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Related Experiment Videos

Schatzki ring, statistically reexamined.

John C Pezzullo1, Ann M Lewicki

  • 1Department of Clinical Pharmacology and Biostatistics, Georgetown University, Washington, DC, USA. johnp71@aol.com

Radiology
|July 19, 2003
PubMed
Summary

Schatzki

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Area of Science:

  • Gastroenterology
  • Medical Statistics

Background:

  • The lower esophageal ring is a potential cause of dysphagia.
  • Schatzki's 1963 study established a relationship between ring diameter and dysphagia.

Purpose of the Study:

  • To statistically re-evaluate Schatzki's 1963 data on lower esophageal ring diameter and dysphagia.
  • To quantify the association between ring diameter and dysphagia severity and recurrence.

Main Methods:

  • Retrospective statistical analysis of original data from Schatzki's study.
  • Utilized analysis of variance, logistic regression, and receiver operating characteristic (ROC) analysis.
  • Evaluated follow-up data for symptomatic and asymptomatic patients.

Main Results:

  • A highly significant difference in ring diameter was found between asymptomatic patients and those with recurrent dysphagia (P <.001).
  • A 1-mm increase in ring diameter decreased dysphagia likelihood by 31%; a 1-mm decrease increased it by 46%.
  • The 20-mm cutoff demonstrated 96% sensitivity and 58% specificity for dysphagia, with an ROC area of 0.888.

Conclusions:

  • Retrospective analysis validates Schatzki's original conclusions regarding lower esophageal ring diameter and dysphagia.
  • Ring diameter is a significant predictor of recurrent dysphagia, but not single episodes.
  • Missing data in the original study limits definitive answers to some questions.

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