{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:50:43Z","timestamp":1785883843548,"version":"3.56.0"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"03","funder":[{"name":"Japanese Gastroenterological Association","award":["2021\u20131"],"award-info":[{"award-number":["2021\u20131"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Peroral endoscopic myotomy (POEM) is effective for the management of achalasia and its variants; however, it can be ineffective in some patients. We aimed to develop and validate a risk scoring system to predict the clinical failure of POEM preoperatively.<\/jats:p><jats:p>\n          Methods\u2002Consecutive patients who underwent POEM in 14 high volume centers between 2010 and 2020 were enrolled in this study. Clinical failure was defined as an Eckardt score of\u200a\u2265\u200a4 or retreatment. A risk scoring system to predict the short-term clinical failure of POEM was developed using multivariable logistic regression and internally validated using bootstrapping and decision curve analysis.<\/jats:p><jats:p>\n          Results\u2002Of the 2740 study patients, 112 (4.1\u200a%) experienced clinical failure 6 months after POEM. Risk scores were assigned for three preoperative factors as follows: preoperative Eckardt score (1 point), manometric diagnosis (\u22124 points for type II achalasia), and a history of prior treatments (1 point for pneumatic dilation or 12 points for surgical\/endoscopic myotomy). The discriminative capacity (concordance statistics 0.68, 95\u200a%CI 0.62\u20130.72) and calibration (slope 1.15, 95\u200a%CI 0.87\u20131.40) were shown. Decision curve analysis demonstrated its clinical usefulness. Patients were categorized into low (0\u20138 points; estimated risk of clinical failure &lt;\u200a5\u200a%) and high risk (9\u201322 points; \u2265\u200a5\u200a%) groups. The proportions of clinical failure for the categories were stratified according to the mid-term outcomes (log-rank test, P\u200a&lt;\u200a0.001).<\/jats:p><jats:p>\n          Conclusions\u2002This risk scoring system can predict the clinical failure of POEM preoperatively and provide useful information when making treatment decisions.<\/jats:p>","DOI":"10.1055\/a-1876-7554","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T23:21:25Z","timestamp":1655335285000},"page":"217-224","source":"Crossref","is-referenced-by-count":11,"title":["Risk scoring system for the preprocedural prediction of the clinical failure of peroral endoscopic myotomy: a multicenter case\u2013control study"],"prefix":"10.1055","volume":"55","author":[{"given":"Hirofumi","family":"Abe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinwa","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7766-3724","authenticated-orcid":false,"given":"Hiroki","family":"Sato","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan"},{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4107-9264","authenticated-orcid":false,"given":"Yuto","family":"Shimamura","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Shiota","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology & Hepatology, Nagasaki University Hospital, Nagasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiaki","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7494-6347","authenticated-orcid":false,"given":"Hiroyuki","family":"Sakae","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Ominami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2827-931X","authenticated-orcid":false,"given":"Yoshitaka","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Tatsuta","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Aomori, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Ikebuchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, Yonago, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Yokomichi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Yamanashi, Yamanashi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.14309\/ajg.0000000000000731","article-title":"ACG clinical guidelines: diagnosis and management of achalasia","volume":"115","author":"M F Vaezi","year":"2020","journal-title":"Am J Gastroenterol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1055\/s-0029-1244080","article-title":"Peroral endoscopic myotomy (POEM) for esophageal achalasia","volume":"42","author":"H Inoue","year":"2010","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/S2468-1253(20)30296-X","article-title":"Efficacy of surgical or endoscopic treatment of idiopathic achalasia: a systematic review and network meta-analysis","volume":"6","author":"P Mundre","year":"2021","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1016\/j.gie.2019.11.020","article-title":"Peroral endoscopic myotomy for achalasia: a prospective multicenter study in Japan","volume":"91","author":"H Shiwaku","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.gie.2019.07.036","article-title":"A risk-scoring system to predict clinical failure for patients with achalasia after peroral endoscopic myotomy","volume":"91","author":"X Y Liu","year":"2020","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.gie.2020.06.028","article-title":"Development of a preoperative