{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:03:35Z","timestamp":1791839015734,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool used to evaluate lower esophageal sphincter (LES) function. EPSIS allows the measurement of intragastric pressure (IGP) during gastric insufflation through esophagogastroduodenoscopy (EGD) and records its pressure waveform. This study aimed to assess the usefulness and applicability of EPSIS as an adjunct diagnostic modality for achalasia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This case\u2013control study was conducted using a database of patients who underwent EGD, barium swallow (BS), high\u2010resolution manometry (HRM), and EPSIS between January 2022 and December 2022. The achalasia (experimental) group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935) consisted of patients with a definitive diagnosis of achalasia. The control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934) consisted of patients with no abnormalities in EGD, BS, or HRM and no abnormal acid reflux confirmed with 24\u2010h pH\u2010impedance monitoring. EPSIS findings were compared between the two groups and characterized by the waveform pattern (uphill or flat), maximum IGP (IGP\u2010Max), pressure difference, and the gradient of the waveform.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients in the achalasia group showed an uphill pattern, in contrast to 21 patients (61.8%) in the control group. IGP\u2010Max demonstrated the best diagnostic accuracy for achalasia, with a cut\u2010off value of 15.8\u2009mmHg (100% sensitivity, 58.8% specificity, and area under the curve [AUC] 0.78). The pressure gradient also demonstrated good diagnostic accuracy, with a cut\u2010off value of 0.40\u2009mmHg\/s (80% sensitivity, 61.8% specificity, and AUC 0.76).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated that EPSIS can be applied as a diagnostic modality in patients with achalasia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.14695","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T20:35:50Z","timestamp":1695933350000},"page":"565-572","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Endoscopic pressure study integrated system for the diagnosis of achalasia"],"prefix":"10.1111","volume":"36","author":[{"given":"Yohei","family":"Nishikawa","sequence":"first","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo 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"}]},{"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":"Marc Julius","family":"Navarro","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa University Koto Toyosu Hospital  Tokyo Japan"},{"name":"Institute of Digestive and Liver Diseases St. Luke's Medical Center  Quezon City 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