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Questioning the Value of Esophageal Motility Testing in Chest Pain of Noncardiac Origin

Winslow Engel, MD; John H. Lawrence, MD
Arch Intern Med. 1987;147(2):212. doi:10.1001/archinte.1987.00370020032023.
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To the Editor.  —We would like to call attention to two problems with the article by Chobanian et al1 in a recent issue of the Archives: one is typographical, and the other is substantive.First, the number of abnormal radionuclide transit tests is reported as 17. This number must be 27 if there were indeed 39 patients in this part of the study and the reported sensitivity is 79%.More importantly, the authors do not achieve their stated purpose, which is "to define better the role of the esophagus as a cause of chest pain and to assess the utility of noninvasive and invasive tests of esophageal structure and function." This study does help define the prevalence of esophageal motility disorders among individuals with noncardiac chest pain, and it provides a potentially useful analysis of the test characteristics for video-esophagography and radionuclide transit. To establish that there is


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