{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:47:25Z","timestamp":1788850045375,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["R01 DK092217\u201004 (PI: Pandolfino)"],"award-info":[{"award-number":["R01 DK092217\u201004 (PI: Pandolfino)"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Supragastric belching (SGB) and rumination are behavioral disorders associated with proton pump inhibitor (PPI) non\u2010response and can be diagnosed using multichannel intraluminal impedance\u2010pH (MII\u2010pH) and post\u2010prandial high\u2010resolution impedance manometry (PPHRIM). This pilot study compared diagnostic yield and inter\u2010rater agreement for SGB and rumination using MII\u2010pH and PPHRIM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three esophageal physiologists performed blinded interpretations of MII\u2010pH and PPHRIM in 22 PPI non\u2010responders. Raters selected from 4 diagnostic impressions (normal, GERD, behavioral disorders, GERD+behavioral disorders) without clinical context. Primary outcomes were diagnostic impressions compared against clinical gold standard impression, between raters, and between test modalities. Following a 28\u2010month wash\u2010out period, raters re\u2010interpreted MII\u2010pH with clinical context and under consensus definition of diagnostic criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Compared to gold standard, rater accuracy for presence of behavioral disorders ranged from 45 to 77% on MII\u2010pH and 45\u201359% on PPHRIM. On MII\u2010pH, inter\u2010rater agreement was fair for diagnosis (\u01380.32, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and suboptimal for presence of behavioral disorders (\u01380.13, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.14). On PPHRIM, inter\u2010rater agreement was suboptimal for both diagnosis (\u01380.03, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.34) and presence of a behavioral disorder (\u0138\u20100.22, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.96). Inter\u2010rater agreement improved in <jats:italic>post hoc<\/jats:italic> MII\u2010pH interpretations. Rumination was more frequently identified on PPHRIM (23, 35%) compared to MII\u2010pH (7, 11%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Diagnostic accuracy and inter\u2010rater agreement are higher for MII\u2010pH than PPHRIM, and behavioral disorders are more frequently identified on PPHRIM. Identifying behavioral disorders on MII\u2010pH and PPHRIM has implications for clinical evaluation of PPI non\u2010response; clinical context is essential for accurate study interpretation. Further work is needed to standardize definitions and interpretations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14106","type":"journal-article","created":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T11:37:35Z","timestamp":1615289855000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Diagnostic yield and reliability of post\u2010prandial high\u2010resolution manometry and impedance\u2010ph for detecting rumination and supragastric belching in PPI non\u2010responders"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8137-9782","authenticated-orcid":false,"given":"Kelli","family":"DeLay","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical Campus Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology and Hepatology Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7798-7638","authenticated-orcid":false,"given":"Sabine","family":"Roman","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lyon Hospices Civils de Lyon, Digestive Physiology, Hopital E Herriot Lyon France"},{"name":"Universit\u00e9 de Lyon, Lyon I University, Digestive Physiology Lyon France"},{"name":"Universit\u00e9 de Lyon, Inserm U1032 LabTAU Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3388-0660","authenticated-orcid":false,"given":"C. Prakash","family":"Gyawali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology Division of Gastroenterology University of Padua Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Tye","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Gastroenterology and Hepatology Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kaizer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical Campus Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7872-2033","authenticated-orcid":false,"given":"Rena","family":"Yadlapati","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Colorado Anschutz Medical Campus Aurora Colorado USA"},{"name":"UCSD Center for Esophageal Diseases Division of Gastroenterology University of California San Diego San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.12.014"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2013.06.005"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.05.049"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/00912700122009953"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.03.063"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coph.2018.09.001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-019-0704-7"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.428"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-314722"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0045-4"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12920"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.09.011"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2019.12.002"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02119.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00711.x"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13067"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00427.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(94)90815-X"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2011.605467"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.giec.2014.06.002"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12024"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12954"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1017992808762"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.670"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.01.016"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.07.049"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm15002"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000295"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.165"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.06.034"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12974"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13104"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04742.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0044-5"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.1.158"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00787-018-1153-9"}],"container-title":["Neurogastroenterology &amp; 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