Document Detail


Does reflux monitoring with multichannel intraluminal impedance change clinical decision making?
MedLine Citation:
PMID:  21407105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Multichannel intraluminal impedance with pH (pH-MII) has become the criterion standard test for the evaluation of gastroesophageal reflux disease, but it is not clear whether the results of this test change clinical decision making. The goal of the present study was to determine the differences in clinical decision making by attending physicians based on the pH probe results versus MII results.
METHODS: We conducted a prospective study in which physicians were initially given pH probe results and asked how they would change the patient's clinical management based on these results. Physicians were then given the MII results and asked how their management would change. Physicians then were asked whether they believed MII affected their clinical decision making overall.
RESULTS: pH probe results changed clinical management 40% of the time and MII results changed clinical management an additional 22% of the time. Clinical decision making was not influenced by the performance of pH-MII on or off acid suppression. The escalation of acid suppression therapy was the main management change that occurred based on the pH-MII results.
CONCLUSIONS: The addition of MII to the standard pH probe resulted in a change in management in approximately 25% of the patients, suggesting that there may be a role for pH-MII in clinical practice.
Authors:
Rachel Rosen; Kristen Hart; Samuel Nurko
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric gastroenterology and nutrition     Volume:  52     ISSN:  1536-4801     ISO Abbreviation:  J. Pediatr. Gastroenterol. Nutr.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-18     Completed Date:  2011-07-26     Revised Date:  2012-03-07    
Medline Journal Info:
Nlm Unique ID:  8211545     Medline TA:  J Pediatr Gastroenterol Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  404-7     Citation Subset:  IM    
Affiliation:
Center for Motility and Functional Gastrointestinal Disorders, Children's Hospital Boston, Boston, MA 02115, USA. rachel.rosen@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Decision Making
Diagnostic Techniques, Digestive System / instrumentation*
Electric Impedance
Electrochemical Techniques*
Esophageal pH Monitoring / instrumentation
Esophagus*
Female
Fundoplication
Gastroesophageal Reflux / diagnosis*,  drug therapy*,  therapy
Gastrointestinal Agents / administration & dosage,  therapeutic use
Hospitals, Pediatric
Humans
Hydrogen-Ion Concentration
Infant
Male
Medical Staff, Hospital
Physician's Practice Patterns*
Prospective Studies
Grant Support
ID/Acronym/Agency:
K23 DK073713-01A1/DK/NIDDK NIH HHS; K23DK073713/DK/NIDDK NIH HHS; K24DK082792/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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