一种新型自动化诊断程序在高分辨率食管测压中的应用价值。
Utility of a new automated diagnostic program in high-resolution esophageal manometry.
作者信息
Kuribayashi Shiko, Akiyama Junichi, Ikeda Haruo, Nagai Kazue, Hosaka Hiroko, Hamada Mariko, Onimaru Manabu, Kawami Noriyuki, Hayashi Kunihiko, Iwakiri Katsuhiko, Inoue Haruhiro, Kusano Motoyasu, Uraoka Toshio
机构信息
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Division of Gastroenterology and Hepatology, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
出版信息
J Gastroenterol. 2021 Jul;56(7):633-639. doi: 10.1007/s00535-021-01794-z. Epub 2021 May 13.
BACKGROUND
A new automated diagnostic program for high-resolution esophageal manometry (HREM) has been developed. This diagnostic program could detect locations of landmarks and could make final diagnoses automatically. However, the accuracy of the program is not known. The aim of this study was to evaluate the accuracy of the automated diagnostic program for HREM.
METHODS
A total of 445 studies were enrolled. An HREM system (Starlet®) was used, and esophageal motility was diagnosed using the Chicago classification v3.0. First, the locations of the upper esophageal sphincter, transition zone, lower esophageal sphincter, esophago-gastric junction, crural diaphragm and stomach were determined, and each swallow was checked manually. Then, the parameters of the Chicago classification were calculated using an analytic program of the Starlet, and diagnoses were made by three experts. Second, all study raw data were analyzed again by the automated diagnostic program. Diagnoses made by the program were compared to those made by experts to evaluate the accuracy of the diagnoses.
RESULTS
The new diagnostic program could identify the landmarks of each swallow, calculate the parameters and make a final diagnosis within 10 s. The diagnoses made by the automated diagnostic program were not matched to those made by experts in only 10 studies, and the overall accuracy of the new automated diagnostic program thus reached 97.8% (435/445).
CONCLUSIONS
The new automated diagnostic program for HREM is clinically useful in terms of high diagnostic accuracy and time-saving.
背景
已开发出一种用于高分辨率食管测压（HREM）的新型自动化诊断程序。该诊断程序能够检测地标位置并自动做出最终诊断。然而，该程序的准确性尚不清楚。本研究的目的是评估HREM自动化诊断程序的准确性。
方法
共纳入445项研究。使用HREM系统（Starlet®），并采用芝加哥分类法v3.0对食管动力进行诊断。首先，确定食管上括约肌、过渡区、食管下括约肌、食管胃交界处、膈脚和胃的位置，并对每次吞咽进行人工检查。然后，使用Starlet的分析程序计算芝加哥分类的参数，并由三位专家做出诊断。其次，通过自动化诊断程序再次分析所有研究原始数据。将该程序做出的诊断与专家做出的诊断进行比较，以评估诊断的准确性。
结果
新的诊断程序能够在10秒内识别每次吞咽的地标，计算参数并做出最终诊断。自动化诊断程序做出的诊断仅在10项研究中与专家做出的诊断不匹配，因此新自动化诊断程序的总体准确率达到97.8%（435/445）。
结论
新的HREM自动化诊断程序在诊断准确性高和节省时间方面具有临床实用性。
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