TY - JOUR
T1 - Methods of anorectal manometry vary widely in clinical practice
T2 - Results from an international survey
AU - The International Anorectal Physiology Working Party Group (IAPWG)
AU - Carrington, E. V.
AU - Heinrich, H.
AU - Knowles, C. H.
AU - Rao, S. S.
AU - Rao, Satish Sanku Chander
AU - Scott, S. M.
AU - Carrington, Emma
AU - Heinrich, Henriette
AU - Knowles, Charles
AU - Scott, Mark
AU - Heinrich, Henriette
AU - Rao, Satish
AU - Fox, Mark
AU - Altomare, Donato
AU - Bharucha, Adil
AU - Burgell, Rebecca
AU - Chiarioni, Guiseppe
AU - Dinning, Phil
AU - Felt-Bersma, Richelle
AU - Farouk, Ridzuan
AU - Jung, Kee Wook
AU - Myung, Seung Jae
AU - Lembo, Anthony
AU - Malcolm, Alison
AU - Mion, François
AU - Roman, Sabine
AU - Pehl, Christian
AU - Troche, Jose Remes
AU - Reveille, Robert
AU - Vaizey, Carolynne
AU - Whitehead, William
AU - Wong, Rueben K.
N1 - Publisher Copyright:
© 2017 John Wiley & Sons Ltd
PY - 2017/8
Y1 - 2017/8
N2 - Background: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. Methods: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM. Study methodology and performance characteristics between institutions were compared. Key Results: One hundred and seven complete responses were included from 30 countries. Seventy-nine (74%) institutions performed at least two studies per week. Forty-nine centers (47%) applied conventional ARM (≤8 pressure sensors) and 57 (53%) high-resolution ARM (HR-ARM). Specialist centers were most likely to use HR-ARM compared to regional hospitals and office-based practice (63% vs 37%). Most conventional ARM systems used water-perfused technology (34/49); solid-state hardware was more frequently used in centers performing HR-ARM (44/57). All centers evaluated rest and squeeze. There was marked variation in the methods used to report results of maneuvers. No two centers had identical protocols for patient preparation, setup, study, and data interpretation, and no center fully complied with published guidelines. Conclusions & Inferences: There is significant discrepancy in methods for data acquisition, analysis, and interpretation of ARM. This is likely to impact clinical interpretation, transfer of data between institutions, and research collaboration. There is a need for expert international co-operation to standardize ARM.
AB - Background: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. Methods: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM. Study methodology and performance characteristics between institutions were compared. Key Results: One hundred and seven complete responses were included from 30 countries. Seventy-nine (74%) institutions performed at least two studies per week. Forty-nine centers (47%) applied conventional ARM (≤8 pressure sensors) and 57 (53%) high-resolution ARM (HR-ARM). Specialist centers were most likely to use HR-ARM compared to regional hospitals and office-based practice (63% vs 37%). Most conventional ARM systems used water-perfused technology (34/49); solid-state hardware was more frequently used in centers performing HR-ARM (44/57). All centers evaluated rest and squeeze. There was marked variation in the methods used to report results of maneuvers. No two centers had identical protocols for patient preparation, setup, study, and data interpretation, and no center fully complied with published guidelines. Conclusions & Inferences: There is significant discrepancy in methods for data acquisition, analysis, and interpretation of ARM. This is likely to impact clinical interpretation, transfer of data between institutions, and research collaboration. There is a need for expert international co-operation to standardize ARM.
KW - anal manometry
KW - anorectal dysfunction
KW - anorectal manometry
KW - anorectal physiology
KW - constipation
KW - faecal/fecal incontinence
KW - high-resolution anorectal manometry
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U2 - 10.1111/nmo.13016
DO - 10.1111/nmo.13016
M3 - Article
C2 - 28101937
AN - SCOPUS:85022216314
SN - 1350-1925
VL - 29
JO - Neurogastroenterology and Motility
JF - Neurogastroenterology and Motility
IS - 8
M1 - e13016
ER -