Interrater Reliability of Functional Lumen Imaging Probe (FLIP) Panometry and High-Resolution Manometry for Assessment of Esophageal Motility Disorders. The American journal of gastroenterology Chen, J. W., Khan, A., Chokshi, R. V., Clarke, J. O., Fass, R., Garza, J. M., Gupta, M., Gyawali, C. P., Jain, A. S., Katz, P., Konda, V., Lazarescu, A., Lynch, K. L., Schnoll-Sussman, F., Spechler, S. J., Vela, M. F., Yadlapati, R., Schauer, J. M., Kahrilas, P. J., Pandolfino, J. E., Carlson, D. A. 2023


High-resolution manometry (HRM) and functional lumen imaging probe (FLIP) are primary and/or complementary diagnostic tools for evaluation of esophageal motility. We aimed to assess the interrater agreement and accuracy of HRM and FLIP interpretation.Esophageal motility specialists from multiple institutions completed the interpretation of 40 consecutive HRM and 40 FLIP studies. Interrater agreement was assessed using intraclass correlation coefficient (ICC) for continuous variables and Fleiss' kappa statistics for nominal variables. Accuracies of rater interpretation were assessed using the consensus of three experienced raters as the reference standard.Fifteen raters completed the HRM and FLIP studies. Excellent interrater agreement was seen in supine median Integral Relaxation Pressure (ICC 0.96 (95% CI 0.95, 0.98)), and good agreement was seen with assessment of esophagogastric junction (EGJ) outflow, peristalsis, and assignment of a CCv4.0 diagnosis using HRM (?=0.71, 0.75, and 0.70). Excellent interrater agreement for EGJ-distensibility index and maximum diameter (0.91 (0.90, 0.94), 0.92 (0.89, 0.95)) was seen and moderate to good agreement was seen in assignment of EGJ opening classification, contractile response pattern, and motility classification (?=0.68, 0.56, 0.59) on FLIP. Rater accuracy for CCv4.0 diagnosis on HRM was 82% (95% confidence interval 78-84%) and for motility diagnosis on FLIP Panometry was 78% (72-81%).Our study demonstrates high levels of interrater agreement and accuracy in interpretation of HRM and FLIP metrics and moderate to high levels for motility classification in FLIP, supporting the use of these approaches for primary or complementary evaluation of esophageal motility disorders.

View details for DOI 10.14309/ajg.0000000000002285

View details for PubMedID 37042784