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The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis

BACKGROUND AND AIM: Capsule endoscopy (CE) is a non‐invasive diagnostic modality enabling real time video imaging of the gastrointestinal (GI) mucosa. Pan‐enteric capsule endoscopy (PCE) is now able to thoroughly assess the entire GI tract, including for inflammatory bowel disease (IBD). Our aim was...

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Autores principales: Tamilarasan, Aravind Gokul, Tran, Yvonne, Paramsothy, Sudarshan, Leong, Rupert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092087/
https://www.ncbi.nlm.nih.gov/pubmed/36150392
http://dx.doi.org/10.1111/jgh.16007
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author Tamilarasan, Aravind Gokul
Tran, Yvonne
Paramsothy, Sudarshan
Leong, Rupert
author_facet Tamilarasan, Aravind Gokul
Tran, Yvonne
Paramsothy, Sudarshan
Leong, Rupert
author_sort Tamilarasan, Aravind Gokul
collection PubMed
description BACKGROUND AND AIM: Capsule endoscopy (CE) is a non‐invasive diagnostic modality enabling real time video imaging of the gastrointestinal (GI) mucosa. Pan‐enteric capsule endoscopy (PCE) is now able to thoroughly assess the entire GI tract, including for inflammatory bowel disease (IBD). Our aim was to evaluate the diagnostic accuracy of PCEs in IBD. METHODS: We comprehensively searched electronic databases (MEDLINE, SCOPUS, EMBASE, and Cochrane Central Register of Controlled Trials) for studies comparing the diagnostic accuracy of PCE with endoscopic evaluation, intestinal ultrasound or magnetic resonance enterography (MRE). Data were analyzed by calculating forest plots and the use of the I (2) statistic for heterogeneity. RESULTS: Fourteen studies were identified, with seven studies evaluating PCE diagnostic yield in Crohn's disease (CD) and seven studies in ulcerative colitis (UC). In CD, there was a trend to superiority of PCE over MRE and colonoscopy with a pooled odds ratio (OR) of 1.25 (95% CI, 0.85–1.86%) for the detection of CD. This translates to an increased diagnostic yield of 5% and 7% for PCE compared with MRE and colonoscopy, respectively. PCEs had a diagnostic sensitivity for the detection of UC of 93.8% (95% CI, 87.6–97.0%) and a specificity of 69.8% (95% CI, 38.2–89.6%). CONCLUSION: PCEs have a comparable diagnostic yield to colonoscopy and MRE in Crohn's disease. The major difficulty remains standardization of PCE scoring systems and the lack of transmural assessment. In UC, PCE has an excellent diagnostic sensitivity and positive predictive value, but there are limitations to its use including the lack of histologic assessment and poor specificity.
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spelling pubmed-100920872023-04-13 The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis Tamilarasan, Aravind Gokul Tran, Yvonne Paramsothy, Sudarshan Leong, Rupert J Gastroenterol Hepatol Meta‐Analysis BACKGROUND AND AIM: Capsule endoscopy (CE) is a non‐invasive diagnostic modality enabling real time video imaging of the gastrointestinal (GI) mucosa. Pan‐enteric capsule endoscopy (PCE) is now able to thoroughly assess the entire GI tract, including for inflammatory bowel disease (IBD). Our aim was to evaluate the diagnostic accuracy of PCEs in IBD. METHODS: We comprehensively searched electronic databases (MEDLINE, SCOPUS, EMBASE, and Cochrane Central Register of Controlled Trials) for studies comparing the diagnostic accuracy of PCE with endoscopic evaluation, intestinal ultrasound or magnetic resonance enterography (MRE). Data were analyzed by calculating forest plots and the use of the I (2) statistic for heterogeneity. RESULTS: Fourteen studies were identified, with seven studies evaluating PCE diagnostic yield in Crohn's disease (CD) and seven studies in ulcerative colitis (UC). In CD, there was a trend to superiority of PCE over MRE and colonoscopy with a pooled odds ratio (OR) of 1.25 (95% CI, 0.85–1.86%) for the detection of CD. This translates to an increased diagnostic yield of 5% and 7% for PCE compared with MRE and colonoscopy, respectively. PCEs had a diagnostic sensitivity for the detection of UC of 93.8% (95% CI, 87.6–97.0%) and a specificity of 69.8% (95% CI, 38.2–89.6%). CONCLUSION: PCEs have a comparable diagnostic yield to colonoscopy and MRE in Crohn's disease. The major difficulty remains standardization of PCE scoring systems and the lack of transmural assessment. In UC, PCE has an excellent diagnostic sensitivity and positive predictive value, but there are limitations to its use including the lack of histologic assessment and poor specificity. John Wiley and Sons Inc. 2022-10-08 2022-12 /pmc/articles/PMC10092087/ /pubmed/36150392 http://dx.doi.org/10.1111/jgh.16007 Text en © 2022 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Meta‐Analysis
Tamilarasan, Aravind Gokul
Tran, Yvonne
Paramsothy, Sudarshan
Leong, Rupert
The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis
title The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis
title_full The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis
title_fullStr The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis
title_full_unstemmed The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis
title_short The diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: A systematic review and meta‐analysis
title_sort diagnostic yield of pan‐enteric capsule endoscopy in inflammatory bowel disease: a systematic review and meta‐analysis
topic Meta‐Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10092087/
https://www.ncbi.nlm.nih.gov/pubmed/36150392
http://dx.doi.org/10.1111/jgh.16007
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