Enhanced physiological assessment of continence and defecation provided by anorectal high-resolution manometry with pressure topography (AR-HRM) as set out in the London Classification appears to provide improvements over conventional line tracings (CLT). However, evidence demonstrating a significant diagnostic advantage of AR-HRM over CLT is limited. The aim of this study is to investigate whether the inter-rater agreement and/or accuracy for diagnosis of anorectal disorders is different between AR-HRM and CLT. This follows the successful model used to demonstrate the superiority of esophageal HRM for diagnosis of upper GI motility disorders.

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