High-resolution technology may improve the diagnostic value of antroduodenal manometry (ADM), according to studies conducted on adults. The two forms of high-resolution displays—conventional line plots (CLP) and pressure topographic plots (PTP)—and high- and low-resolution ADM recordings have not been compared in any studies. In comparison to low-resolution recordings, researchers anticipated that high-resolution ADM was a better diagnostic modality with higher inter-observer and intra-observer agreement.

Three skilled pediatric neurogastroenterologists blindly evaluated 24 anonymized ADM investigations. With a 20-channel catheter and a low-compliance water-perfused system. Data were shown in CLP, PTP, and both high- and low-resolution formats during various sessions separated by at least six weeks. Utilizing previously identified diagnoses and particular pre- and post-prandial manometric patterns, accuracy was assessed. Calculations were made for both inter- and intra-observer agreements.

The 3 observers had a significant inter-observer agreement with the diagnosis, according to analysis using high-resolution CLP (Krippendorff’s alpha: 0.832; average pairwise percentage agreement: 88.9%). The average pairwise percentage agreement for diagnoses between PTP and low-resolution CLP was poor (Krippendorff’s alpha: 0.600; average pairwise percentage agreement: 75.3%; Krippendorff’s alpha: 0.390; average pairwise percentage agreement: 60.2%, respectively). Krippendorff’s alpha ranges for the intra-observer agreement were 0.891–1 for CLP and 0.19393–0.34621 for PTP.

In comparison to low-resolution recordings, the investigation showed that high-resolution ADM had greater diagnostic accuracy. PTP, however, was not yet dependable in determining foregut motor patterns, while being well established for other motility research. It was obvious that sophisticated and more advanced software was needed for PTP display analysis.

Reference: journals.lww.com/jpgn/Abstract/2022/12000/Intra__and_Inter_observer_Agreement_of_High.4.aspx