Optimizing the high-resolution manometry (HRM) study protocol

Area of Science:

• Gastroenterology
• Medical Devices
• Diagnostic Procedures

Background:

• Esophageal manometry catheter intolerance can prolong high-resolution manometry (HRM) studies and increase patient distress.
• Assessing the impact of obtaining the landmark phase at the end of the study when the patient has acclimatized to the HRM catheter is crucial.

Purpose of the Study:

• To evaluate the effect of a modified high-resolution manometry protocol on study duration and patient tolerance.
• To determine if shifting the landmark phase to the end of the study impacts the quality of diagnostic interpretation.

Main Methods:

• A study involving 366 patients undergoing esophageal HRM over a 1-year period.
• Comparison of a standard protocol (landmark phase first) with a modified protocol (landmark phase last).
• Analysis of study duration, technical characteristics, and motor findings between the two protocols.

Main Results:

• The modified protocol, used in 10.4% of patients with poor catheter tolerance, resulted in a significantly longer study duration (15.6 min vs. 12.9 min).
• Despite longer overall duration, the time to complete study maneuvers was not significantly different between protocols.
• A significant percentage (31.4%) of modified protocol patients could not complete their first maneuver within the standard 95th percentile time (6.1 min).

Conclusions:

• Modifying the high-resolution manometry protocol by obtaining the landmark phase at the end optimizes study duration.
• This protocol modification does not compromise the quality of the diagnostic interpretation.
• The findings suggest a potential improvement in patient experience and study efficiency.