title: The Chicago Classification 3.0 Results in More Normal Findings and Fewer Hypotensive Findings With No Difference in Other Diagnoses.
abstract: High-resolution manometry (HRM) is the preferred method for the evaluation of motility disorders. Recently, an update of the diagnostic criteria (Chicago 3.0) has been published. The aim of this study was to compare the performance criteria of Chicago version 2.0 (CC2.0) vs. 3.0 (CC3.0) in a cohort of healthy volunteers and symptomatic patients.
  
  
  
  HRM studies of asymptomatic and symptomatic individuals from several centers of Spain and Latin America were analyzed using both CC2.0 and CC3.0. The final diagnosis was grouped into hierarchical categories: obstruction (achalasia and gastro-esophageal junction obstruction), major disorders (distal esophageal spasm, absent peristalsis, and jackhammer), minor disorders (failed frequent peristalsis, weak peristalsis with small or large defects, ineffective esophageal motility, fragmented peristalsis, rapid contractile with normal latency and hypertensive peristalsis) and normal. The results were compared using McNemar's and Kappa tests.
  
  
  
  HRM was analyzed in 107 healthy volunteers (53.3% female; 18-69 years) and 400 symptomatic patients (58.5% female; 18-90 years). In healthy volunteers, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 7.5% and 5.6%, respectively, major disorders in 1% and 2.8%, respectively, minor disorders in 25.2% and 15%, respectively, and normal in 66.4% and 76.6%, respectively. In symptomatic individuals, using CC2.0 and CC3.0, obstructive disorders were diagnosed in 11% and 11.3%, respectively, major disorders in 14% and 14%, respectively, minor disorders in 33.3% and 24.5%, respectively, and normal in 41.8% and 50.3%, respectively. In both groups of individuals, only an increase in normal and a decrease in minor findings using CC3.0 were statistically significant using McNemar's test.
  
  
  
  CC3.0 increases the number of normal studies when compared with CC2.0, essentially at the expense of fewer minor disorders, with no significant differences in major or obstructive disorders. As the relevance of minor disorders is questionable, our data suggest that CC3.0 increases the relevance of abnormal results.
authors.affiliation: Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: H
authors.initials: H
authors.lastname: Monrroy
authors.affiliation: Universidad del Desarrollo, School of Medicine, Clínica Alemana de Santiago, Santiago, Chile.
authors.forename: D
authors.initials: D
authors.lastname: Cisternas
authors.affiliation: Hospital Universitario, School of Medicine, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: C
authors.initials: C
authors.lastname: Bilder
authors.affiliation: Hospital Universitario, School of Medicine, Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Ditaranto
authors.affiliation: Universidad Veracruzana, Veracruz, México.
authors.forename: J
authors.initials: J
authors.lastname: Remes-Troche
authors.affiliation: Universidad Veracruzana, Veracruz, México.
authors.forename: A
authors.initials: A
authors.lastname: Meixueiro
authors.affiliation: Universidad Veracruzana, Veracruz, México.
authors.forename: M A
authors.initials: MA
authors.lastname: Zavala
authors.affiliation: Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); Department of Medicine, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Serra
authors.affiliation: Motility and Functional Gut Disorders Unit, University Hospital Germans Trias i Pujol, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd); Department of Medicine, Autonomous University of Barcelona, Badalona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Marín
authors.affiliation: Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ruiz de León
authors.affiliation: Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Pérez de la Serna
authors.affiliation: San Ignacio Hospital Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: A
authors.initials: A
authors.lastname: Hani
authors.affiliation: San Ignacio Hospital Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: A
authors.initials: A
authors.lastname: Leguizamo
authors.affiliation: University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Abrahao
authors.affiliation: Axxis Hospital, Quito, Ecuador.
authors.forename: R
authors.initials: R
authors.lastname: Coello
authors.affiliation: Motility Lab, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
authors.forename: M A
authors.initials: MA
authors.lastname: Valdovinos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004931:Esophageal Achalasia / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D004935:Esophageal Diseases / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D015154:Esophageal Motility Disorders / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology; D015155:Esophageal Spasm, Diffuse / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D004943:Esophagogastric Junction / Q000503:physiopathology; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007843:Latin America; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010528:Peristalsis / Q000502:physiology; D013030:Spain; D055815:Young Adult