Table 3.
Appropriate Quality Measures for Esophageal Manometry
| Category | Appropriate Quality Measure for Esophageal Manometry |
Median Score (min, max) |
|---|---|---|
| Competency | 1. IF esophageal manometry is performed, THEN the technician must be competent to perform esophageal manometry. * |
9 (2,9) |
| 2. IF a physician is considered competent to interpret esophageal manometry, THEN the physician must interpret a minimum number of esophageal manometry studies annually.* |
9 (5,9) | |
| Pre-procedural | 3. IF a patient is referred for esophageal manometry, THEN the patient should have undergone an evaluation for structural abnormalities prior to manometry.+ |
8 (3,9) |
| 4. IF an esophageal manometry is performed, THEN informed consent must be obtained and documented.* |
8 (3,9) | |
| Procedural | 5. IF an esophageal manometry study is performed, THEN a time interval of at least 30 seconds should occur between swallows. |
9 (4,9) |
| 6. IF an esophageal manometry study is performed, THEN at least 10 wet swallows should be attempted. |
9 (6,9) | |
| 7. IF an esophageal manometry study is performed, THEN at least 7 evaluable wet swallows should be included. |
7 (3,9) | |
| Interpretation | 8. IF an esophageal manometry study is interpreted, THEN a complete procedure report should document |
Composite Measure |
| a. Reason for referral | a. 9 (9,9) | |
| b. Clinical diagnosis | b. 9 (9,9) | |
| c. Diagnosis according to formally validated classification scheme* |
c. 9 (5,9) | |
| d. Documentation of formally validated classification scheme used* |
d. 9 (5,9) | |
| e. Summary of results | e. 9 (9,9) | |
| f. Tabulated results including: | f. 9 (6,9) | |
| i. Upper esophageal sphincter activity+ | f(i) 9 (2,9) | |
| ii. Interpretation of esophagogastric junction relaxation |
f(ii) 9 (8,9) | |
| iii. Documentation of pressure inversion point if technically feasible+ |
f(iii) 8.5 (7,9) | |
| iv. Pressurization pattern | f(iv) 9 (7,9) | |
| v. Contractile pattern | f(v) 9 (6,9) | |
| g. Technical limitation (if applicable) + | g. 9 (9,9) | |
| h. Communication to referring provider | h. 9 (8,9) | |
*
Indicates measures ranked with disagreement in Round 1 and discussed during Round 2.
+
Indicates newly proposed measures that were discussed and ranked in Round 2.