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Jornal de Pediatria
On-line version ISSN 1678-4782
VAN OS, E.; DE SCHRYVER, J.; HOUWEN, R. H. J. and TEN, W. E. Tjon A.. Gastroesophageal reflux disease in children: how reliable is the gold standard?. J. Pediatr. (Rio J.) [online]. 2009, vol.85, n.1, pp. 84-86. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572009000100015.
OBJECTIVE: To investigate the causes and degree of interobserver variability in esophageal pH monitoring for the diagnosis of gastroesophageal reflux. METHODS: This retrospective study included all children (n = 72) who underwent pH monitoring during 1 year at Maxima Medical Centre in Veldhoven, the Netherlands. RESULTS: An interobserver variability of 18% was found. Variability was caused by differences in opinion about the duration of registration, doubts about probe position, artifacts and drift of baseline pH. CONCLUSIONS: Most of these problems can be eliminated by posttest calibration and assessment of the pH electrode position. However, a clear definition of monitoring artifacts is lacking. This study shows that mutual agreement in the interpretation of pH studies was fair (kappa coefficient of 0.70).
Keywords : Gastroesophageal reflux; gold standard; children; pH monitoring.