{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:19:37Z","timestamp":1778692777860,"version":"3.51.4"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"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","award":["R01 DK137775"],"award-info":[{"award-number":["R01 DK137775"]}],"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":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intrabolus pressure (IBP) reflects the pressure within the esophageal lumen during bolus transit and serves as a physiologic marker of outflow resistance at the esophagogastric junction (EGJ). The lack of a standardized or validated method to measure IBP is a critical limitation for interpreting high resolution manometry (HRM) and identification of clinically relevant EGJ outflow obstruction (EGJOO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Three distinct cohorts, \u201cControls\u201d, Normal motility\u201d, and \u201cconclusive EGJOO\u201d were selected from a prospectively enrolled cohort of adult patients. All patients had at least undergone HRM with impedance (HRIM), and functional lumen impedance probe (FLIP) testing. 4D HRM analysis was performed blinded to clinical characteristics. 4D HRM IBP results were assessed on a per\u2010swallow and also on a per\u2010patient level. Receiver operating curve (ROCs) to assess each metrics prediction of conclusive EGJOO vs. not EGJOO (normal motility and controls) were utilized for the per\u2010swallow analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>33 controls, 35 normal motility, and 15 conclusive EGJOO patients were included. Swallow level analysis was conducted on 156 swallows, 165 swallows, and 61 swallows from each group, respectively. Per\u2010swallow analysis demonstrated differences between conclusive EGJOO, normal motility, and controls for all ten IBP measures (P\u2010values &lt;\u20090.001), with greater IBP measures in conclusive EGJOO than in normal motility and controls. The 1\u2009s max IBP had the greatest AUROC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions &amp; Inferences<\/jats:title>\n                    <jats:p>Standardized measurement of IBP using an optimized method (1\u2010s max IBP) within the 4D\u2010HRM framework with impedance\u2010confirmed bolus tracking and phase\u2010specific measures represents a physiologically grounded and clinically meaningful advance in HRIM interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70320","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T03:51:14Z","timestamp":1776052274000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Addressing Gaps in the Chicago Classification Version 4.0: Defining an Optimal Intrabolus Pressure Measurement on Esophageal Manometry"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1570-6474","authenticated-orcid":false,"given":"Muhammed M.","family":"Alikhan","sequence":"first","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidan D.","family":"Smires","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-2070","authenticated-orcid":false,"given":"Wenjun","family":"Kou","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob M.","family":"Schauer","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Preventive Medicine Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neelesh A.","family":"Patankar","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, McCormick School of Engineering Northwestern University  Evanston Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology Feinberg School of Medicine, Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(91)90010-I"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14193"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.1993.264.3.G407"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00091.2017"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12308"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14423"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003151"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2025.02.013"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2025.01.234"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820969050"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dote.12360"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70320","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.70320","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T13:43:23Z","timestamp":1777470203000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/nmo.70320"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70320","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-01-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70320"}}