Does reflux monitoring with multichannel intraluminal impedance change clinical decision making?
Does reflux monitoring with multichannel intraluminal impedance change clinical decision making?
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DOI：
10.1097/mpg.0b013e3182078081
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发表时间：
2011-04
影响因子：
2.9
通讯作者：
Nurko S
中科院分区：
文献类型：
--
作者：
Rosen R;Hart K;Nurko S
多通道腔内阻抗与pH（pH-MII）已成为胃食管反流病的评价标准测试，但目前尚不清楚该测试的结果是否会改变临床决策。本研究的目的是确定主治医生根据pH探针结果与MII结果进行临床决策的差异。我们进行了一项前瞻性研究，医生最初获得pH探针结果，并询问他们如何根据这些结果改变患者的临床管理。然后医生们得到了MII的结果，并询问他们的管理将如何改变。然后医生被问到他们是否认为MII影响了他们的临床决策。pH探针结果改变了40%的临床管理，MII结果改变了另外22%的临床管理。临床决策不受pH-MII开启或关闭酸抑制性能的影响。根据pH-MII结果，酸抑制治疗的升级是发生的主要管理变更。将MII添加到标准pH探针中导致约25%的患者的管理发生变化，表明pH-MII在临床实践中可能发挥作用。
Multichannel intraluminal impedance with pH (pH-MII) has become the criterion standard test for the evaluation of gastroesophageal reflux disease, but it is not clear whether the results of this test change clinical decision making. The goal of the present study was to determine the differences in clinical decision making by attending physicians based on the pH probe results versus MII results. We conducted a prospective study in which physicians were initially given pH probe results and asked how they would change the patient’s clinical management based on these results. Physicians were then given the MII results and asked how their management would change. Physicians then were asked whether they believed MII affected their clinical decision making overall. pH probe results changed clinical management 40% of the time and MII results changed clinical management an additional 22% of the time. Clinical decision making was not influenced by the performance of pH-MII on or off acid suppression. The escalation of acid suppression therapy was the main management change that occurred based on the pH-MII results. The addition of MII to the standard pH probe resulted in a change in management in approximately 25% of the patients, suggesting that there may be a role for pH-MII in clinical practice.