{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:06:18Z","timestamp":1791529578658,"version":"4.3.4"},"reference-count":16,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:00:00Z","timestamp":1706140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V112C-088"],"award-info":[{"award-number":["V112C-088"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["MOST 111-2628-B-075-011"],"award-info":[{"award-number":["MOST 111-2628-B-075-011"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Science and Technology, Taiwan","award":["V112C-088"],"award-info":[{"award-number":["V112C-088"]}]},{"name":"Ministry of Science and Technology, Taiwan","award":["MOST 111-2628-B-075-011"],"award-info":[{"award-number":["MOST 111-2628-B-075-011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>High-resolution manometry (HRM) facilitates the detailed evaluation of esophageal motility. In December 2020, Chicago classification (CC) version 4.0 introduced modifications to improve consistency and accuracy. We conducted this study to compare the differences in the interpretations of HRM examinations between CC 3.0 and 4.0. Consecutive HRM records at a Taiwan tertiary medical center, including wet swallows and MRS performed in both supine and sitting positions from October 2019 to May 2021, were retrospectively reviewed and analyzed using both CC versions 3.0 and 4.0. A total of 105 patients were enrolled, and 102 patients completed the exam, while three could not tolerate HRM sitting up. Refractory gastroesophageal reflux disease (GERD) symptoms (n = 65, 63.7%) and dysphagia (n = 37, 36.3%) were the main indications. A total of 18 patients (17.6%) were reclassified to new diagnoses using CC 4.0. Of the 11 patients initially diagnosed with absent contractility, 3 (27.3%) were reclassified as having Type 1 achalasia. Of the 18 patients initially diagnosed with IEM, 6 (33.3%) were reclassified as normal. The incidence of diagnosis changes was similar in both the dysphagia and refractory GERD symptoms groups (21.6% versus 15.3%, p = 0.43). The use of CC 4.0 led to changes in the diagnoses of esophageal motility disease, irrespective of examination indications. Early adoption improves the accuracy of diagnoses and affects patient management.<\/jats:p>","DOI":"10.3390\/diagnostics14030263","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T08:44:07Z","timestamp":1706172247000},"page":"263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Comparison between Chicago Classification Versions 3.0 and 4.0 and Their Impact on Manometric Diagnoses in Esophageal High-Resolution Manometry Cases"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8100-9036","authenticated-orcid":false,"given":"En Xian Sarah","family":"Low","sequence":"first","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Department of Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore 609606, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Po","family":"Wang","sequence":"additional","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Institute of Brain Science, National Yang-Ming University, Taipei 11221, Taiwan"},{"name":"Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 11221, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Cheng","family":"Ye","sequence":"additional","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 11221, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Yi","family":"Liu","sequence":"additional","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1100-6152","authenticated-orcid":false,"given":"Kuan-Yi","family":"Sung","sequence":"additional","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Division of Gastroenterology, Department of Medicine, Fu Jen Catholic University Hospital, Taipei 24352, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-En","family":"Lin","sequence":"additional","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Division of Gastroenterology, Department of Medicine, Taipei City Hospital Chongxing Branch, Taipei 10321, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Liang","family":"Lu","sequence":"additional","affiliation":[{"name":"Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan"},{"name":"Institute of Brain Science, National Yang-Ming University, Taipei 11221, Taiwan"},{"name":"Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei 11221, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1053\/j.gastro.2004.11.007","article-title":"American Gastroenterological Association medical position statement: Clinical use of esophageal manometry","volume":"128","author":"Pandolfino","year":"2005","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2720","DOI":"10.1111\/j.1572-0241.2000.03178.x","article-title":"Application of topographical methods to clinical esophageal manometry","volume":"95","author":"Clouse","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s11894-017-0576-7","article-title":"Chicago Classification of Esophageal Motility Disorders: Lessons Learned","volume":"19","author":"Rohof","year":"2017","journal-title":"Curr. Gastroenterol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1111\/j.1365-2982.2009.01311.x","article-title":"High-resolution manometry in clinical practice: Utilizing pressure topography to classify oesophageal motility abnormalities","volume":"21","author":"Pandolfino","year":"2009","journal-title":"Neurogastroenterol. Motil. Off. J. Eur. Gastrointest. Motil. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1365-2982.2011.01834.x","article-title":"Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography","volume":"24","author":"Bredenoord","year":"2012","journal-title":"Neurogastroenterol. Motil. Off. J. Eur. Gastrointest. Motil. Soc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/nmo.12477","article-title":"The Chicago Classification of esophageal motility disorders, v3.0","volume":"27","author":"Kahrilas","year":"2015","journal-title":"Neurogastroenterol. Motil. Off. J. Eur. Gastrointest. Motil. Soc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e14058","DOI":"10.1111\/nmo.14058","article-title":"Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0(\u00a9)","volume":"33","author":"Yadlapati","year":"2021","journal-title":"Neurogastroenterol. 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Soc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1732","DOI":"10.1016\/0016-5085(92)91428-7","article-title":"Predictors of outcome in patients with achalasia treated by pneumatic dilation","volume":"103","author":"Eckardt","year":"1992","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S0892-1997(02)00097-8","article-title":"Validity and reliability of the reflux symptom index (RSI)","volume":"16","author":"Belafsky","year":"2002","journal-title":"J. Voice"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1046\/j.1365-2036.2003.01576.x","article-title":"A validated symptoms questionnaire (Chinese GERDQ) for the diagnosis of gastro-oesophageal reflux disease in the Chinese population","volume":"17","author":"Wong","year":"2003","journal-title":"Aliment. Pharmacol. 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Dysphagia.","DOI":"10.1007\/s00455-023-10628-4"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/3\/263\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:49:19Z","timestamp":1760104159000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/3\/263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,25]]},"references-count":16,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["diagnostics14030263"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14030263","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,25]]}}}