title: High-resolution manometry: reliability of automated analysis of upper esophageal sphincter relaxation parameters.
abstract: OBJECTIVE
  At present, automated analysis of high-resolution manometry (HRM) provides details of upper esophageal sphincter (UES) relaxation parameters. The aim of this study was to assess the accuracy of automatic analysis of UES relaxation parameters.
  
  
  METHODS
  One hundred and fifty three subjects (78 males, mean age 68.6 years, range 26-97) underwent HRM. UES relaxation parameters were interpreted twice, once visually (V) by two experts and once automatically (AS) using the ManoView ESO analysis software. Agreement between the two analysis methods was assessed using Bland-Altman plots and Lin's concordance correlation coefficient (CCC).
  
  
  RESULTS
  The agreement between V and AS analyses of basal UES pressure (CCC 0.996; 95% confidence interval (CI) 0.994-0.997) and residual UES pressure (CCC 0.918; 95% CI 0.895-0.936) was good to excellent. Agreement for time to UES relaxation nadir (CCC 0.208; 95% CI 0.068-0.339) and UES relaxation duration (CCC 0.286; 95% CI 0.148-0.413) between V and AS analyses was poor. There was moderate agreement for recovery time of UES relaxation (CCC 0.522; 95% CI 0.397-0.627) and peak pharyngeal pressure (CCC 0.695; 95% CI 0.605-0.767) between V and AS analysis.
  
  
  CONCLUSIONS
  AS analysis was unreliable, especially regarding the time variables of UES relaxation. Due to the difference in the clinical interpretation of pharyngoesophageal dysfunction between V and AS analysis, the use of visual analysis is justified.
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul, Republic of Korea. joonlee@schmc.ac.kr.
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Ji Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Seong Ran
authors.initials: SR
authors.lastname: Jeon
authors.forename: Wan Jung
authors.initials: WJ
authors.lastname: Kim
authors.forename: Hyun Gun
authors.initials: HG
authors.lastname: Kim
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Kim
authors.forename: Jun Hyung
authors.initials: JH
authors.lastname: Cho
authors.forename: Won Young
authors.initials: WY
authors.lastname: Park
authors.forename: Ji Woong
authors.initials: JW
authors.lastname: Park
authors.forename: Yang Gyun
authors.initials: YG
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000503:physiopathology*; D049631:Esophageal Sphincter, Upper / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D010614:Pharynx / Q000503:physiopathology*; D011312:Pressure; D015203:Reproducibility of Results; D012146:Rest / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors