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Unedited Computer Analysis During Ambulatory MII-pH Provides Accurate Detection of Reflux Episodes in GERD Patients

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Aravapalli, Amit MD1; Arevalo, Lubin MD1; Singh, Erick MD1; Pohl, Daneil MD1; Waites, Vincent BS, MS2; Mabary, Jerry BS, MS2; Castell, Donald MD1

American Journal of Gastroenterology: October 2010 - Volume 105 - Issue - p S22–S23
Abstracts: ESOPHAGUS
Free

1. Medical University of South Carolina, Charleston, SC; 2. Sandhill Scientific, Inc., Highlands Ranch, CO.

Purpose: Background. Ambulatory multichannel intraluminal impedance-pH (MII-pH) testing is the gold standard for detection of all types of reflux episodes in patients with GERD and their relation to symptoms. However, its use has been limited due to a potentially time-consuming visual analysis of the MII-pH tracings. An automated analysis (AutoSCAN, Sandhill Scientific, Inc.) enables faster review of tracings, but its reliability has not been thoroughly assessed. Aim. To determine how frequently MII-pH monitoring without human oversight (unedited AutoSCAN) can correctly detect reflux episodes in patients with symptoms suggestive of GERD.

Methods: We retrospectively reviewed the MII-pH tracings of 200 patients performed as part of their evaluation for GERD. (100 on PPI bid and 100 off PPI). Each tracing was interpreted using AutoSCAN (AS) and compared blindly with the final consensus of three expert readers analysis (EA) from our laboratory. The level of accuracy in the detection of reflux episodes based on the sensitivity was measured.

Results: The measured sensitivity for unedited AS compared to EA was 81% (On PPI group) and 84% (Off PPI group). The EA resulted in a total of 5698 reflux episodes (3363 on PPI and 2335 off PPI). The number of true positives (TP) when unedited AS was performed was 2720 On PPI and 2006 Off PPI. Data are summarized in the table below.

Conclusion: Automated analysis of reflux shows good level of sensitivity with the expert analysis consensus suggesting that it can be used as a helpful screening tool for the detection of reflux episodes in a busy clinical practice.

Disclosure: Dr Donald Castell Medical Director Sandhill Scientific, Inc.; Jerry E. Mabary Vice President Sandhill Scientific, Inc.; Vincent J Waites Employee Sandhill Scientific, Inc.

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