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Diagnostic Yield of Ambulatory Reflux Monitoring Systems for Evaluation of Chronic Laryngeal Symptoms.
Krause, Amanda J; Greytak, Madeline; Kaizer, Alexander M; Carlson, Dustin A; Chan, Walter W; Chen, Chien-Lin; Gyawali, C Prakash; Jenkins, Andrew; Pandolfino, John E; Polamraju, Vinathi; Wong, Ming-Wun; Yadlapati, Rena.
Afiliación
  • Krause AJ; Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California, USA.
  • Greytak M; Department of Medicine, Division of Gastroenterology and Hepatology, University of California San Diego, La Jolla, California, USA.
  • Kaizer AM; Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado, USA.
  • Carlson DA; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Chan WW; Department of Medicine, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Chen CL; Harvard Medical School, Boston, Massachusetts, USA.
  • Gyawali CP; Department of Medicine, Division of Gastroenterology and Hepatology, Tzu Chi University, Hualien County, Taiwan.
  • Jenkins A; Department of Medicine, Division of Gastroenterology, Washington University, St. Louis, Missouri, USA.
  • Pandolfino JE; Department of Medicine, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA.
  • Polamraju V; Harvard Medical School, Boston, Massachusetts, USA.
  • Wong MW; Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Yadlapati R; Department of Medicine, Division of Gastroenterology, Washington University, St. Louis, Missouri, USA.
Am J Gastroenterol ; 119(4): 627-634, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-37830520
INTRODUCTION: Among patients with chronic laryngeal symptoms, ambulatory reflux monitoring off acid suppression is recommended to evaluate for laryngopharyngeal reflux (LPR). However, reflux monitoring systems are diverse in configuration and monitoring capabilities, which present a challenge in creating a diagnostic reference standard in these patients. This study aimed to compare diagnostic yield and performance between reflux monitoring systems in patients with chronic laryngeal symptoms. METHODS: This multicenter, international study of adult patients referred for evaluation of LPR over a 5-year period (March 2018-May 2023) assessed and compared diagnostic yield of pathologic gastroesophageal reflux (GER+) on ambulatory reflux monitoring off acid suppression. RESULTS: Of 813 patients, 296 (36%) underwent prolonged wireless pH, 532 (65%) underwent 24-hour pH-impedance monitoring, and 15 (2%) underwent both tests. Overall diagnostic yield for GER+ was 36% and greater for prolonged wireless pH compared with that for 24-hour pH-impedance monitoring (50% vs 27%; P < 0.01). Among 15 patients who underwent both prolonged wireless pH and 24-h pH-impedance monitoring, concordance between systems for GER+ was 40%. The most common source of discordance was strong evidence of GER+ across multiple days on prolonged wireless pH compared with no evidence of GER+ on pH-impedance. DISCUSSION: In this multicenter international study of patients with chronic laryngeal symptoms referred for LPR evaluation, diagnostic yield of ambulatory reflux monitoring off acid suppression was 36% and rose to 50% when using wireless pH monitoring. In patients referred for chronic laryngeal symptoms, 24-hour pH-impedance monitoring may risk a low negative predictive value in patients with unproven GER+ disease.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esofagitis Péptica / Reflujo Laringofaríngeo Límite: Adult / Humans Idioma: En Revista: Am J Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Esofagitis Péptica / Reflujo Laringofaríngeo Límite: Adult / Humans Idioma: En Revista: Am J Gastroenterol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos