The utility of balloon‐based and standard impedance technology to diagnose esophageal mucosal diseases in children
Background Standard impedance catheters and balloon‐based mucosal impedance catheters (BBMI) have been used to assess mucosal integrity and diagnose mucosal diseases. The goal of this study was to determine the age‐related technical issues associated with mucosal balloon inflation, validate the BBMI...
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| Veröffentlicht in: | Neurogastroenterology and motility 2024-03, Vol.36 (3), p.e14726-n/a |
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| creator | Rosen, Rachel Du, Maritha Akkara, Anna Catacora, Andrea Wen, Anna Liu, Enju Nurko, Samuel |
| description | Background
Standard impedance catheters and balloon‐based mucosal impedance catheters (BBMI) have been used to assess mucosal integrity and diagnose mucosal diseases. The goal of this study was to determine the age‐related technical issues associated with mucosal balloon inflation, validate the BBMI measurement against a standard impedance probe, and compare software‐generated diagnoses to histologic diagnoses.
Methods
We prospectively recruited patients undergoing endoscopy, during which patients underwent standard mucosal impedance catheters and BBMI measurements. Measurements were compared to each other, to the histologic diagnoses, and to the number of eosinophils per high power field. We then compared the patients' diagnosis to that assigned by the BBMI software.
Key Results
Sixty‐two patients (mean age: 62 ± 62 months) were recruited, including non‐GERD (N = 40), GERD (N = 15), and EoE (N = 7) patients. There were significant differences between the impedance values measured by the two technologies at each esophageal height (p |
| doi_str_mv | 10.1111/nmo.14726 |
| format | Article |
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Standard impedance catheters and balloon‐based mucosal impedance catheters (BBMI) have been used to assess mucosal integrity and diagnose mucosal diseases. The goal of this study was to determine the age‐related technical issues associated with mucosal balloon inflation, validate the BBMI measurement against a standard impedance probe, and compare software‐generated diagnoses to histologic diagnoses.
Methods
We prospectively recruited patients undergoing endoscopy, during which patients underwent standard mucosal impedance catheters and BBMI measurements. Measurements were compared to each other, to the histologic diagnoses, and to the number of eosinophils per high power field. We then compared the patients' diagnosis to that assigned by the BBMI software.
Key Results
Sixty‐two patients (mean age: 62 ± 62 months) were recruited, including non‐GERD (N = 40), GERD (N = 15), and EoE (N = 7) patients. There were significant differences between the impedance values measured by the two technologies at each esophageal height (p < 0.003). There were significant correlations between the mean impedance values taken by the two catheters in the distal (r2 = 0.272, p = 0.04), mid (r2 = 0.371, p < 0.001), and proximal (r2 = 0.259, p = 0.05) esophagus. There were significant differences in BBMI impedance values across diagnoses in the mid and proximal esophagus (p = 0.024 and 0.025, respectively). While not statistically significant (p = 0.061–0.073), the standard catheter showed similar trends by diagnosis. Using the BBMI diagnostic prediction software, 33%–72% of patients were misclassified.
Conclusion and Inferences
While there was significant variability in impedance values between technologies within patients, regional measurements were consistent across catheters. Automated analyses lacked the sensitivity to diagnose inflammatory disorders.
Both standard mucosal impedance testing and balloon‐based testing could generally differentiate children with and without GERD, eosinophilic esophagitis, and non‐GERD disorders, though the absolute impedance values differed greatly between devices and neither device had adequate sensitivity to diagnose children without biopsies.</description><identifier>ISSN: 1350-1925</identifier><identifier>EISSN: 1365-2982</identifier><identifier>DOI: 10.1111/nmo.14726</identifier><identifier>PMID: 38129704</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Balloon treatment ; Catheters ; Diagnosis ; Endoscopy ; eosinophilic esophagitis ; Esophagus ; Gastroesophageal reflux ; gastroesophageal reflux disease ; impedance ; inflammation ; Inflammatory diseases ; Leukocytes (eosinophilic) ; Mucosa ; Software ; Statistical analysis</subject><ispartof>Neurogastroenterology and motility, 2024-03, Vol.36 (3), p.e14726-n/a</ispartof><rights>2023 John Wiley & Sons Ltd.</rights><rights>Copyright © 2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3536-b775acc3dd3904ac596bc0b9a7b7b9439b5ea7101c1b1add076dab55b5bcd1783</citedby><cites>FETCH-LOGICAL-c3536-b775acc3dd3904ac596bc0b9a7b7b9439b5ea7101c1b1add076dab55b5bcd1783</cites><orcidid>0000-0003-3949-3060 ; 0000-0003-0936-4807</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fnmo.14726$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fnmo.14726$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38129704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rosen, Rachel</creatorcontrib><creatorcontrib>Du, Maritha</creatorcontrib><creatorcontrib>Akkara, Anna</creatorcontrib><creatorcontrib>Catacora, Andrea</creatorcontrib><creatorcontrib>Wen, Anna</creatorcontrib><creatorcontrib>Liu, Enju</creatorcontrib><creatorcontrib>Nurko, Samuel</creatorcontrib><title>The utility of balloon‐based and standard impedance technology to diagnose esophageal mucosal diseases in children</title><title>Neurogastroenterology and motility</title><addtitle>Neurogastroenterol Motil</addtitle><description>Background
Standard impedance catheters and balloon‐based mucosal impedance catheters (BBMI) have been used to assess mucosal integrity and diagnose mucosal diseases. The goal of this study was to determine the age‐related technical issues associated with mucosal balloon inflation, validate the BBMI measurement against a standard impedance probe, and compare software‐generated diagnoses to histologic diagnoses.
Methods
We prospectively recruited patients undergoing endoscopy, during which patients underwent standard mucosal impedance catheters and BBMI measurements. Measurements were compared to each other, to the histologic diagnoses, and to the number of eosinophils per high power field. We then compared the patients' diagnosis to that assigned by the BBMI software.
Key Results
Sixty‐two patients (mean age: 62 ± 62 months) were recruited, including non‐GERD (N = 40), GERD (N = 15), and EoE (N = 7) patients. There were significant differences between the impedance values measured by the two technologies at each esophageal height (p < 0.003). There were significant correlations between the mean impedance values taken by the two catheters in the distal (r2 = 0.272, p = 0.04), mid (r2 = 0.371, p < 0.001), and proximal (r2 = 0.259, p = 0.05) esophagus. There were significant differences in BBMI impedance values across diagnoses in the mid and proximal esophagus (p = 0.024 and 0.025, respectively). While not statistically significant (p = 0.061–0.073), the standard catheter showed similar trends by diagnosis. Using the BBMI diagnostic prediction software, 33%–72% of patients were misclassified.
Conclusion and Inferences
While there was significant variability in impedance values between technologies within patients, regional measurements were consistent across catheters. Automated analyses lacked the sensitivity to diagnose inflammatory disorders.
Both standard mucosal impedance testing and balloon‐based testing could generally differentiate children with and without GERD, eosinophilic esophagitis, and non‐GERD disorders, though the absolute impedance values differed greatly between devices and neither device had adequate sensitivity to diagnose children without biopsies.</description><subject>Balloon treatment</subject><subject>Catheters</subject><subject>Diagnosis</subject><subject>Endoscopy</subject><subject>eosinophilic esophagitis</subject><subject>Esophagus</subject><subject>Gastroesophageal reflux</subject><subject>gastroesophageal reflux disease</subject><subject>impedance</subject><subject>inflammation</subject><subject>Inflammatory diseases</subject><subject>Leukocytes (eosinophilic)</subject><subject>Mucosa</subject><subject>Software</subject><subject>Statistical analysis</subject><issn>1350-1925</issn><issn>1365-2982</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kb9uFDEQhy0EIiFQ8ALIEg0Um_jPer0uUURIpIQ0oV6N7bk7R177WO8quo5H4BnzJDi5QIGUKWam-PRpND9C3nN2zGudpDEf81aL7gU55LJTjTC9ePmwK9ZwI9QBeVPKLWOsE233mhzIngujWXtI5psN0mUOMcw7mlfUQow5p_tfvy0U9BSSp2WuHSZPw7hFD8khndFtUo55vaNzpj7AOuWCFEvebmCNEOm4uFzq9KFgNRUaEnWbEP2E6S15tYJY8N3TPCI_zr7enJ43l9ffLk6_XDZOKtk1VmsFzknvpWEtOGU665g1oK22ppXGKgTNGXfccvCe6c6DVcoq6zzXvTwin_be7ZR_LljmYQzFYYyQMC9lEIYpJZTguqIf_0Nv8zKlel2lRNerXj5Sn_eUm3IpE66G7RRGmHYDZ8NDFEONYniMorIfnoyLHdH_I__-vgIne-AuRNw9bxq-X13vlX8A5LqVeg</recordid><startdate>202403</startdate><enddate>202403</enddate><creator>Rosen, Rachel</creator><creator>Du, Maritha</creator><creator>Akkara, Anna</creator><creator>Catacora, Andrea</creator><creator>Wen, Anna</creator><creator>Liu, Enju</creator><creator>Nurko, Samuel</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3949-3060</orcidid><orcidid>https://orcid.org/0000-0003-0936-4807</orcidid></search><sort><creationdate>202403</creationdate><title>The utility of balloon‐based and standard impedance technology to diagnose esophageal mucosal diseases in children</title><author>Rosen, Rachel ; Du, Maritha ; Akkara, Anna ; Catacora, Andrea ; Wen, Anna ; Liu, Enju ; Nurko, Samuel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3536-b775acc3dd3904ac596bc0b9a7b7b9439b5ea7101c1b1add076dab55b5bcd1783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Balloon treatment</topic><topic>Catheters</topic><topic>Diagnosis</topic><topic>Endoscopy</topic><topic>eosinophilic esophagitis</topic><topic>Esophagus</topic><topic>Gastroesophageal reflux</topic><topic>gastroesophageal reflux disease</topic><topic>impedance</topic><topic>inflammation</topic><topic>Inflammatory