri Cohen; Joel A Friedlander Journal: J Pediatr Gastroenterol Nutr Date: 2019-05 Impact factor: 2.839
Authors: Daniel R Duncan; Janine Amirault; Nikki Johnston; Paul Mitchell; Kara Larson; Rachel L Rosen Journal: J Pediatr Gastroenterol Nutr Date: 2016-08 Impact factor: 2.839