title: Interobserver variability in the interpretation of colon manometry studies in children.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, WI 53045, USA. Msood@mcw.edu
authors.forename: Manu R
authors.initials: MR
authors.lastname: Sood
authors.forename: Hayat
authors.initials: H
authors.lastname: Mousa
authors.forename: Neel
authors.initials: N
authors.lastname: Tipnis
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.forename: Steven
authors.initials: S
authors.lastname: Werlin
authors.forename: Sergio
authors.initials: S
authors.lastname: Fernandez
authors.forename: Olivia
authors.initials: O
authors.lastname: Liem
authors.forename: Pippa
authors.initials: P
authors.lastname: Simpson
authors.forename: Colin
authors.initials: C
authors.lastname: Rudolph
mesh_terms: D002648:Child; D003106:Colon / Q000502:physiology*; D005215:Fasting; D005769:Gastrointestinal Motility; D006801:Humans; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D009119:Muscle Contraction; D015588:Observer Variation; D019518:Postprandial Period; D012016:Reference Values; D014796:Visual Perception