Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA.
Neurogastroenterol Motil. 2010 Dec;22(12):1308-17. doi: 10.1111/j.1365-2982.2010.01572.x.
Many studies assessed gastric retention over time utilizing different models, mostly with scintigraphic measures at varied endpoints from limited number of normal volunteers. With a standardized 4-h gastric emptying (GE) protocol, we compared model fit by the linear, power exponential (PE), and modified power exponential (MPE) models to contrast differences in GE among different groups based on clinical diagnosis and gender.
We retrospectively collected 320 patient records with four consecutive hourly scintigraphic measures of percent intragastric residual at the Kansas University Medical Center. We obtained parameter estimates with the Bayesian hierarchical models using informative priors from previous research.
The PE or MPE model captured the time dependent GE rate better than the linear model. The estimated GE rates more than doubled for those without gastroparesis compared to patients diagnosed with gastroparesis. Males tended to empty gastric content faster but were not significantly different from females at the 5% level.
CONCLUSIONS & INFERENCES: The point estimates and 95% credible interval for GE rates obtained with the PE and MPE models may provide an alternative diagnostic tool for clinicians since it utilizes gastric emptying scintigraphy measures at multiple endpoints which may be sensitive to different aspects of the disease. No agreement in lag phases was obtained by the three models based on respective definitions from previous researches, but similar results would be obtained with the PE and MPE models if both defined lag phase by back projecting the regression lines to the same gastric retention level.
许多研究利用不同的模型评估了随时间推移的胃潴留情况，这些模型大多使用放射性核素扫描技术，以有限数量的正常志愿者为研究对象，终点时间不一。我们采用标准化的 4 小时胃排空（GE）方案，比较了线性、幂指数（PE）和改良幂指数（MPE）模型的拟合优度，旨在根据临床诊断和性别差异，比较不同组别间的 GE 差异。
我们回顾性地收集了堪萨斯大学医学中心的 320 例患者的连续 4 小时放射性核素扫描记录，以评估每小时胃内残留百分比。我们使用来自先前研究的信息先验，通过贝叶斯分层模型获得参数估计。
PE 或 MPE 模型比线性模型更好地捕捉到了随时间变化的 GE 率。与诊断为胃轻瘫的患者相比，无胃轻瘫的患者 GE 率估计值增加了一倍以上。男性的胃排空速度较快，但在 5%的水平上与女性无显著差异。
PE 和 MPE 模型获得的 GE 率的点估计值和 95%可信区间，可能为临床医生提供一种替代的诊断工具，因为它利用了放射性核素扫描技术在多个终点的测量值，这些测量值可能对疾病的不同方面较为敏感。基于先前研究的定义，三种模型均未在滞后期方面达成一致，但如果 PE 和 MPE 模型均通过将回归线向后投影到相同的胃残留水平来定义滞后期，则会得到相似的结果。
