{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T19:40:04Z","timestamp":1774294804260,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T00:00:00Z","timestamp":1496707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subtyping achalasia by high\u2010resolution manometry (<jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>) is clinically relevant as response to therapy and prognosis have shown to vary accordingly. The aim of this study was to assess inter\u2010 and intrarater reliability of diagnosing achalasia and achalasia subtyping in children using the Chicago Classification (<jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content>) V3.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Six observers analyzed 40 pediatric <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> recordings (22 achalasia and 18 non\u2010achalasia) twice by using dedicated analysis software (ManoView 3.0, Given Imaging, Los Angeles, CA, USA). Integrated relaxation pressure (<jats:styled-content style=\"fixed-case\">IRP<\/jats:styled-content>4s), distal contractile integral (<jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content>), intrabolus pressurization pattern (<jats:styled-content style=\"fixed-case\">IBP<\/jats:styled-content>), and distal latency (<jats:styled-content style=\"fixed-case\">DL<\/jats:styled-content>) were extracted and analyzed hierarchically. Cohen's \u03ba (2 raters) and Fleiss\u2019 \u03ba (&gt;2 raters) and the intraclass correlation coefficient (<jats:styled-content style=\"fixed-case\">ICC<\/jats:styled-content>) were used for categorical and ordinal data, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the results of dedicated analysis software only, intra\u2010 and interrater reliability was <jats:italic>excellent<\/jats:italic> and <jats:italic>moderate<\/jats:italic> (\u03ba=0.89 and \u03ba=0.52, respectively) for differentiating achalasia from non\u2010achalasia. For subtyping achalasia, reliability decreased to <jats:italic>substantial<\/jats:italic> and <jats:italic>fair<\/jats:italic> (\u03ba=0.72 and \u03ba=0.28, respectively). When observers were allowed to change the software\u2010driven diagnosis according to their own interpretation of the manometric patterns, intra\u2010 and interrater reliability increased for diagnosing achalasia (\u03ba=0.98 and \u03ba=0.92, respectively) and for subtyping achalasia (\u03ba=0.79 and \u03ba=0.58, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intra\u2010 and interrater agreement for diagnosing achalasia when using <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> and the <jats:styled-content style=\"fixed-case\">CC<\/jats:styled-content> was very good to excellent when results of automated analysis software were interpreted by experienced observers. More variability was seen when relying solely on the software\u2010driven diagnosis and for subtyping achalasia. Therefore, diagnosing and subtyping achalasia should be performed in pediatric motility centers with significant expertise.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13113","type":"journal-article","created":{"date-parts":[[2017,6,6]],"date-time":"2017-06-06T08:50:44Z","timestamp":1496739044000},"source":"Crossref","is-referenced-by-count":20,"title":["Intra\u2010 and interrater reliability of the Chicago Classification of achalasia subtypes in pediatric high\u2010resolution esophageal manometry (<scp>HRM<\/scp>) recordings"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9297-4790","authenticated-orcid":false,"given":"M. M. J.","family":"Singendonk","sequence":"first","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Emma Children's Hospital\/AMC  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Center for Motility and Functional Gastrointestinal Disorders  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Oors","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Emma Children's Hospital\/AMC  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Rommel","sequence":"additional","affiliation":[{"name":"Translational Research Center for Gastrointestinal Diseases University of Leuven  Leuven Belgium"},{"name":"Department of Neurosciences ExpORL University of Leuven  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8112-8414","authenticated-orcid":false,"given":"M. P.","family":"van Wijk","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Emma Children's Hospital\/AMC  Amsterdam The Netherlands"},{"name":"Department of Pediatric Gastroenterology VU University Medical Center  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. A.","family":"Benninga","sequence":"additional","affiliation":[{"name":"Pediatric Gastroenterology and Nutrition Emma Children's Hospital\/AMC  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Nurko","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Center for Motility and Functional Gastrointestinal Disorders  Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. I.","family":"Omari","sequence":"additional","affiliation":[{"name":"Department of Neurosciences ExpORL University of Leuven  Leuven Belgium"},{"name":"Gastroenterology Unit Women's and Children's Health Network  Adelaide SA Australia"},{"name":"School of Medicine Flinders University  Bedford Park SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v6.i4.105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-012-3214-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1020572328777"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.10.057"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-013-0410-6"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-012-0253-9"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01311.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.43"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12397"},{"key":"e_1_2_9_12_1","first-page":"140","article-title":"Pediatric gastrointestinal motility disorders: challenges and a clinical update","volume":"4","author":"Chumpitazi B","year":"2008","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01416.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12029"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12488"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.353"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01532.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4304-9"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2013.19.4.485"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.12.027"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-010-1318-4"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.07.022"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1037\/1082-989X.1.2.150"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.04.017"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01952.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00119.2014"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12613"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.03.058"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.13113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T09:24:42Z","timestamp":1695979482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.13113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,6]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1111\/nmo.13113"],"URL":"https:\/\/doi.org\/10.1111\/nmo.13113","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,6]]},"article-number":"e13113"}}