Document Detail


Esophageal capsule endoscopy in patients with suspected esophageal disease: double blinded comparison with esophagogastroduodenoscopy and assessment of interobserver variability.
MedLine Citation:
PMID:  18058656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND STUDY AIMS: The study aim was to compare the diagnostic yield of capsule endoscopy and esophagogastroduodenoscopy (EGD) in patients with suspected esophageal disease. Secondary aims were to assess interobserver variability of capsule endoscopy readings and safety. PATIENTS AND METHODS: In total, 98 patients (53 men, 53 +/- 13 years) with an indication for EGD were included. The patient population was artificially enriched to include two thirds of patients with abnormal esophageal findings at EGD, which was followed by capsule endoscopy. Capsule recordings were blindly read by three endoscopists, one from the center that recruited the patient and two from the other center. Study outcomes were the findings described on EGD and capsule endoscopy, agreement between EGD and capsule endoscopy for findings, quality of the capsule recording, and interobserver agreement for capsule endoscopy quality and findings. RESULTS: EGD was normal in 34 patients and showed esophageal findings in 62 (esophagitis 28, hiatus hernia 21, varices 21, Barrett's esophagus 11, others 7). Average esophageal transit time of the capsule was 361 +/- 393 seconds. Capsule endoscopy was normal in 36 patients but detected esophagitis in 23, hiatus hernia in 0, varices in 23, Barrett's esophagus in 18, and others in 4. The positive predictive value of capsule endoscopy was 80.0 % and the negative predictive value was 61.1 %. Overall agreement per patient was moderate between EGD and capsule endoscopy for the per-patient (kappa = 0.42) and per-findings (kappa = 0.40) analyses. Interobserver agreement between capsule endoscopy readings was moderate for findings (kappa = 0.39) and quality assessment (kappa = 0.24). No adverse event was observed after either EGD or capsule endoscopy. CONCLUSION: In this study, despite artificial prevalence enrichment, capsule endoscopy showed a moderate sensitivity and specificity in the detection of esophageal diseases.
Authors:
M Delvaux; I S Papanikolaou; I Fassler; H Pohl; W Voderholzer; T Rösch; G Gay
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2007-12-05
Journal Detail:
Title:  Endoscopy     Volume:  40     ISSN:  1438-8812     ISO Abbreviation:  Endoscopy     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-22     Completed Date:  2008-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  16-22     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Digestive Pathology, Hôpitaux de Brabois, CHU de Nancy, France. m.delvaux@chu-nancy.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Capsule Endoscopy / methods*
Double-Blind Method
Duodenoscopy / methods
Endoscopy, Gastrointestinal / methods*
Esophageal Diseases / diagnosis*
Esophageal Neoplasms / diagnosis
Esophageal and Gastric Varices / diagnosis
Esophagoscopy / methods*
Female
Gastroesophageal Reflux / diagnosis
Gastroscopy / methods
Humans
Male
Middle Aged
Observer Variation
Predictive Value of Tests
Probability
Risk Assessment
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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