A172 THE EFFICACY OF TOPICAL LIDOCAINE IN ESOPHAGEAL MANOMETRY AND AMBULATORY PH MONITORING
Bibliographic record
Abstract
Esophageal manometry (EM) and ambulatory pH monitoring (apH) are essential in the evaluation of esophageal motility disorders. Conventionally, topical nasopharyngeal anesthesia is applied to ameliorate the tolerance of these exams. However, there is presently no evidence supporting this practice. To compare the tolerance of EM and apH with and without topical nasopharyngeal lidocaine anesthesia. A prospective study was conducted between January 2017 and September 2018 at our gastrointestinal motility center. All patients who underwent EM or apH and completed a standardized patient survey (distributed routinely to all patients) were included in this study. Within this survey, patients score their overall satisfaction and report any complications (pain, discomfort, nausea, vomiting, coughing, choking or other) they experienced during three exam phases (catheter insertion, exam recording and in patients undergoing apH, at home recording). From January 2017 to June 2018, all patients had a 2% viscous lidocaine hydrochloride solution applied as topical nasopharyngeal anesthesia before EM and apH. After June 2018, we ceased applying any topical anesthesia before these exams. Patient-reported satisfaction scores and complications were compared between these two patient groups. One hundred and seventy-six patient surveys were included. Lidocaine (n=125) and non-lidocaine (n=51) groups were similar in age (56.9 ± 14.0 vs. 59.5 ± 11.6; p=0.27) and gender distributions (66.1% vs. 71.4% female; p=0.52). Patient satisfaction was high and similar between both groups (4.3 ± 1.1 vs. 4.5 ± 0.9 out of 5; p=0.51). The proportion of patients reporting each complication during each exam phase was also similar between both groups. The intensity of pain or discomfort in patients reporting these complications was comparable between both groups in each exam phase. The application of topical lidocaine during EM and apH does not improve patient tolerance or overall satisfaction and there is therefore no evidence to justify its routine use. 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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".