A novel classification scheme for gastroparesis based on predominant-symptom presentation

Steven P. Harrell, Jamie L. Studts, Gerald W. Dryden, Jennifer Eversmann, Luwa Cai, John Wo

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

AIM: Symptoms of gastroparesis are very diverse. Classifying patients by predominant symptom may improve management strategy. GOAL: To validate a new symptom-predominant classification for gastroparesis using symptom severity and quality-of-life measures. STUDY: Subjects with gastroparesis for >2 months were prospectively enrolled. A physician classified each subject into one of the following: vomiting-predominant, dyspepsia-predominant, or regurgitation- predominant gastroparesis. Subjects also classified themselves independently from the physician. Each subject completed a Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and SF-12v2 Health-Related Quality-Of-Life survey. Receiver operating characteristic curves were constructed with sensitivity and specificity of each PAGI-SYM subscale to differentiate subjects into symptom-predominant subgroups. Area under the curve (AUC) was used to compare the receiver operating characteristic curves. Analysis of variance, Cohen's kappa (κ) statistic, student t test, and Pearson correlation (r) were used. RESULTS: One hundred subjects (87 females, mean 48 y) were enrolled. There was a 78% concordance between physician and subject's classification of gastroparesis with substantial correlation (κ=0.64). PAGI-SYM nausea/vomiting subscale (AUC=0.79) and PAGI-SYM heartburn/ regurgitation subscale (AUC=0.73) were the best in differentiating subjects into vomiting-predominant and regurgitation-predominant gastroparesis, respectively. No subscale was adequate to differentiate dyspepsia-predominant gastroparesis. SF-12v2 total scores significantly correlated with worsening of the total PAGI-SYM scores (r=-0.339 to -0.600, all P

Original languageEnglish (US)
Pages (from-to)455-459
Number of pages5
JournalJournal of Clinical Gastroenterology
Volume42
Issue number5
DOIs
StatePublished - May 2008
Externally publishedYes

Fingerprint

Gastroparesis
Area Under Curve
Vomiting
Dyspepsia
Physicians
ROC Curve
Quality of Life
Heartburn
Nausea
Analysis of Variance
Students
Sensitivity and Specificity

Keywords

  • Dyspepsia
  • Gastroparesis
  • Quality of life
  • Regurgitation
  • Vomiting

ASJC Scopus subject areas

  • Gastroenterology

Cite this

A novel classification scheme for gastroparesis based on predominant-symptom presentation. / Harrell, Steven P.; Studts, Jamie L.; Dryden, Gerald W.; Eversmann, Jennifer; Cai, Luwa; Wo, John.

In: Journal of Clinical Gastroenterology, Vol. 42, No. 5, 05.2008, p. 455-459.

Research output: Contribution to journalArticle

Harrell, Steven P. ; Studts, Jamie L. ; Dryden, Gerald W. ; Eversmann, Jennifer ; Cai, Luwa ; Wo, John. / A novel classification scheme for gastroparesis based on predominant-symptom presentation. In: Journal of Clinical Gastroenterology. 2008 ; Vol. 42, No. 5. pp. 455-459.
@article{014c1248e6d1449fa60a4c0b711b5d13,
title = "A novel classification scheme for gastroparesis based on predominant-symptom presentation",
abstract = "AIM: Symptoms of gastroparesis are very diverse. Classifying patients by predominant symptom may improve management strategy. GOAL: To validate a new symptom-predominant classification for gastroparesis using symptom severity and quality-of-life measures. STUDY: Subjects with gastroparesis for >2 months were prospectively enrolled. A physician classified each subject into one of the following: vomiting-predominant, dyspepsia-predominant, or regurgitation- predominant gastroparesis. Subjects also classified themselves independently from the physician. Each subject completed a Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and SF-12v2 Health-Related Quality-Of-Life survey. Receiver operating characteristic curves were constructed with sensitivity and specificity of each PAGI-SYM subscale to differentiate subjects into symptom-predominant subgroups. Area under the curve (AUC) was used to compare the receiver operating characteristic curves. Analysis of variance, Cohen's kappa (κ) statistic, student t test, and Pearson correlation (r) were used. RESULTS: One hundred subjects (87 females, mean 48 y) were enrolled. There was a 78{\%} concordance between physician and subject's classification of gastroparesis with substantial correlation (κ=0.64). PAGI-SYM nausea/vomiting subscale (AUC=0.79) and PAGI-SYM heartburn/ regurgitation subscale (AUC=0.73) were the best in differentiating subjects into vomiting-predominant and regurgitation-predominant gastroparesis, respectively. No subscale was adequate to differentiate dyspepsia-predominant gastroparesis. SF-12v2 total scores significantly correlated with worsening of the total PAGI-SYM scores (r=-0.339 to -0.600, all P",
keywords = "Dyspepsia, Gastroparesis, Quality of life, Regurgitation, Vomiting",
author = "Harrell, {Steven P.} and Studts, {Jamie L.} and Dryden, {Gerald W.} and Jennifer Eversmann and Luwa Cai and John Wo",
year = "2008",
month = "5",
doi = "10.1097/MCG.0b013e31815ed084",
language = "English (US)",
volume = "42",
pages = "455--459",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - A novel classification scheme for gastroparesis based on predominant-symptom presentation