risk-scoring system for predicting poor responders to peroral endoscopic myotomy","volume":"93","author":"S Urakami","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/0016-5085(92)91428-7","article-title":"Predictors of outcome in patients with achalasia treated by pneumatic dilation","volume":"103","author":"V F Eckardt","year":"1992","journal-title":"Gastroenterology"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"W1","DOI":"10.7326\/M14-0698","article-title":"Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): Explanation and elaboration","volume":"162","author":"K G Moons","year":"2015","journal-title":"Ann Intern Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s10388-017-0589-1","article-title":"Descriptive rules for achalasia of the esophagus, June 2012: 4th edition","volume":"14","author":"Japan Esophageal Society","year":"2017","journal-title":"Esophagus"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/nmo.12477","article-title":"The Chicago classification of esophageal motility disorders, v3.0","volume":"27","author":"P J Kahrilas","year":"2015","journal-title":"Neurogastroenterol Motil"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"e13221","DOI":"10.1111\/nmo.13221","article-title":"Clinicomanometric factors associated with clinically relevant esophagogastric junction outflow obstruction from the sandhill high-resolution manometry system","volume":"30","author":"B G Song","year":"2018","journal-title":"Neurogastroenterol Motil"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1111\/nmo.12446","article-title":"Variant parameter values-as defined by the Chicago criteria-produced by ManoScan and a new system with Unisensor catheter","volume":"27","author":"S Kuribayashi","year":"2015","journal-title":"Neurogastroenterol Motil"},{"key":"ref13","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied logistic regression","author":"D W Hosmer","year":"2013"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1002\/sim.1742","article-title":"Presentation of multivariate data for clinical use: the Framingham Study risk score function","volume":"23","author":"L M Sullivan","year":"2014","journal-title":"Stat Med"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1177\/0272989X06295361","article-title":"Decision curve analysis: a novel method for evaluating prediction models","volume":"26","author":"A J Vickers","year":"2006","journal-title":"Med Decis Making"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"3234","DOI":"10.1007\/s00464-016-5352-5","article-title":"Pre-treatment Eckardt score is a simple factor for predicting one-year peroral endoscopic myotomy failure in patients with achalasia","volume":"31","author":"Y Ren","year":"2017","journal-title":"Surg Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1055\/a-0658-5783","article-title":"The effect of prior treatment on clinical outcomes in patients with achalasia undergoing peroral endoscopic myotomy","volume":"51","author":"Z Q Liu","year":"2019","journal-title":"Endoscopy"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1016\/j.cgh.2017.01.031","article-title":"Efficacy and safety of peroral endoscopic myotomy for treatment of achalasia after failed heller myotomy","volume":"15","author":"S Ngamruengphong","year":"2017","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1053\/j.gastro.2012.12.027","article-title":"Outcomes of treatment for achalasia depend on manometric subtype","volume":"144","author":"W O Rohof","year":"2013","journal-title":"Gastroenterology"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1053\/j.gastro.2010.03.058","article-title":"A unique esophageal motor pattern that involves longitudinal muscles is responsible for emptying in achalasia esophagus","volume":"139","author":"S J Hong","year":"2010","journal-title":"Gastroenterology"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1053\/j.gastro.2008.07.022","article-title":"Achalasia: a new clinically relevant classification by high-resolution manometry","volume":"135","author":"J E Pandolfino","year":"2008","journal-title":"Gastroenterology"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1001\/archsurg.1995.01430060047009","article-title":"Comparison of medical and minimally invasive surgical therapy for primary esophageal motility disorders","volume":"130","author":"M G Patti","year":"1995","journal-title":"Arch Surg"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1056\/NEJMoa1905380","article-title":"Endoscopic or surgical myotomy in patients with idiopathic achalasia","volume":"381","author":"Y B Werner","year":"2019","journal-title":"NEJM"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1876-7554.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:25:56Z","timestamp":1677630356000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1876-7554"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,15]]},"references-count":23,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,2,28]]},"published-print":{"date-parts":[[2023,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1876-7554","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,6,15]]},"published":{"date-parts":[[2022,6,15]]}}}