The Reverse Red-Green-Blue Rule: A Color-Coded Approach for Simplified Achalasia Diagnosis via High-Resolution Manometry
Bibliographic record
Abstract
Background: Achalasia is a rare motility disorder of the esophagus. The diagnosis involves clinical suspicion based on history details and results of high-resolution manometry (HRM) as recommended by the Chicago classification (CCv4.0). Interpreting data obtained through HRM can be complex especially for the novice user. Methods: We propose therefore a color-based algorithm involving the "reversed red-green-blue (RGB)" rule as a simplified way to establish the diagnosis based on colors obtained through the HRM pressure sensors. The rule is based on the simple acknowledgment of the dominant color present in the mid-portion of the HRM figure such that, for type I (classic) achalasia, the blue color illustrates the minimal pressurization and absent peristalsis. In type II (pan-pressurized) achalasia, the green color illustrates pan-esophageal pressurization, while in type III (spastic) achalasia, red color illustrates the spastic contractions. Results: This rule, which we present as a conceptual framework and has not yet been prospectively validated, provides an intuitive tool for clinicians dealing with HRMs diagnosing achalasia. Conclusion: Further studies are required to assess the diagnostic accuracy of this rule, alongside the potential for incorporating such rules into artificial intelligence (AI)-based models for manometric diagnosis of esophageal motility disorders.
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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 | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
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".