Optimisation of the reflux-symptom association statistics for use in XXXX being investigated by 24-hour pH impedance.

@entity1 @entity2749 @entity354
BACKGROUND AND AIM: pH-impedance monitoring is used to diagnose symptomatic @entity354 ( @entity354 ) based on symptom association probability (SAP). Current criteria for calculation of SAP are optimised for heartburn in adults. @entity1 , however, demonstrate a different symptom profile. The aim of the present study was to optimise criteria for calculation of SAP in @entity1 with @entity354 . @entity1 AND METHODS: Ten @entity1 referred for investigation of symptomatic reflux were enrolled. @entity354 episodes were recorded using a pH-impedance probe, which remained in place for 48 hours. During the test, cough, crying, and regurgitation were marked. Impedance recordings were analysed for the occurrence of @entity2749 . SAP for behaviors following reflux episodes was separately calculated for day 1 and day 2 using automated reporting software, which enabled the time window used for SAP calculations to be modified from 15 to 600 seconds. Day-to-day agreement of SAP was assessed by calculating the 95% limits of agreement (mean difference    1.96 standard deviations of differences) and their confidence intervals. RESULTS: The number of @entity354 episodes and symptom episodes reported did not differ from day to day. The best agreement in SAP between the 2 days was found using time intervals of 2 minutes for cough, 5 minutes for crying, and 15 seconds and/or 2 to 5 minutes for regurgitation. CONCLUSIONS: We conclude that the standard 2-minute time interval is appropriate for the investigation of cough and regurgitation symptoms. The day-to-day agreement of SAP for crying was poor using standard criteria, and our results suggest increasing the reflux-symptom association time interval to 5 minutes.
