Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Neurogastroenterol Motil. 2018 Jun;30(6):e13289. doi: 10.1111/nmo.13289. Epub 2018 Jan 11.
Novel high-resolution impedance manometry (HRIM) metrics of bolus flow time (BFT) and esophageal impedance integral (EII) ratio have demonstrated clinical utility, though the reliability of their analysis has not been assessed. We aimed to evaluate the inter-rater agreement of the BFT and EII ratio.
HRIM studies including five upright, liquid swallows from 40 adult patients were analyzed by two raters using a customized MATLAB program to generate the BFT and EII ratio. Inter-rater agreement was assessed using the intraclass correlation coefficient (ICC) for median values generated per patient and also for all 200 swallows.
The ICC (95% confidence interval, CI) for BFT was 0.873 (0.759-0.933) for median values and 0.838 (0.778-0.881) for all swallows. The ICC (95% CI) for EII ratio was 0.983 (0.968-0.991) for median values and 0.905 (0.875-0.928) for all swallows. Median values for both BFT and EII ratio were similar between the two raters (P-values .05).
The BFT and EII ratio can be reliably calculated as supported by generally excellent inter-rater agreement. Thus, broader utilization of these measures appears feasible and would facilitate further evaluation of their clinical utility.
新型高分辨率阻抗测压（HRIM）的几项流量时间（BFT）和食管阻抗积分（EII）比值的新指标已经证明具有临床应用价值，尽管其分析的可靠性尚未得到评估。我们旨在评估 BFT 和 EII 比值的观察者间一致性。
通过两位观察者使用定制的 MATLAB 程序对 40 名成人患者的 5 个直立液体吞咽的 HRIM 研究进行分析，以生成 BFT 和 EII 比值。使用每位患者的中位数产生的组内相关系数（ICC）评估观察者间的一致性，同时还评估了所有 200 次吞咽的一致性。
BFT 的 ICC（95%置信区间，CI）中位数为 0.873（0.759-0.933），所有吞咽为 0.838（0.778-0.881）。EII 比值的 ICC（95%CI）中位数为 0.983（0.968-0.991），所有吞咽为 0.905（0.875-0.928）。两位观察者的 BFT 和 EII 比值中位数差异无统计学意义（P 值>.05）。
BFT 和 EII 比值的计算结果具有很好的观察者间一致性，因此可以可靠地计算。因此，这些措施的更广泛应用似乎是可行的，并将有助于进一步评估其临床应用价值。
