Inter-Observer.docVIP

The American Journal of Gastroenterology 2007 102, S119–S156; 47 Inter-Observer Agreement between Multi-Channel Intraluminal Impedance-pH MII-pH Software Analysis and an Experienced MII-pH Test Reviewer Dawn D. Ferguson, MD, MHS, Kenneth R. DeVault, MD., *Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN and Internal Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL. Purpose: Over the past decade, new technologies have emerged to evaluate gastroesophageal reflux disease GERD . One such technique is the 24-hour MII-pH study. This test was designed to detect both acid and non-acid reflux NAR . A significant drawback of this technique is that reviewing impedance tracings that were collected over a 24-hour period can be cumbersome and time consuming. In an attempt to make this task easier, one of the manufactures of this device has created a software tool to identify impedance detected reflux episodes based on a number of published parameters. To the best of our knowledge, the utility of an experienced reviewer hand-editing MII-pH tracings after the software analysis has never been evaluated. Methods: We randomly selected 20 MII-pH studies performed at our institution on patients that were taking a proton-pump inhibitor twice daily. We ran the proprietary software analysis tool Sleuth?, Sandhill Scientific, Inc., Highlands Ranch, CO on all of these studies using the same pre-programmed parameters. An experienced reviewer of MII-pH studies DDF reviewed all the tracings. The reviewer had the ability to add or delete reflux episodes that had been detected by the software tool. We separately recorded the computer and reviewers analysis in regards to the total number NAR episodes. We determined whether the study was considered positive or negative based on published criteria of NAR. We used Cohens kappa coefficient to evaluate the inter-observer agreement between the software analysis and