{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:31:25Z","timestamp":1753878685996,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,2,23]],"date-time":"2017-02-23T00:00:00Z","timestamp":1487808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32 DK007130"],"award-info":[{"award-number":["T32 DK007130"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Chicago Classification (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) uses high\u2010resolution manometry (<jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>) software tools to designate esophageal motor diagnoses. We evaluated changes in diagnostic designations between two <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> versions, and determined motor patterns not identified by either version.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this observational cohort study of consecutive patients undergoing esophageal <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> over a 6\u2010year period, proportions meeting <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 2.0 and 3.0 criteria were segregated into esophageal outflow obstruction, hypermotility, and hypomotility disorders. Contraction wave abnormalities (<jats:styled-content style=\"fixed-case\">CWA<\/jats:styled-content>), and \u2018normal\u2019 cohorts were recorded. Symptom burden was characterized using dominant symptom intensity and global symptom severity. Motor diagnoses, presenting symptoms, and symptom burden were compared between <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 2.0 and 3.0, and in cohorts not meeting <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Of 2569 eligible studies, 49.9% met <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 2.0 criteria, but only 40.3% met <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 3.0 criteria (<jats:italic>P<\/jats:italic>&lt;.0001). Between <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 2.0 and 3.0, 82.8% of diagnoses were concordant. Discordance resulted from decreasing proportions of hypermotility (4.4%) and hypomotility (9.0%) disorders, and increase in \u2018normal\u2019 designations (13.0%); esophageal outflow obstruction showed the least variation between <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> versions. Symptom burden was higher with <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 3.0 diagnoses (<jats:italic>P<\/jats:italic>\u2264.005) but not with <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 2.0 diagnoses (<jats:italic>P<\/jats:italic>\u2265.1). Within \u2018normal\u2019 cohorts for both <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> versions, <jats:styled-content style=\"fixed-case\">CWA<\/jats:styled-content> were associated with higher likelihood of esophageal symptoms, especially dysphagia, regurgitation, and heartburn, compared to truly normal studies (<jats:italic>P<\/jats:italic>\u2264.02 for each comparison).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Despite lower sensitivity, <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 3.0 identifies esophageal motor disorders with higher symptom burden compared to <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> 2.0. <jats:styled-content style=\"fixed-case\">CWA<\/jats:styled-content>, which are associated with both transit and perceptive symptoms, are not well identified by either version.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13042","type":"journal-article","created":{"date-parts":[[2017,2,23]],"date-time":"2017-02-23T08:32:50Z","timestamp":1487838770000},"source":"Crossref","is-referenced-by-count":11,"title":["Comparison of motor diagnoses by Chicago Classification versions 2.0 and 3.0 on esophageal high\u2010resolution manometry"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-5901","authenticated-orcid":false,"given":"A.","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St Louis MO"},{"name":"Division of Gastroenterology Duke University School of Medicine and Durham Veterans Affairs Medical Center Durham NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Cassell","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St Louis MO"},{"name":"Division of Gastroenterology University of Colorado Denver CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Sainani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St Louis MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St Louis MO"},{"name":"Gastroenterology Department The First Hospital of Jilin University Changchun Jilin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Shahid","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St Louis MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St Louis MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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