Reproducibility of high-definition (3D) manometry and its agreement with high-resolution (2D) manometry in women with fecal incontinence

S. Chakraborty, K. J. Feuerhak, A. R. Zinsmeister, Adil Eddie Bharucha

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: While widely used in clinical practice, the reproducibility of high-definition anorectal manometry (HD-ARM) remains unclear. We evaluated the intra-individual reproducibility of HD-ARM and compared pressures measured with HD-ARM and high-resolution anorectal manometry (HR-ARM). Methods: Thirty-six women with fecal incontinence had an initial HD-ARM (HD-ARM1); on the same day, after randomization, 21 had a second (HD-ARM2). Sixteen women had a third (HD-ARM3) 4 weeks later. Twenty-five had also been evaluated by HR-ARM previously. Rectoanal pressures were assessed at rest, during squeeze and simulated evacuation. Concordance among pressures was assessed with Lin's concordance correlation coefficient (CCC). Key Results: Anal resting and squeeze pressures measured with HD-ARM were reproducible on the same and different days; for average resting pressures of HD-ARM1 vs HD-ARM2, CCC = 0.73 (95% confidence interval [CI]: 0.53-0.94), and for HD-ARM1 vs HD-ARM3, CCC = 0.60 (95% CI: 0.28-0.93). For maximum squeeze pressures of HD-ARM1 vs HD-ARM2, CCC = 0.86 (95% CI: 0.75-0.97), and for HD-ARM1 vs HD-ARM3, CCC = 0.56 (95% CI: 0.21-0.91). The rectoanal gradient during evacuation was significantly concordant between HD-ARM1 and HD-ARM2 but not HD-ARM1 and HD-ARM3. Resting (CCC = 0.38 [95% CI: 0.14-0.62]) and squeeze pressures (CCC = 0.73 [95% CI: 0.57-0.89]) measured with HD-ARM1 and HR-ARM were also concordant. Conclusions & Inferences: Among women with fecal incontinence, measurements with HD-ARM were reproducible on the same (anal resting and squeeze pressures and rectoanal gradient during evacuation) and different days (anal resting and squeeze pressures) and correlated with HR-ARM measurements. These findings support use of HD-ARM and HR-ARM for longitudinal assessments of anal resting and squeeze pressures.

Original languageEnglish (US)
JournalNeurogastroenterology and Motility
DOIs
StateAccepted/In press - 2016

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Fecal Incontinence
Manometry
Pressure
Confidence Intervals
Random Allocation

Keywords

  • Anorectal
  • Fecal incontinence
  • High definition
  • High resolution
  • Manometry
  • Reproducibility

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

@article{00926443804d43e182ee34fdcea7095c,
title = "Reproducibility of high-definition (3D) manometry and its agreement with high-resolution (2D) manometry in women with fecal incontinence",
abstract = "Background: While widely used in clinical practice, the reproducibility of high-definition anorectal manometry (HD-ARM) remains unclear. We evaluated the intra-individual reproducibility of HD-ARM and compared pressures measured with HD-ARM and high-resolution anorectal manometry (HR-ARM). Methods: Thirty-six women with fecal incontinence had an initial HD-ARM (HD-ARM1); on the same day, after randomization, 21 had a second (HD-ARM2). Sixteen women had a third (HD-ARM3) 4 weeks later. Twenty-five had also been evaluated by HR-ARM previously. Rectoanal pressures were assessed at rest, during squeeze and simulated evacuation. Concordance among pressures was assessed with Lin's concordance correlation coefficient (CCC). Key Results: Anal resting and squeeze pressures measured with HD-ARM were reproducible on the same and different days; for average resting pressures of HD-ARM1 vs HD-ARM2, CCC = 0.73 (95{\%} confidence interval [CI]: 0.53-0.94), and for HD-ARM1 vs HD-ARM3, CCC = 0.60 (95{\%} CI: 0.28-0.93). For maximum squeeze pressures of HD-ARM1 vs HD-ARM2, CCC = 0.86 (95{\%} CI: 0.75-0.97), and for HD-ARM1 vs HD-ARM3, CCC = 0.56 (95{\%} CI: 0.21-0.91). The rectoanal gradient during evacuation was significantly concordant between HD-ARM1 and HD-ARM2 but not HD-ARM1 and HD-ARM3. Resting (CCC = 0.38 [95{\%} CI: 0.14-0.62]) and squeeze pressures (CCC = 0.73 [95{\%} CI: 0.57-0.89]) measured with HD-ARM1 and HR-ARM were also concordant. Conclusions & Inferences: Among women with fecal incontinence, measurements with HD-ARM were reproducible on the same (anal resting and squeeze pressures and rectoanal gradient during evacuation) and different days (anal resting and squeeze pressures) and correlated with HR-ARM measurements. These findings support use of HD-ARM and HR-ARM for longitudinal assessments of anal resting and squeeze pressures.",
keywords = "Anorectal, Fecal incontinence, High definition, High resolution, Manometry, Reproducibility",
author = "S. Chakraborty and Feuerhak, {K. J.} and Zinsmeister, {A. R.} and Bharucha, {Adil Eddie}",
year = "2016",
doi = "10.1111/nmo.12950",
language = "English (US)",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Reproducibility of high-definition (3D) manometry and its agreement with high-resolution (2D) manometry in women with fecal incontinence

AU - Chakraborty, S.

