{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:40:16Z","timestamp":1781588416977,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T00:00:00Z","timestamp":1511222400000},"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":[[2018,4]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Multiple rapid swallows (MRS<\/jats:styled-content>) is a provocative test for assessment of contraction reserve, however reproducibility on repetitive MRS<\/jats:styled-content> is incompletely understood. Our aim was to determine the optimal number of MRS<\/jats:styled-content> sequences for consistent assessment of contraction reserve.<\/jats:p><\/jats:sec>Methods<\/jats:title>One hundred and fifty\u2010nine consecutive patients (79 IEM<\/jats:styled-content> and 80 normal motility) who underwent high\u2010resolution manometers were enrolled. Ten single swallows (SS<\/jats:styled-content>) and 10 MRS<\/jats:styled-content> were performed. Gold standard for evaluation of the contraction reserve was the ratio between the mean DCI<\/jats:styled-content> of 10 MRS<\/jats:styled-content> and the mean DCI<\/jats:styled-content> of 10 SS<\/jats:styled-content> (MRS<\/jats:styled-content>\/SS DCI<\/jats:styled-content> ratio). Rates of false negatives and false positives were calculated for increasing numbers of MRS<\/jats:styled-content> sequences, using either mean DCI<\/jats:styled-content> or the MRS<\/jats:styled-content> with the highest DCI<\/jats:styled-content>.<\/jats:p><\/jats:sec>Key Results<\/jats:title>According to the gold standard, 50 IEM<\/jats:styled-content> and 50 normal motility patients had contraction reserve. With progressively increasing numbers of MRS<\/jats:styled-content> sequences, contraction reserve was detected using mean MRS DCI<\/jats:styled-content> within three and four MRS<\/jats:styled-content> sequences in IEM<\/jats:styled-content> and normal motility respectively, whereas two and three MRS<\/jats:styled-content> sequences were needed using the MRS<\/jats:styled-content> sequence with the highest DCI<\/jats:styled-content>. False positives were much higher with highest DCI<\/jats:styled-content> method compared with mean DCI<\/jats:styled-content>, (22% vs 9% respectively in IEM<\/jats:styled-content>; 24% vs 9% in normal motility) when three MRS<\/jats:styled-content> sequences were considered.<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>At least three MRS<\/jats:styled-content> are needed to reliably assess contraction reserve. The mean DCI<\/jats:styled-content> of the three MRS<\/jats:styled-content> sequences is the best variable to utilize as evidence of contraction reserve.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13253","type":"journal-article","created":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T09:40:27Z","timestamp":1511257227000},"source":"Crossref","is-referenced-by-count":48,"title":["Optimal number of multiple rapid swallows needed during high\u2010resolution esophageal manometry for accurate prediction of contraction reserve"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8475-5464","authenticated-orcid":false,"given":"A.","family":"Mauro","sequence":"first","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano \u2013 Italy Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Savarino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Surgery, Oncology and Gastroenterology University of Padua Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"De Bortoli","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Translational Research and New Technology in Medicine and Surgery University of Pisa Cisanello Hospital Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Tolone","sequence":"additional","affiliation":[{"name":"Division of General and Bariatric Surgery Department of Surgery Second University of Naples Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano \u2013 Italy Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Franchina","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano \u2013 Italy Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-0660","authenticated-orcid":false,"given":"C. P.","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Penagini","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Universit\u00e0 degli Studi di Milano \u2013 Italy Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2016.06.021"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01308293"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01273.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2350-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.289"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12728"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12310"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13071"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12719"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13104"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2012.01971.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2014.10.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2007.03525.x"},{"key":"e_1_2_8_16_1","first-page":"754","article-title":"How many swallows are required to establish reliable esophageal peristaltic parameters in normal subjects? 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