. Author manuscript; available in PMC: 2019 Jul 1.

Published in final edited form as: Am J Gastroenterol. 2018 Apr 24;113(7):980–986. doi: 10.1038/s41395-018-0045-4

Table 4.

Expert Panelist Preference for Non-Invasive Anti-Reflux Interventions

Hypothetical Patient Scenario	Order of Expert Preference
Breakthrough Acid, Large Hiatal Hernia	1. H2RA (92% 1^st choice) 2. TLESR inhibition (77% 2^nd choice) 3. Neuromodulation (84% not preferred) 4. CBT (92% not preferred)
Breakthrough Acid, Small or No Hiatal Hernia	1. H2RA (85% 1^st choice) 2. TLESR inhibition (69% 2^nd choice) 3. Neuromodulation (62% not preferred) 4. CBT (62% not preferred)
Reflux Sensitivity, Large Hiatal Hernia	1. H2RA (38% 1^st choice) 2. Neuromodulation (38% 2^nd choice) 3. TLESR inhibition (46% 3^rd choice) 4. CBT (38% 4^th choice)
Reflux Sensitivity, Small or No Hiatal Hernia	1. CBT (8% 1^st choice) 2. Neuromodulation (46% 2^nd choice) 3. TLESR inhibition (39% not preferred) 4. H2RA (46% not preferred)
Elevated Reflux Burden, Large Hiatal Hernia	1. TLESR inhibition (46% 1^st choice) 2. Neuromodulation (31% 2^nd choice) 3. CBT (31% not preferred) 4. H2RA (70% not preferred)
Elevated Reflux Burden, Small or No Hiatal Hernia	1. TLESR inhibition (62% 1^st choice) 2. Neuromodulation (31% 2^nd choice) 3. CBT (31% 3^rd choice) 4. H2RA (70% not preferred)

Cognitive behavioral therapy (CBT); Histamine-2 receptor antagonist (H2RA), Transient lower esophageal sphincter relaxation (TLESR). Data in parenthesis indicates the preference option (1^st, 2^nd, 3^rd, 4^th or not preferred) with highest agreement among panel.