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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
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Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

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Gastroesophageal reflux disease in children: how reliable is the gold standard?

E van Os1, J De Schryver, R H J Houwen

  • 1Department of Pediatrics, University Medical Centre St. Radboud, Nijmegen, The Netherlands.

Jornal De Pediatria
|February 10, 2009
PubMed

Insights

Interobserver variability in esophageal pH monitoring was 18%, often due to interpretation issues. Post-test calibration and probe assessment can improve agreement in diagnosing gastroesophageal reflux disease.

Area of Science:

  • Gastroenterology
  • Pediatric Medicine
  • Diagnostic Techniques

Background:

  • Gastroesophageal reflux (GER) diagnosis relies on esophageal pH monitoring.
  • Interobserver variability can impact diagnostic accuracy.

Purpose of the Study:

  • To determine the extent of interobserver variability in esophageal pH monitoring.
  • To identify the causes of this variability in pediatric patients.

Main Methods:

  • Retrospective analysis of 72 pediatric patients undergoing esophageal pH monitoring.
  • Evaluation of diagnostic interpretations by multiple observers.

Main Results:

  • An 18% interobserver variability was observed.
  • Variability stemmed from disagreements on registration duration, probe placement, artifacts, and baseline pH drift.

Conclusions:

  • Post-test calibration and electrode position assessment can mitigate variability.
  • A lack of clear definitions for monitoring artifacts persists.
  • Fair agreement (kappa coefficient of 0.70) was found in pH study interpretation.
Abstract

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