Blinded comparison of esophageal capsule endoscopy versus conventional endoscopy for a diagnosis of Barrett's esophagus in patients with chronic gastroesophageal reflux
| Autor: | Otto S. Lin, William Spaulding, Drew B. Schembre, Michael Gluck, Richard A. Kozarek, Klaus Mergener, Susan E. McCormick, Geoffrey C. Jiranek, Nicoline Lomah, John J. Brandabur, David J. Patterson, Fred Drennan, James E. Bredfeldt, Kamran Ayub |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
medicine.medical_specialty Gastroenterology Capsule Endoscopy Sensitivity and Specificity law.invention Barrett Esophagus Capsule endoscopy law Predictive Value of Tests Internal medicine Positive predicative value Medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Esophagus Prospective cohort study Aged medicine.diagnostic_test business.industry Reflux Middle Aged medicine.disease digestive system diseases Endoscopy medicine.anatomical_structure Predictive value of tests Barrett's esophagus Chronic Disease Gastroesophageal Reflux Esophagoscopy business |
| Zdroj: | Gastrointestinal endoscopy. 65(4) |
| ISSN: | 0016-5107 |
| Popis: | Background Esophageal capsule endoscopy (ECE) is an alternative to EGD for Barrett's esophagus screening. A multicenter study found ECE to be safe, well tolerated, and accurate; however, a post hoc adjudication process was used that may have biased results. Objective To assess the accuracy of ECE for the diagnosis of Barrett's esophagus. Design Prospective and blinded, with no adjudication. Patients Screening patients with chronic gastroesophageal reflux and surveillance patients with known Barrett's esophagus. Interventions ECE followed by EGD in each subject. Main Outcome Measurements Sensitivity, specificity, and positive and negative predictive values of ECE for Barrett's esophagus by using EGD results, with histologic confirmation as the criterion standard. Results Ninety-six subjects were enrolled, of whom 90 (94%) completed the study, including 66 screening and 24 surveillance patients. ECE was 67% sensitive and 84% specific for identifying Barrett's esophagus, diagnosing 14 of 21 cases of biopsy-confirmed Barrett's esophagus. Positive and negative predictive values were 22% and 98%, respectively (calculated for screening patients only). Sensitivity for short- and long-segment Barrett's esophagus was similar. Conclusions Our blinded, unadjudicated study shows that ECE had only moderate sensitivity and specificity for identifying Barrett's esophagus. ECE in its present form is not suitable as a primary screening tool for Barrett's esophagus but may be used in patients unwilling to undergo EGD. Inadequate visualization of the gastroesophageal junction may be the cause of suboptimal ECE accuracy; this may be improved by advances in ingestion protocol and capsule calibration. |
| Databáze: | OpenAIRE |
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