AU - Feuerhak, K. J.

AU - Zinsmeister, A. R.

AU - Bharucha, Adil Eddie

PY - 2016

Y1 - 2016

N2 - Background: While widely used in clinical practice, the reproducibility of high-definition anorectal manometry (HD-ARM) remains unclear. We evaluated the intra-individual reproducibility of HD-ARM and compared pressures measured with HD-ARM and high-resolution anorectal manometry (HR-ARM). Methods: Thirty-six women with fecal incontinence had an initial HD-ARM (HD-ARM1); on the same day, after randomization, 21 had a second (HD-ARM2). Sixteen women had a third (HD-ARM3) 4 weeks later. Twenty-five had also been evaluated by HR-ARM previously. Rectoanal pressures were assessed at rest, during squeeze and simulated evacuation. Concordance among pressures was assessed with Lin's concordance correlation coefficient (CCC). Key Results: Anal resting and squeeze pressures measured with HD-ARM were reproducible on the same and different days; for average resting pressures of HD-ARM1 vs HD-ARM2, CCC = 0.73 (95% confidence interval [CI]: 0.53-0.94), and for HD-ARM1 vs HD-ARM3, CCC = 0.60 (95% CI: 0.28-0.93). For maximum squeeze pressures of HD-ARM1 vs HD-ARM2, CCC = 0.86 (95% CI: 0.75-0.97), and for HD-ARM1 vs HD-ARM3, CCC = 0.56 (95% CI: 0.21-0.91). The rectoanal gradient during evacuation was significantly concordant between HD-ARM1 and HD-ARM2 but not HD-ARM1 and HD-ARM3. Resting (CCC = 0.38 [95% CI: 0.14-0.62]) and squeeze pressures (CCC = 0.73 [95% CI: 0.57-0.89]) measured with HD-ARM1 and HR-ARM were also concordant. Conclusions & Inferences: Among women with fecal incontinence, measurements with HD-ARM were reproducible on the same (anal resting and squeeze pressures and rectoanal gradient during evacuation) and different days (anal resting and squeeze pressures) and correlated with HR-ARM measurements. These findings support use of HD-ARM and HR-ARM for longitudinal assessments of anal resting and squeeze pressures.

AB - Background: While widely used in clinical practice, the reproducibility of high-definition anorectal manometry (HD-ARM) remains unclear. We evaluated the intra-individual reproducibility of HD-ARM and compared pressures measured with HD-ARM and high-resolution anorectal manometry (HR-ARM). Methods: Thirty-six women with fecal incontinence had an initial HD-ARM (HD-ARM1); on the same day, after randomization, 21 had a second (HD-ARM2). Sixteen women had a third (HD-ARM3) 4 weeks later. Twenty-five had also been evaluated by HR-ARM previously. Rectoanal pressures were assessed at rest, during squeeze and simulated evacuation. Concordance among pressures was assessed with Lin's concordance correlation coefficient (CCC). Key Results: Anal resting and squeeze pressures measured with HD-ARM were reproducible on the same and different days; for average resting pressures of HD-ARM1 vs HD-ARM2, CCC = 0.73 (95% confidence interval [CI]: 0.53-0.94), and for HD-ARM1 vs HD-ARM3, CCC = 0.60 (95% CI: 0.28-0.93). For maximum squeeze pressures of HD-ARM1 vs HD-ARM2, CCC = 0.86 (95% CI: 0.75-0.97), and for HD-ARM1 vs HD-ARM3, CCC = 0.56 (95% CI: 0.21-0.91). The rectoanal gradient during evacuation was significantly concordant between HD-ARM1 and HD-ARM2 but not HD-ARM1 and HD-ARM3. Resting (CCC = 0.38 [95% CI: 0.14-0.62]) and squeeze pressures (CCC = 0.73 [95% CI: 0.57-0.89]) measured with HD-ARM1 and HR-ARM were also concordant. Conclusions & Inferences: Among women with fecal incontinence, measurements with HD-ARM were reproducible on the same (anal resting and squeeze pressures and rectoanal gradient during evacuation) and different days (anal resting and squeeze pressures) and correlated with HR-ARM measurements. These findings support use of HD-ARM and HR-ARM for longitudinal assessments of anal resting and squeeze pressures.

KW - Anorectal

KW - Fecal incontinence

KW - High definition

KW - High resolution

KW - Manometry

KW - Reproducibility

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U2 - 10.1111/nmo.12950

DO - 10.1111/nmo.12950

M3 - Article

C2 - 27696628

AN - SCOPUS:84990244752

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

ER -