Gastric Alimetry® in the management of chronic gastroduodenal disorders: impact to diagnosis and healthcare utilization
Chris Varghese, Charlotte Daker, Alexandria Lim, Gabrielle Sebaratnam, William Xu, Bernard Kean, Chris Cederwall- Gastroenterology
Abstract
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 healthcare utilization following the introduction of Gastric Alimetry into clinical care.
Methods
Consecutive data from two 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. Pre- and post-test health care utilization was reported. A preliminary management framework was established through experiential learning.
Results
50 participants (45 women; median age 30; 19 with gastroparesis, 25 with CNVS, and 7 with FD) underwent Gastric Alimetry testing. One-third of patients had a spectral abnormality (18% dysrhythmic / low-amplitude). Of the remainder, 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 (mean $39,724, SD ± 63,566 vs $19,937, SD ± 35,895, p=0.037).
Conclusion
Gastric Alimetry aided diagnosis and management of patients with chronic gastroduodenal symptoms by enabling phenotype-informed care. The high majority of tests aided management decisions, which was associated with reduced healthcare utilization.