A125 ABNORMAL REFLUX IS UNCOMMON IN PATIENTS PRESENTING WITH ISOLATED OROPHARYNGEAL SYMPTOMS
Bibliographic record
Abstract
Abstract Background Gastroesophageal reflux disease (GERD) is often implicated as a potential etiology for various oropharyngeal (OP) symptoms. Although ambulatory reflux monitoring has been recommended by professional societies for the assessment of OP symptoms, it is unclear if objective measures of acid exposure in the esophagus correlate with the presence of these OP symptoms. Aims The aim of this study is to determine the prevalence of abnormal 24-hour pH monitoring in patients presenting with various OP symptoms in our motility unit. Methods A retrospective chart review was performed on all patients referred for 24-hour pH monitoring for the evaluation of OP symptoms to the open-access Clinical Motility Unit at the University Health Network between January 1, 2008 and June 1, 2019. Seven symptom categories were examined including cough, globus, throat discomfort, voice change, dental erosion, altered taste, and sensation of phlegm in the throat. The results of the 24-hour pH monitoring were collected. A test was considered abnormal if while off anti-secretory therapy the overall acid exposure (pH < 4) in the distal esophagus was greater than 4.2% of the total time or if while on anti-secretory therapy the overall acid exposure in the esophagus was greater than 1.2% of the time. Descriptive statistics were performed to analyze the data. Results 384 patients were included in the final analysis. 167 patients (43.5%) presented with cough, 63 (16.4%) with globus, 86 (22.4%) with throat discomfort, 19 (5.9%) with voice changes, 13 (3.4%) with dental erosion, 17 (4.4%) with altered taste and 19 (4.9%) with sensation of phlegm in the throat. Overall, 19.5% of patients presenting with oropharyngeal symptoms had abnormal 24-hour pH monitoring. Abnormal 24-hr pH monitoring was present in 24.6% of those with cough, 15.9% of those with globus, 16.3% of those with throat discomfort, 21.1% of those with voice changes, 23.1% of those with dental erosion, 5.9% of those with altered taste and 10.5% of those with sensation of phlegm in the throat. Conclusions This study demonstrates that only a small proportion of patients with OP symptoms have abnormal gastroesophageal acid reflux based on objective 24-hour pH monitoring. Given these findings, future studies to examine the factors that predict having abnormal 24-hour pH monitoring in patients presenting with OP symptoms will help guide resource management of motility testing to determine which patients would benefit most from this type of evaluation. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".