The sensitivity of acoustic cough recording relative to intraesophageal pressure recording and patient report during reflux testing.
The sensitivity of acoustic cough recording relative to intraesophageal pressure recording and patient report during reflux testing.
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DOI：
10.1111/nmo.12445
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发表时间：
2014-11
影响因子：
3.5
通讯作者：
Khatwa U
中科院分区：
文献类型：
--
作者：
Rosen R;Amirault J;Heinz N;Litman H;Khatwa U
使用多通道管腔内阻抗和pH（pH-MII）进行反流测试的主要适应症之一是将反流事件与咳嗽等症状相关联。成人和儿童研究表明，使用咳嗽作为模型，患者报告的症状是不准确的。不幸的是，记录咳嗽的食管内压力记录（IEPR）更具侵入性，这限制了其在儿童中的实用性。本研究的主要目的是验证在pH-MII检测期间声学咳嗽记录（ACR）的使用。我们招募了接受pH-MII测试的儿童，以评估咳嗽。我们同时将IEPR和pH-MII导管以及声学记录（ACR）设备放置在每名患者体内。由设盲的研究者对每个24小时ACR、pH-MII和IEPR追踪进行评分。计算每种症状记录方法的敏感性。共检测到2698例咳嗽; 1140例为患者报告（PR），2425例为IEPR，2400例为ACR。PR相对于ACR的敏感性为45.9%，IEPR相对于ACR的敏感性为93.6%。通过ACR识别咳嗽具有很强的评定者间可靠性（κ=0.78）。声学记录是一种在pH-MII测试期间记录咳嗽的无创、灵敏的方法，非常适合儿科人群。
One of the primary indications for reflux testing with multichannel intraluminal impedance with pH (pH-MII) is to correlate reflux events with symptoms such as cough. Adult and pediatric studies have shown, using cough as a model, that patient report of symptoms is inaccurate. Unfortunately, intraesophageal pressure recording (IEPR) to record coughs is more invasive which limits its utility in children. The primary aim of this study is to validate the use of acoustic cough recording (ACR) during pH-MII testing. We recruited children undergoing pH-MII testing for the evaluation of cough. We simultaneously placed IEPR and pH-MII catheters as well as an acoustic recording (ACR) device in each patient. Each 24 hour ACR, pH-MII, and IEPR tracing was scored by blinded investigators. Sensitivities for each method of symptom recording were calculated. 2698 coughs were detected in total; 1140 were patient reported (PR), 2425 were IEPR detected, and 2400 were ACR detected. The sensitivity of PR relative to ACR was 45.9% and the sensitivity of IEPR relative to ACR was 93.6%. There was strong inter-rater reliability (κ=0.78) for the identification of cough by ACR. Acoustic recording is a non-invasive, sensitive method of recording cough during pH-MII testing that is well suited for the pediatric population.
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