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Related Experiment Video

Updated: Jun 13, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
06:46

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

Published on: December 14, 2020

Inter-observer agreement for multichannel intraluminal impedance-pH testing.

K Ravi1, K R DeVault, J A Murray

  • 1Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|May 13, 2010
PubMed
Summary
This summary is machine-generated.

Multichannel intraluminal impedance-pH (MII-pH) with Autoscan™ shows moderate agreement for detecting nonacid reflux (NAR). Agreement improves when considering total reflux episodes, not just NAR, for study interpretation.

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Area of Science:

  • Gastroenterology
  • Digestive System Disorders
  • Medical Device Technology

Background:

  • Ambulatory multichannel intraluminal impedance-pH (MII-pH) is crucial for detecting acid and nonacid reflux (NAR).
  • Automated analysis software, like Autoscan™, enhances MII-pH study interpretation efficiency.
  • Inter-observer agreement for NAR detection using MII-pH and automated software requires further investigation in adults.

Purpose of the Study:

  • To evaluate inter-observer agreement among reviewers and with Autoscan™ software for identifying pathologic nonacid reflux (NAR) using MII-pH studies.
  • To assess agreement on total reflux episodes (acid and NAR) as a marker for pathologic reflux.

Main Methods:

  • Twenty 24-hour MII-pH studies from patients on twice-daily proton pump inhibitors were analyzed by Autoscan™.
  • Four independent reviewers interpreted the same MII-pH studies, modifying Autoscan™'s initial reflux detection.
  • Cohen's kappa (κ) statistic was used to quantify inter-observer agreement for NAR and total reflux episodes.

Main Results:

  • Moderate inter-observer agreement was found for pathologic NAR (κ=0.57 between reviewers, κ=0.56 between reviewers and Autoscan™).
  • Higher agreement was observed when evaluating total reflux episodes (κ=0.72 between reviewers, κ=0.74 between reviewers and Autoscan™).
  • Two reviewers showed better agreement with Autoscan™ and each other on NAR episodes, while the other two had distinct agreement patterns.

Conclusions:

  • Inter-observer agreement for pathologic NAR detection with MII-pH and Autoscan™ is moderate.
  • Considering total reflux episodes improves agreement compared to focusing solely on NAR.
  • Reviewer interpretation variability exists, impacting the reliability of automated NAR detection in MII-pH studies.