{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:58:42Z","timestamp":1783353522625,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,19]],"date-time":"2024-05-19T00:00:00Z","timestamp":1716076800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,5,19]],"date-time":"2024-05-19T00:00:00Z","timestamp":1716076800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007197","name":"U.S. Public Health Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007197","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Functional lumen imaging probe (FLIP) panometry evaluates esophageal motility, including the contractile response to distension, that is, secondary peristalsis. Impaired\/disordered contractile response (IDCR) is an abnormal, but nonspecific contractile response that can represent either hypomotility or spastic motor disorders on high\u2010resolution manometry (HRM). We hypothesized that FLIP pressure could be incorporated to clarify IDCR and aimed to determine its utility in a cohort of symptomatic esophageal motility patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      173 adult patients that had IDCR on FLIP panometry and HRM with a conclusive Chicago Classification v4.0 (CCv4.0) diagnosis were included and analyzed as development (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009118) and validation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955) cohorts. FLIP pressure values were assessed for prediction of either hypomotility or spasm, defined on HRM\/CCv4.0.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      HRM\/CCv4.0 diagnoses were normal motility in 48 patients (28%), \u201chypomotility\u201d (ineffective esophageal motility, absent contractility, or Type I or II achalasia) in 89 (51%), and \u201cspasm\u201d (Type III achalasia, distal esophageal spasm, or hypercontractile esophagus) in 36 (21%). The pressure at esophagogastric junction\u2010distensibility index (DI) (60\u2009mL) was lower in hypomotility (median [interquartile range] 34 [28\u201342] mmHg) than in spasm (49 [40\u201362] mmHg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and had an area under the receiver operating characteristic curve of 0.80 (95% CI 0.73\u20130.88) for hypomotility and 0.76 (0.69\u20130.83) for spasm. For \u201cspasm\u201d on HRM, a threshold FLIP pressure of &gt;35\u2009mmHg provided 90% sensitivity (47% specificity) while &gt;55\u2009mmHg provided 93% specificity (40% sensitivity).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion &amp; Inferences<\/jats:title>\n                    <jats:p>Pressure on FLIP panometry can help clarify the significance of IDCR, with low\u2010pressure IDCR associated with hypomotility and high\u2010pressure IDCR suggestive of spastic motor disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.14818","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T01:25:37Z","timestamp":1716168337000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Discriminating \u201cimpaired\u201d from \u201cdisordered\u201d contractile response on FLIP panometry by utilizing pressure measurement"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5352-587X","authenticated-orcid":false,"given":"Leya","family":"Chambo","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Kenneth C. Griffin Esophageal Center of Northwestern Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Kenneth C. Griffin Esophageal Center of Northwestern Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourav","family":"Halder","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Kenneth C. Griffin Esophageal Center of Northwestern Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8260-1250","authenticated-orcid":false,"given":"Peter J.","family":"Kahrilas","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Kenneth C. Griffin Esophageal Center of Northwestern Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vani","family":"Konda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Baylor University Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine, Kenneth C. Griffin Esophageal Center of Northwestern Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001532"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2019.06.039"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14192"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.06.040"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000734"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14193"},{"key":"e_1_2_10_9_1","first-page":"S\u2010344","article-title":"FLIP panometry helps identify clinically relevant esophagogastric junction outflow obstruction per Chicago Classification v4.0","volume":"162","author":"Carlson DA","year":"2022","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2020.03.040"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-023-10419-w"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14540"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.07.042"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14116"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13240"},{"key":"e_1_2_10_16_1","article-title":"Achalasia subtypes can be identified with functional luminal imaging probe (FLIP) panometry using a supervised machine learning process","author":"Carlson DA","year":"2020","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14638"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.454"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04212.x"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.35.11.1523"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.36.4.499"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000773"},{"key":"e_1_2_10_23_1","article-title":"Heterogeneity of primary and secondary peristalsis in systemic sclerosis: a new model of \"scleroderma esophagus\"","author":"Carlson DA","year":"2021","journal-title":"Neurogastroenterol Motil"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm21239"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14134"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.12.027"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14182"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14818","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.14818","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.14818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:55:07Z","timestamp":1773291307000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.14818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,19]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/nmo.14818"],"URL":"https:\/\/doi.org\/10.1111\/nmo.14818","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,19]]},"assertion":[{"value":"2024-03-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14818"}}