Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings

M. M. J. Singendonk; M. J. Smits; I. E. Heijting; M. P. van Wijk; S. Nurko; R. Rosen; P. W. Weijenborg; R. Abu-Assi; D. R. Hoekman; S. Kuizenga-Wessel; G. Seiboth; M. A. Benninga; T. I. Omari; S. Kritas

doi:https://doi.org/10.1111/nmo.12488

Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings

M. M. J. Singendonk, M. J. Smits, I. E. Heijting, M. P. van Wijk, S. Nurko, R. Rosen, P. W. Weijenborg, R. Abu-Assi, D. R. Hoekman, S. Kuizenga-Wessel, G. Seiboth, M. A. Benninga, T. I. Omari, S. Kritas

Research output: Contribution to journal › Article › Academic › peer-review

20 Citations (Scopus)

Abstract

The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss' kappa (κ) and intraclass correlation coefficient (ICC). Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45-0.82). Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia

Original language	English
Pages (from-to)	269-276
Number of pages	8
Journal	Neurogastroenterology and Motility
Volume	27
Issue number	2
DOIs	https://doi.org/10.1111/nmo.12488
Publication status	Published - Feb 2015

Keywords

Adolescent
Child
Cohort Studies
Esophageal Motility Disorders/classification
Humans
Image Interpretation, Computer-Assisted/methods
Manometry/methods
Reproducibility of Results

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https://doi.org/10.1111/nmo.12488

Cite this

Singendonk, M. M. J., Smits, M. J., Heijting, I. E., van Wijk, M. P., Nurko, S., Rosen, R., Weijenborg, P. W., Abu-Assi, R., Hoekman, D. R., Kuizenga-Wessel, S., Seiboth, G., Benninga, M. A., Omari, T. I., & Kritas, S. (2015). Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings. Neurogastroenterology and Motility, 27(2), 269-276. https://doi.org/10.1111/nmo.12488

@article{13afc028134d45c2a458397a9ba11227,

title = "Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings",

abstract = "The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss' kappa (κ) and intraclass correlation coefficient (ICC). Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45-0.82). Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia",

keywords = "Adolescent, Child, Cohort Studies, Esophageal Motility Disorders/classification, Humans, Image Interpretation, Computer-Assisted/methods, Manometry/methods, Reproducibility of Results",

author = "Singendonk, {M. M. J.} and Smits, {M. J.} and Heijting, {I. E.} and {van Wijk}, {M. P.} and S. Nurko and R. Rosen and Weijenborg, {P. W.} and R. Abu-Assi and Hoekman, {D. R.} and S. Kuizenga-Wessel and G. Seiboth and Benninga, {M. A.} and Omari, {T. I.} and S. Kritas",

year = "2015",

month = feb,

doi = "https://doi.org/10.1111/nmo.12488",

language = "English",

volume = "27",

pages = "269--276",

journal = "Neurogastroenterology and Motility",

issn = "1350-1925",

publisher = "Wiley-Blackwell",

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Singendonk, MMJ, Smits, MJ, Heijting, IE, van Wijk, MP, Nurko, S, Rosen, R, Weijenborg, PW, Abu-Assi, R, Hoekman, DR, Kuizenga-Wessel, S, Seiboth, G, Benninga, MA, Omari, TI & Kritas, S 2015, 'Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings', Neurogastroenterology and Motility, vol. 27, no. 2, pp. 269-276. https://doi.org/10.1111/nmo.12488

TY - JOUR

T1 - Inter- and intrarater reliability of the Chicago Classification in pediatric high-resolution esophageal manometry recordings

AU - Singendonk, M. M. J.

AU - Smits, M. J.

AU - Heijting, I. E.

AU - van Wijk, M. P.

AU - Nurko, S.

AU - Rosen, R.

AU - Weijenborg, P. W.

AU - Abu-Assi, R.

AU - Hoekman, D. R.

AU - Kuizenga-Wessel, S.

AU - Seiboth, G.

AU - Benninga, M. A.

AU - Omari, T. I.

AU - Kritas, S.

PY - 2015/2

Y1 - 2015/2

N2 - The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss' kappa (κ) and intraclass correlation coefficient (ICC). Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45-0.82). Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia

AB - The Chicago Classification (CC) facilitates interpretation of high-resolution manometry (HRM) recordings. Application of this adult based algorithm to the pediatric population is unknown. We therefore assessed intra and interrater reliability of software-based CC diagnosis in a pediatric cohort. Thirty pediatric solid state HRM recordings (13M; mean age 12.1 ± 5.1 years) assessing 10 liquid swallows per patient were analyzed twice by 11 raters (six experts, five non-experts). Software-placed anatomical landmarks required manual adjustment or removal. Integrated relaxation pressure (IRP4s), distal contractile integral (DCI), contractile front velocity (CFV), distal latency (DL) and break size (BS), and an overall CC diagnosis were software-generated. In addition, raters provided their subjective CC diagnosis. Reliability was calculated with Cohen's and Fleiss' kappa (κ) and intraclass correlation coefficient (ICC). Intra- and interrater reliability of software-generated CC diagnosis after manual adjustment of landmarks was substantial (mean κ = 0.69 and 0.77 respectively) and moderate-substantial for subjective CC diagnosis (mean κ = 0.70 and 0.58 respectively). Reliability of both software-generated and subjective diagnosis of normal motility was high (κ = 0.81 and κ = 0.79). Intra- and interrater reliability were excellent for IRP4s, DCI, and BS. Experts had higher interrater reliability than non-experts for DL (ICC = 0.65 vs ICC = 0.36 respectively) and the software-generated diagnosis diffuse esophageal spasm (DES, κ = 0.64 vs κ = 0.30). Among experts, the reliability for the subjective diagnosis of achalasia and esophageal gastric junction outflow obstruction was moderate-substantial (κ = 0.45-0.82). Inter- and intrarater reliability of software-based CC diagnosis of pediatric HRM recordings was high overall. However, experience was a factor influencing the diagnosis of some motility disorders, particularly DES and achalasia

KW - Adolescent

KW - Child

KW - Cohort Studies

KW - Esophageal Motility Disorders/classification

KW - Humans

KW - Image Interpretation, Computer-Assisted/methods

KW - Manometry/methods

KW - Reproducibility of Results

U2 - https://doi.org/10.1111/nmo.12488

DO - https://doi.org/10.1111/nmo.12488

M3 - Article

C2 - 25521418

SN - 1350-1925

VL - 27

SP - 269

EP - 276

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

IS - 2

ER -