The following is a summary of “Interrater Reliability of Functional Lumen Imaging Probe Panometry and High-Resolution Manometry for the Assessment of Esophageal Motility Disorders,” published in the August 2023 issue of Gastroenterology and Nutrition by Chen, et al.
High-resolution manometry (HRM) and functional lumen imaging probe (FLIP) are essential for evaluating esophageal motility as primary or complementary diagnostic methods. For a study, researchers sought to assess the interrater agreement and accuracy of interpretations of HRM and FLIP studies.
Specialists in esophageal motility from various institutions analyzed 40 consecutive HRM and 40 FLIP studies. Interrater agreement was evaluated using the intraclass correlation coefficient (ICC) for continuous variables and Fleiss’ κ statistics for nominal variables. The accuracy of rater interpretations was compared to the consensus of three experienced raters, considered the reference standard.
Fifteen raters completed the HRM and FLIP studies. Excellent interrater agreement was observed for supine median integral relaxation pressure (ICC 0.96, 95% CI 0.95–0.98). Good agreement was noted for esophagogastric junction (EGJ) outflow assessment, peristalsis, and assignment of Chicago Classification version 4.0 diagnosis using HRM (κ = 0.71, 0.75, and 0.70, respectively). Excellent interrater agreement was found for EGJ distensibility index and maximum diameter (0.91 [0.90–0.94], 0.92 [0.89–0.95]), with a moderate-to-good agreement in EGJ opening classification, contractile response pattern, and motility classification on FLIP (κ = 0.68, 0.56, and 0.59, respectively). Rater accuracy for Chicago Classification version 4.0 diagnosis using HRM was 82% (95% CI 78%–84%), while for motility diagnosis using FLIP Panometry, it was 78% (95% CI 72%–81%).
The study highlighted substantial interrater agreement and accuracy in interpreting HRM and FLIP metrics, with moderate-to-high levels for motility classification using FLIP. The findings supported the utility of HRM and FLIP as primary or complementary tools for assessing esophageal motility disorders.