Interobserver Variability in the Interpretation of Colon Manometry Studies in Children

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 55; no. 5; pp. 548 - 551
• Main Authors: Sood, Manu R., Mousa, Hayat, Tipnis, Neel, Di Lorenzo, Carlo, Werlin, Steven, Fernandez, Sergio, Liem, Olivia, Simpson, Pippa, Rudolph, Colin
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Copyright by ESPGHAN and NASPGHAN 01.11.2012; Lippincott Williams & Wilkins
• Subjects: Biological and medical sciences; Child; Colon - physiology; colon manometry; constipation; Fasting; fecal incontinence; Feeding. Feeding behavior; Fundamental and applied biological sciences. Psychology; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal Motility; Humans; Manometry - methods; Medical sciences; Middle Aged; Muscle Contraction; Observer Variation; Other diseases. Semiology; Postprandial Period; Reference Values; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Visual Perception; Human; Manometry; Variability; Metabolic diseases; colon manometry; fecal incontinence; Interindividual comparison; Gastroenterology; Digestive diseases; Intestinal disease; Anal incontinence; Colon; Constipation; Child; Anorectal disease
• DOI: 10.1097/MPG.0b013e3182569c8b
• ISSN: 0277-2116

ABSTRACT Objectives: The aim of the present study was to evaluate the variability in interpretation of colon manometry (CM) in children. Methods: Fifty‐seven colon motility studies were independently reviewed by 5 observers. Each observer was required to report on the colonic motility during fasting, after administration of a meal, and after bisacodyl stimulation. They were also asked to comment whether CM study was normal or abnormal and whether in their opinion the postprandial recording provided clinically useful information. Results: The median (range) agreement regarding the presence of high‐amplitude propagating contractions (HAPC) was 83% (80%–92%). The interpretation of gastrocolonic response produced the most inconsistent results with median (range) agreemnet of 64% (53%–95%). The postprandial period was reported to be useful in only 3% to 24% of the studies. The median (range) agreement regarding the overall interpretation of the study being either normal or abnormal was 87% (83%–90%). Conclusions: The most easily recognizable contraction pattern during CM is the high‐amplitude propagating contractions. Visual interpretation of the gastrocolonic response produces the most inconsistent results and maximum variability. Abbreviated CM studies without the postprandial period or routine calculation of the motility index to evaluate gastrocolonic response can help make colon manometries more objective and reliable.