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Related Experiment Videos

Optimizing Approach to Nonobstructive Dysphagia: A Cost-Minimization Analysis.

Ashwin Gupta1, Rishi Naik2, Michael Vaezi2

  • 1Vanderbilt University School of Medicine.

Journal of Clinical Gastroenterology
|July 8, 2026
PubMed
Summary
This summary is machine-generated.

For diagnosing nonobstructive dysphagia (NOD), esophageal high-resolution manometry (HRM) is more cost-effective than esophageal impedance planimetry (EndoFLIP). Utilizing HRM first can save $1 to $2 billion annually in healthcare costs.

Keywords:
and esophageal impedance planimetrybarium esophagramdysphagiaesophageal manometryupper endoscopy

Related Experiment Videos

Area of Science:

  • Gastroenterology
  • Medical Economics

Background:

  • Dysphagia impacts over 15 million US adults, with normal esophagogastroduodenoscopy (EGD) in 32% of cases necessitating further investigation.
  • Nonobstructive dysphagia (NOD) diagnosis requires cost-effective evaluation strategies.

Purpose of the Study:

  • To identify the most cost-effective diagnostic and management approach for nonobstructive dysphagia (NOD).

Main Methods:

  • Comparative cost analysis of initial workup strategies for NOD: esophageal high-resolution manometry (HRM), esophageal impedance planimetry (EndoFLIP), and empiric dilation followed by HRM or EndoFLIP.
  • Utilized published cohort data for HRM and EndoFLIP diagnosis distributions in NOD.

Main Results:

  • HRM-first strategies are more cost-effective than EndoFLIP-based approaches for NOD, with average per-patient cost savings of $300-$430.
  • HRM remains cost-effective unless HRM failure rates exceed 48.8%.

Conclusions:

  • Implementing HRM instead of EndoFLIP for initial NOD workup could yield $1-$2 billion in healthcare savings.
  • EndoFLIP's higher cost and frequent need for follow-up testing contribute to its lower cost-effectiveness, though patient comfort is an unmeasured factor.