Insight Analysis.docx

Insight Analysis.docx

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InsightAnalysis

AnorectalManometry

INSIGHT™

Analysis

TheInsightAcquisitionstudypromptstheuserwhenandwheretotakemeasurements.Thereisminimaleditingpostprocedurewhentheseinstructionswereperformedasinstructedduringtheprocedure.

Editingresponsibilitiesinclude:

1.Assessingthatthemeasurementareaisfreeofartifactandofadequatesamplingsize.

2.Checkingcomputeranalysiscursorsonthesqueezepressureandsqueezedurationmeasurementsforaccuracy.

3.Printingwaveforms.Optional

4.Printingreport.

ToBegin

∙ClickontheOpenFileIcon.

∙SelectAnorectalFile.

∙HighlightthepatientfileforeditingandclickonOpen.

∙Thepatientwaveformwillbedisplayed.

RestingPressureStudy

♦UsetheAxisMagnifiertoenlargetheareacontainingtherestingpressurestudy.

♦Changerangetoencompasspressurewithingrapharea.

♦Adjustbaselineifnecessarytoplacetherectalpressureonthex-axisforeachchannel.

♦Reviewrestingwaveformtocheckaccuracyofprobedepthannotation.

∙Correctprobedepthsbydoubleclickingonthedeptheventandchangingdepthappropriatelywithineditingwindow.

∙Clickonprobedepthannotationanddragtocorrectplacementofannotationonwaveformifincorrectlyplaced.

♦Reviewyellowmeasurementboxesforaccuracy.Theyellowboxshouldincludeareasfreeofartifact.

♦

Afterallmeasurementshavebeeneditedfortherestingpressurestudy,clicktheSaveIcon.Thissavesallthechangesyou’vemade.Itisimportanttoperiodicallysavethechangesshouldyourcomputerlosepower.

♦

PrintthissectionofthewaveformbyclickingonthePrinterIcon.

∙ClickonStripchart.

∙ClickonScreen.Thiswillprinttheactualtracingdisplayedonthescreen.

∙ClickFittoPage.

∙ClickPropertiesandsetthepagelayouttoLandscape（thisonlyhastobedonethefirsttime–itwilldefaulttolandscapeforsubsequentprinting）.

∙

ClickOK.

♦ClickontheEntireProcedureIcontodisplaythecompletestudy.

SqueezePressureStudy

♦

UsetheAxisMagnifiertoenlargetheareacontainingthesqueeze

pressurestudy.

♦ClickontheAnalysisIcon.

♦Reviewthesqueezestudywaveformtochecktheaccuracyofprobedepth,annotationsandmeasurementboxes.Theentirecontractionshouldbewithintheyellowmeasurementarea.

♦Measurementcursorsshouldaccuratelyreflect:

oahorizontalbarattheanalrestingpressurebeforetheincreasedsqueezepressure.

oahorizontalbarattherectalbaselineNOTE:

Thislineisoftenhardtovisualizebecauseitisonx-axisline.

oaxatthehighestcontractionpressure.

♦Clickanddraghorizontalanalrestingpressurecursor（ifnecessary）torestingpressurebeforethesqueeze.

Clickanddragcursortorestingpressure

Movingtherestingcursorwillprovideanaccuratesqueezepressure

DurationStudy

♦UsetheAxisMagnifiertoenlargetheareacontainingthesqueeze

durationstudy.

♦

Assesssqueezedurationmeasurementforaccuracyofmeasurementcursors

♦ClickontheanalysisIcon.

♦Clickwithindurationmeasurementtoactivatemeasurement.

♦Checkaccuracyofcursorplacement.Theleftverticalbarshouldbeattheupslopeofthesqueezecontractionandtherightverticalcursorshouldbewherethesqueezepressurefatigues（50%oftheinitialsqueezepressure）.

♦ClicktheSaveIcon.

♦

Printthescreen.

∙ClickonthePrinterIcon.

∙ClickonStripchart.

∙ClickonScreen.

∙ClickonFittoPage.

∙

ClickOK.

♦ClickontheEntireProcedureIcontodisplaythecompletestudy.

RAIRandSensation

♦UsetheAxisMagnifiertoenlargetheareacontainingtheRAIRstudy.

♦CheckaccuracyoftheRAIRmeasurements.

∙BaselinemeasurementplacedbeforefirstRAIRinflation.

∙EntirerelaxationIASshouldbewithintheyellowmeasurementarea.

♦

ClicktheSaveIcon.

♦Printthescreen.

♦

ClickonthePrinterIcon.

∙ClickonStripchart.

∙ClickonScreen.

∙ClickonFittoPage.

∙

ClickOK.

♦ClickontheEntireProcedureIcontodisplaythecompletestudy.

PushStudy

NOTE:

Thismeasurementisusuallyqualitativeandnotmeasured.Itmaybenotedasdecreasedpressure,nochange,orparadoxicalresponse.Ifquantitationisdesired,followthesesteps:

♦UsetheAxisMagnifiertoenlargetheareacontainingthepushpressurestudy.

♦Assessyellowmeasurementareatoensurepushmaneuveriswithinyellowmeasurementarea.

♦Clickanddraghorizontalcursortothelowestpressurewhenthereisanormalresponseortothehighestpressurewhenthereisaparadoxicalresponse.

oAnormalresponsewilldemonstratealowerpressurethantheanalrestingpressureatthatdepth.

♦Printthescreen.