AU - Harrell, Steven P.

AU - Studts, Jamie L.

AU - Dryden, Gerald W.

AU - Eversmann, Jennifer

AU - Cai, Luwa

AU - Wo, John

PY - 2008/5

Y1 - 2008/5

N2 - AIM: Symptoms of gastroparesis are very diverse. Classifying patients by predominant symptom may improve management strategy. GOAL: To validate a new symptom-predominant classification for gastroparesis using symptom severity and quality-of-life measures. STUDY: Subjects with gastroparesis for >2 months were prospectively enrolled. A physician classified each subject into one of the following: vomiting-predominant, dyspepsia-predominant, or regurgitation- predominant gastroparesis. Subjects also classified themselves independently from the physician. Each subject completed a Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and SF-12v2 Health-Related Quality-Of-Life survey. Receiver operating characteristic curves were constructed with sensitivity and specificity of each PAGI-SYM subscale to differentiate subjects into symptom-predominant subgroups. Area under the curve (AUC) was used to compare the receiver operating characteristic curves. Analysis of variance, Cohen's kappa (κ) statistic, student t test, and Pearson correlation (r) were used. RESULTS: One hundred subjects (87 females, mean 48 y) were enrolled. There was a 78% concordance between physician and subject's classification of gastroparesis with substantial correlation (κ=0.64). PAGI-SYM nausea/vomiting subscale (AUC=0.79) and PAGI-SYM heartburn/ regurgitation subscale (AUC=0.73) were the best in differentiating subjects into vomiting-predominant and regurgitation-predominant gastroparesis, respectively. No subscale was adequate to differentiate dyspepsia-predominant gastroparesis. SF-12v2 total scores significantly correlated with worsening of the total PAGI-SYM scores (r=-0.339 to -0.600, all P

AB - AIM: Symptoms of gastroparesis are very diverse. Classifying patients by predominant symptom may improve management strategy. GOAL: To validate a new symptom-predominant classification for gastroparesis using symptom severity and quality-of-life measures. STUDY: Subjects with gastroparesis for >2 months were prospectively enrolled. A physician classified each subject into one of the following: vomiting-predominant, dyspepsia-predominant, or regurgitation- predominant gastroparesis. Subjects also classified themselves independently from the physician. Each subject completed a Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and SF-12v2 Health-Related Quality-Of-Life survey. Receiver operating characteristic curves were constructed with sensitivity and specificity of each PAGI-SYM subscale to differentiate subjects into symptom-predominant subgroups. Area under the curve (AUC) was used to compare the receiver operating characteristic curves. Analysis of variance, Cohen's kappa (κ) statistic, student t test, and Pearson correlation (r) were used. RESULTS: One hundred subjects (87 females, mean 48 y) were enrolled. There was a 78% concordance between physician and subject's classification of gastroparesis with substantial correlation (κ=0.64). PAGI-SYM nausea/vomiting subscale (AUC=0.79) and PAGI-SYM heartburn/ regurgitation subscale (AUC=0.73) were the best in differentiating subjects into vomiting-predominant and regurgitation-predominant gastroparesis, respectively. No subscale was adequate to differentiate dyspepsia-predominant gastroparesis. SF-12v2 total scores significantly correlated with worsening of the total PAGI-SYM scores (r=-0.339 to -0.600, all P

KW - Dyspepsia

KW - Gastroparesis

KW - Quality of life

KW - Regurgitation

KW - Vomiting

UR - http://www.scopus.com/inward/record.url?scp=42449112144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42449112144&partnerID=8YFLogxK

U2 - 10.1097/MCG.0b013e31815ed084

DO - 10.1097/MCG.0b013e31815ed084

M3 - Article

C2 - 18344894

AN - SCOPUS:42449112144

VL - 42

SP - 455

EP - 459

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 5

ER -