diseases</topic><topic>Leukocytes (eosinophilic)</topic><topic>Mucosa</topic><topic>Software</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rosen, Rachel</creatorcontrib><creatorcontrib>Du, Maritha</creatorcontrib><creatorcontrib>Akkara, Anna</creatorcontrib><creatorcontrib>Catacora, Andrea</creatorcontrib><creatorcontrib>Wen, Anna</creatorcontrib><creatorcontrib>Liu, Enju</creatorcontrib><creatorcontrib>Nurko, Samuel</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Neurogastroenterology and motility</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rosen, Rachel</au><au>Du, Maritha</au><au>Akkara, Anna</au><au>Catacora, Andrea</au><au>Wen, Anna</au><au>Liu, Enju</au><au>Nurko, Samuel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The utility of balloon‐based and standard impedance technology to diagnose esophageal mucosal diseases in children</atitle><jtitle>Neurogastroenterology and motility</jtitle><addtitle>Neurogastroenterol Motil</addtitle><date>2024-03</date><risdate>2024</risdate><volume>36</volume><issue>3</issue><spage>e14726</spage><epage>n/a</epage><pages>e14726-n/a</pages><issn>1350-1925</issn><eissn>1365-2982</eissn><abstract>Background
Standard impedance catheters and balloon‐based mucosal impedance catheters (BBMI) have been used to assess mucosal integrity and diagnose mucosal diseases. The goal of this study was to determine the age‐related technical issues associated with mucosal balloon inflation, validate the BBMI measurement against a standard impedance probe, and compare software‐generated diagnoses to histologic diagnoses.
Methods
We prospectively recruited patients undergoing endoscopy, during which patients underwent standard mucosal impedance catheters and BBMI measurements. Measurements were compared to each other, to the histologic diagnoses, and to the number of eosinophils per high power field. We then compared the patients' diagnosis to that assigned by the BBMI software.
Key Results
Sixty‐two patients (mean age: 62 ± 62 months) were recruited, including non‐GERD (N = 40), GERD (N = 15), and EoE (N = 7) patients. There were significant differences between the impedance values measured by the two technologies at each esophageal height (p < 0.003). There were significant correlations between the mean impedance values taken by the two catheters in the distal (r2 = 0.272, p = 0.04), mid (r2 = 0.371, p < 0.001), and proximal (r2 = 0.259, p = 0.05) esophagus. There were significant differences in BBMI impedance values across diagnoses in the mid and proximal esophagus (p = 0.024 and 0.025, respectively). While not statistically significant (p = 0.061–0.073), the standard catheter showed similar trends by diagnosis. Using the BBMI diagnostic prediction software, 33%–72% of patients were misclassified.
Conclusion and Inferences
While there was significant variability in impedance values between technologies within patients, regional measurements were consistent across catheters. Automated analyses lacked the sensitivity to diagnose inflammatory disorders.
Both standard mucosal impedance testing and balloon‐based testing could generally differentiate children with and without GERD, eosinophilic esophagitis, and non‐GERD disorders, though the absolute impedance values differed greatly between devices and neither device had adequate sensitivity to diagnose children without biopsies.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38129704</pmid><doi>10.1111/nmo.14726</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3949-3060</orcidid><orcidid>https://orcid.org/0000-0003-0936-4807</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Balloon treatment Catheters Diagnosis Endoscopy eosinophilic esophagitis Esophagus Gastroesophageal reflux gastroesophageal reflux disease impedance inflammation Inflammatory diseases Leukocytes (eosinophilic) Mucosa Software Statistical analysis |
| title | The utility of balloon‐based and standard impedance technology to diagnose esophageal mucosal diseases in children |
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