Movecursortolowestpushpressure

SlowInflationSensation

♦UsetheAxismagnifiertoenlargetheareacontainingthesensationstudy

♦Assessannotationsoffirstsensation,urge,andmaximumtoleratedforaccuracy

♦Printthescreen.

♦

ClickonthePrinterIcon.

∙ClickonStripchart.

∙ClickonScreen.

∙ClickonFittoPage.

∙

ClickOK.

♦ClickontheEntireProcedureIcontodisplaythecompletestudy.

Compliance（thisstudyrequirestheuseofStimSenseduringacquisition）

♦UsetheAxisMagnifiertoenlargetheareacontainingtheCompliancestudy.

♦Assessmeasurementareasateachinflation.

♦Measurementshouldbe

inthestimulationballoonchannelonly,30secondsafterinflationwhentherectumhasaccommodatedthevolume.

♦

Printthescreen

♦ClickonthePrinterIcon.

∙ClickonStripchart.

∙ClickonScreen.

∙ClickonFittoPage.

∙ClickOK.

GeneratingaReport

♦ClickonReportonthemenu.

♦ClickonCreateReport.

♦Selecttheprocedurestobeincludedinthereport.

∙ClickonOptionstochangestheparametersreportedforeachprocedureperformed.Simplyselectordeselectthedesiredoption.Thecomputerwilldefaulttoyourlastselections.

♦SelectReportTemplatedesired–thecomputerdefaultstoyourlastselection.

♦ClickOK.

Thereportwillbedisplayed.

♦

Editthereportasdesired.

♦ClickthePrinterIcon（thereportwillbeprinted）.

MeasurementAdjustments

AdjusttheTimeDisplayed

∙Movecursortothetimemenuandclickonarrow

∙

Movethecursortotheappropriatetimeframeandclick

∙OrusetheAxisMagnifiertomagnifythatportionofthewaveformcontainingthestudyofinterest.

ClicktheLastViewtoreturntopreviousscreendisplay

AdjusttheRange

∙

Movethecursortotherangebuttontotheleftofthechannelsandclick

∙Movethecursortothedesiredrangeandclick

∙IftheAllhasacheckmarkbesideittherangewillchangeforallthechannels

∙ToremovetheAllclickonit,clickontherangebuttonagainandthenclickonthedesiredrange（onlythechannelyouchangedwilldisplaythenewrange）

AddaMeasurement

∙

ClickontheAnalysisIcon

∙ClickontheCreateMeasurementIconintheresultsbox

∙Movethecursortothewaveform

∙Holddowntheleftmousebuttoninthemostproximalchannelatthepointwhereyouwishtostartameasurement

∙Whileholdingdownthemousebuttondragtheboxwhichappearsonthescreentotheright（anddownifcreatingameasurementinmorethanonechannel）untiltherightedgeiswhereyouwanttoendthemeasurement

∙Releasethemousebutton（theboxcreatedshouldencompasstheareadesiredforanalysis）

∙TheCreateMeasurementBoxwillappear

∙SelecttheappropriateStudy

∙ClickontheappropriatemeasurementinType

∙thechannelsshouldreflectthesiteswherethesensorsarelocated

∙Adjustprobedepthand/orballoonvolumeifapplicable

∙ClickOK

ChangetheBeginningofaMeasurement

∙Placethecursoronthemeasurementyouwishtochangeandclicktoactivatethemeasurement（adottedlineshouldsurroundthemeasurement）

∙Placethecursorontheleftedgeofthemeasurementbox

（aboxwitharrowswillappear）

∙Holddowntheleftmousebuttonanddragthestartof

themeasurementtotheproperlocation.Releasethemousebutton

ChangetheEndoftheMeasurement

∙

Placethecursorontherightedgeofthemeasurementbox

（aboxwitharrowswillappear）

∙Holddowntheleftmousebuttonanddragtheendofthemeasurementtotheproperlocation.Releasethemousebutton

ChangetheMeasurementParameters

∙Doubleclickonthemeasurement

∙Maketheappropriatechanges

∙ClickOK

DeleteaMeasurement

∙Clickonmeasurementtoactivateit（CAUTION-Makesurethemeasurementyouwishtodeleteistheactivemeasurement.Theactivemeasurementissurroundedbyadottedline.）

∙PressDelete

∙Themeasurementwillbedeleted

Ifyoumakeamistakeandwishtorestorethemeasurementclickontheredobuttononthetopmenu

AddanEvent

∙Placethecursoronthepointwhereyouwishtoaddtheeventandclick

∙

MovethecursortotheCreateEventIconandclick

∙TheListshouldbeAnorectalorAllEvents

∙ClickonNamemenuarrow

∙Movecursortothenameoftheeventyouarecreatingandclick

∙AddanyValuesrequired

∙ClickonOK

MoveanEvent

∙Placethecursorontheeventline

∙Holddowntheleftmousebuttonanddragtheeventlinetothenewlocation

∙Releasethemousebutton

∙Iftheprobedepthneedstobechanged,doubleclickontheevent

∙ChangetheListand/orNameifneededbyclickingonthearrowandselectingthecorrectitem

∙AdjustanyValuesnecessary

∙ClickOK

DeleteanEvent

∙

Placethecursorontheeventline,itwillchangeto

∙

Whenthecursorappearslikethis,doubleclicktobringupthe

ChangeEventBox

∙ClickonDeleteEvent

∙

Theeventwillbedeleted

Ifyoumakeamistakeandwishtorestoretheeventclickonth