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• W1805804500 abstract "Background: The High resolution manometry (HRM) provides a colorful representation of esophageal motility based on its spatiotemporal plot (STP) compared to the previously used conventional linear plot (LP). The diagnostic accuracy of STP compared to the LP has been reported to be increased, especially higher diagnostic yield in novice than advanced learners. Three-dimensional animation plot (3-DP) (SandhillTM, Highland Ranch, CO) can aggregate the information from the STP profiles and regenerate the esophageal motion as threedimensional model with moving pictures. However, the clinical usefulness and diagnostic yield of 3-DP have not been fully validated. We aimed to investigate the additional diagnostic yield and ease of interpretation of 3-DP compared to STP and LP among nurses, medical students, and gastrointestinal (GI) fellows. Methods: After standardized electronic tutorials, 20 medical students, 10 nurses, and 6 GI fellows, all of whom were never spoiled from the conventional manometry or HRM previously, were asked to answer to the questionnaire regarding diagnosis to the classified 30 examples of esophageal motility findings in LP, STP, and 3-DP formats in random order ((normalcy (n=15), type I achalasia (n=6), type II or III achalasia (n=7), ineffective esophageal motility (IEM) (n=2)), and asked about subjective preference and availability of interpretation among 3 formats. The diagnostic accuracy was compared among the 3 different display formats, as well as a subjective rating of preference in the diagnosis. The diagnostic accuracy in 3 formats was calculated and compared by logistic regression with generalized estimating equation. Results: The diagnostic accuracy was significantly higher in fellow group (OR=1.62, 95%CI: 1.12 to 2.35, P=0.01), especially in case of normalcy (OR=2.42, 95% CI: 1.42 to 4.11, P<0.01) and IEM (OR=9.42, 95% CI: 3.00 to 29.62, P<0.01). There was no significant difference in diagnostic accuracy among the 3 different display formats. However, 3-DP gained significantly higher diagnostic yield in type I achalasia (OR=1.72, 95%CI: 1.08 to 2.76, P=0.02) than other findings, but lower diagnostic yield in ineffective esophageal motility (OR=0.39, 95%CI: 0.22 to 0.69, P<0.01) than other findings. Students and GI fellows favored STP (58.3%) over 3-DP (36.1%) and LP (5.6%) due to intuitively rapid interpretation. However, nurses preferred 3-DP (80%) over STP (20%) or LP (0%) due to easy understanding. Conclusions: The newly developed 3-DP did not provide more diagnostic yield than LP or STP. However, in type I achalasia, 3-DP showed significantly additional diagnostic yield than other esophageal findings. Groups of less medical knowledge, nurses, showed higher preference to 3-DP over STP or LP. A prospective study based on a large number of laymen might be warranted to validate the usefulness of 3-DP format in HRM." @default.
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• W1805804500 title "Sa1197 The Additional Diagnostic Yield of Newly Developed, Three-Dimensional Animation Plot of High-Resolution Manometry: Comparison to Conventional Linear and Spatiotemporal Plot" @default.
• W1805804500 doi "https://doi.org/10.1016/s0016-5085(12)60904-4" @default.
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