More art than science: impedance analysis prone to interpretation error. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Impedance monitoring for reflux evaluation does not have standardized scoring, which can confound interpretation between observers. We investigated the variability of impedance testing interpretation between physicians and computer software. METHODS: Raw impedance data from 38 patients that underwent impedance monitoring at a tertiary referral center between 2008 and 2013 were collected. Two physicians and computer software each analyzed the same impedance dataset for reflux activity and symptom-reflux correlation. RESULTS: Normalized reflux activity interpretations did not differ between physicians and the computer for acid or non-acid reflux. However, for weakly acidic reflux, there was significant difference between physicians (p < 0.01) and between physician and computer (p < 0.01). In analyzing all reflux, significant variability existed between physicians (p < 0.01) but not between physician and computer. Variability in interpretation altered diagnosis in 24 % of patients when comparing between physicians, 18 % of patients when comparing both physicians to the computer, and an additional 24 % of cases when comparing a single physician to the computer. Symptom-reflux correlation differed in 7 % of physician-physician comparisons versus 8 % of computer-physician comparisons. CONCLUSION: Impedance testing analysis is subject to marked variability between physicians and computer software, making impedance prone to interpretation error that can lead to differences in diagnosis and management.

publication date

  • April 16, 2015

Research

keywords

  • Diagnostic Errors
  • Electronic Data Processing
  • Gastroesophageal Reflux

Identity

Scopus Document Identifier

  • 84930085312

Digital Object Identifier (DOI)

  • 10.1007/s11605-015-2809-0

PubMed ID

  • 25876531

Additional Document Info

volume

  • 19

issue

  • 6