INTRODUCTION Chronic gastroduodenal symptoms are frequently overlapping within existing diagnostic paradigms, and current diagnostic tests are insensitive to underlying pathophysiologies. Gastric Alimetry has emerged as a new diagnostic test of gastric neuromuscular function with time-of-test symptom profiling. This study aimed to assess the impact to diagnosis and health care utilization after the introduction of Gastric Alimetry into clinical care. METHODS Consecutive data of patients from 2 tertiary centers with chronic gastroduodenal symptoms (Rome-IV defined or motility disorder) having integrated care and Gastric Alimetry testing were evaluated. Changes in diagnoses, interventions, and management were quantified. Pretest and posttest health care utilization was reported. A preliminary management framework was established through experiential learning. RESULTS Fifty participants (45 women; median age 30 years; 18 with gastroparesis, 24 with chronic nausea and vomiting syndrome, and 6 with functional dyspepsia) underwent Gastric Alimetry testing. One-third of patients had a spectral abnormality (18% dysrhythmic/low amplitude). Of the remaining patients, 9 had symptoms correlating to gastric amplitude, while 19 had symptoms unrelated to gastric activity. Gastric Alimetry aided management decisions in 84%, including changes in invasive nutritional support in 9/50 cases (18%; predominantly de-escalation). Health care utilization was significantly lower post-Gastric Alimetry testing when compared with the average utilization cost in the year before Gastric Alimetry testing (mean ± SD $39,724 ± 63,566 vs $19,937 ± 35,895, P = 0.037). DISCUSSION Gastric Alimetry aided diagnosis and management of patients with chronic gastroduodenal symptoms by enabling phenotype-informed care. The high majority of results aided management decisions, which was associated with reduced health care utilization.

中文翻译：

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胃容量测定在慢性胃十二指肠疾病治疗中的应用：对诊断和医疗保健利用的影响。

引言慢性胃十二指肠症状在现有的诊断范式中经常重叠，并且当前的诊断测试对潜在的病理生理学不敏感。胃测量法已成为胃神经肌肉功能的一种新诊断测试，具有测试时症状分析功能。本研究旨在评估将胃测量法引入临床护理后对诊断和医疗保健利用的影响。方法 对来自 2 个三级中心的患有慢性胃十二指肠症状（罗马-IV 定义或动力障碍）且接受综合护理和胃测压测试的患者的连续数据进行评估。诊断、干预和管理的变化被量化。报告了测试前和测试后的医疗保健利用率。通过体验式学习，初步建立了管理框架。结果 50 名参与者（45 名女性；中位年龄 30 岁；18 名患有胃轻瘫，24 名患有慢性恶心和呕吐综合征，6 名患有功能性消化不良）接受了胃测量测试。三分之一的患者存在频谱异常（18% 心律失常/低振幅）。其余患者中，9 名患者出现与胃振幅相关的症状，而 19 名患者则出现与胃活动无关的症状。胃测量法有助于 84% 的管理决策，包括 9/50 例中侵入性营养支持的改变（18%；主要是降级）。与胃容量测定测试前一年的平均使用成本相比，胃容量测定测试后的医疗保健利用率显着降低（平均值±SD $39,724 ± 63,566 vs $19,937 ± 35,895，P = 0.037）。讨论胃容量测定通过支持表型知情的护理来帮助诊断和治疗慢性胃十二指肠症状患者。绝大多数结果有助于管理决策，这与医疗保健利用率的降低有关。