July 11, 2006
A wireless device that measures the acidity of stomach contents backwashed into the esophagus allows patients to avoid some of the nose pain and throat discomfort associated with the conventional wired monitor used to manage hard-to-treat gastroesophageal reflux disease. However, while the new technology appears be better tolerated, no studies showed that it was better for diagnosing or managing these patients, said David Mark, MD, lead author of a new review of evidence on wireless esophageal pH monitoring for gastroesophageal reflux disease, or GERD.
The systematic review was conducted by the Blue Cross and Blue Shield Association’s Technology Evaluation Center (TEC), which analyzes clinical and scientific evidence to evaluate whether a technology improves health outcomes.
Of the nine studies included in the TEC review, two measured comfort. The more convincing was a randomized study that compared patients assessed with the wireless device with another group assessed with the wired probe. Patients implanted with the wireless device reported chest discomfort more often, but reported greater satisfaction and less interference with daily life activities.
Mark said the TEC review found no studies that convincingly showed wireless pH monitoring is superior to wired technology. The evidence evaluating the effectiveness of the conventional, wired device is limited and weak, Mark said. So when you have evidence of the standard device that is equivocal, it is difficult to say whether the new technology is better at improving patient health, he added.
The study also found that there is no test to double-check the accuracy of the new technology, but after surveying the evidence, Mark’s team concludes that the diagnostic performance seems to be about the same for the wired and wireless monitors.
The review also found a strong technical track record for implanting the wireless probe and getting it to stay in place.
