{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:10:29Z","timestamp":1781244629692,"version":"3.54.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"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":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Timed barium swallow (TBS) assesses esophageal emptying before and after therapy in patients with achalasia. Our aim was to compare the accuracy of percent change in barium height with traditional absolute cutoff of &lt;5\u00a0cm on post\u2010treatment TBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Consecutive patients with treatment na\u00efve achalasia treated with either PD, HM, or POEM between 1\/2012 and 7\/2017 were eligible for inclusion. The accuracy of percent change in pre\u2010 and post\u2010treatment barium height at 5\u00a0minutes versus an absolute &lt;5\u00a0cm cutoff for assessing treatment response was assessed using the receiver operating curve analysis (ROC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010one patients met the inclusion criteria. The median percent change in barium heights at five minutes in patients who did not improve was 6 percent increase (n\u00a0=\u00a010; mean 10.6) versus 78 percent decrease (n\u00a0=\u00a071; mean 64) in patients who improved (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0001). The AUC for percent change in TBS 5 minutes height was 76% (95% CI 48% to 90%), and a 3% decrease from baseline as a cutoff had a sensitivity of 60% and specificity of 99%. The AUC for post\u2010treatment TBS 5 minutes height was 79% (95% CI 53% to 91%), and the 5\u00a0cm cutoff had a sensitivity of 70% and specificity of 75%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results show that 3% percent improvement in pre\u2010 and post\u2010treatment barium height at 5 minutes rather than absolute cutoff value of &lt;5\u00a0cm on post\u2010treatment TBS is a better indicator of treatment success in achalasia patients. These findings indicate the need for reassessment of tools to identify treatment response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14005","type":"journal-article","created":{"date-parts":[[2020,9,30]],"date-time":"2020-09-30T03:49:02Z","timestamp":1601437742000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Timed barium swallow for assessing long\u2010term treatment response in patients with achalasia: Absolute cutoff versus percent change \u2013 A cross\u2010sectional analytic study"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3688-8243","authenticated-orcid":false,"given":"Wojciech","family":"Blonski","sequence":"first","affiliation":[{"name":"Joy McCann Culverhouse Center for Swallowing Disorders Division of Digestive Diseases and Nutrition University of South Florida Morsani College of Medicine Tampa FL USA <!--Query ID=\"q4\" Text=\"AUTHOR: Please confirm whether all affiliations and corresponding author address have been set correctly.\"-->"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambuj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Research Methodology and Biostatistics Core Office of Research Department of Internal Medicine University of South Florida Morsani College of Medicine Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Radiology University of South Florida Morsani College of Medicine Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel E.","family":"Richter","sequence":"additional","affiliation":[{"name":"Joy McCann Culverhouse Center for Swallowing Disorders Division of Digestive Diseases and Nutrition University of South Florida Morsani College of Medicine Tampa FL USA <!--Query ID=\"q4\" Text=\"AUTHOR: Please confirm whether all affiliations and corresponding author address have been set correctly.\"-->"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.2.9242756"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.370"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.01209.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.6.765"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13522"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-3565(04)00123-5"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.10.015"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.318"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01834.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(92)91428-7"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.402"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doaa087.25"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"e13928","DOI":"10.1111\/nmo.13928","article-title":"The timed barium swallow and its relationship to symptoms in achalasia: analysis of surface area and emptying rate","author":"Sanagapalli S","year":"2020","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.411"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doy071"}],"container-title":["Neurogastroenterology &amp; 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