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Interobserver variability in the interpretation of colon manometry studies in children
Manu R Sood1, Hayat Mousa, Neel Tipnis
1Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, WI 53045, USA. Msood@mcw.edu
Journal of Pediatric Gastroenterology and Nutrition
|April 3, 2012
Summary
Interpreting colon manometry (CM) in children shows variability, especially for gastrocolonic response. Standardizing CM studies by omitting the postprandial period may improve reliability.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Motility Disorders
Background:
- Colon manometry (CM) is used to assess colonic motility in children.
- Variability in CM interpretation can affect clinical decision-making.
Purpose of the Study:
- To evaluate the inter-observer variability in the interpretation of pediatric colon manometry.
- To identify specific aspects of CM interpretation that contribute to variability.
Main Methods:
- Fifty-seven pediatric colon manometry studies were independently reviewed by five observers.
- Observers assessed colonic motility during fasting, postprandial, and bisacodyl-stimulated states.
- Interpretations included overall study normality and the clinical utility of the postprandial period.
Main Results:
- High agreement was observed for identifying high-amplitude propagating contractions (HAPC) (83%).
- The gastrocolonic response showed the most significant variability (64% agreement).
- The postprandial period was deemed clinically useful in only 3-24% of studies.
Conclusions:
- High-amplitude propagating contractions are reliably interpreted during CM.
- Visual interpretation of the gastrocolonic response is highly variable.
- Abbreviated CM studies, potentially excluding the postprandial phase, could enhance objectivity and reliability.
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