Interobserver agreement in describing video capsule endoscopy findings: A multicentre prospective study

Pezzoli, Alessandro; Cannizzaro, Renato; Pennazio, Marco; Rondonotti, Emanuele; Zancanella, L.; Fusetti, N.; Simoni, Marzia; Cantoni, F.; Melina, Raffaele; Alberani, A; Caravelli, G.; Villa, Federica; Chilovi, F.; Casetti, T.; Iaquinto, Gaetano; D’Imperio, N.; Gullini, S.

doi:10.1016/j.dld.2010.07.007

Cited by 35 publications

(22 citation statements)

References 36 publications

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“…Of course, it would be of interest examine different weights of the included variables between the two types of gastrointestinal bleeding. Furthermore, the study lacks a centralized blinded review of SBCE studies, which is a weakness for a diagnostic tool such as SBCE, which is affected by a sub-optimal inter-observer agreement[ 21 ]. Finally, we were unable to adjust our data for drugs consumption, because many drugs, especially opioids, can slow SBTT.…”

Section: Discussionmentioning

confidence: 99%

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding

Girelli

Soncini

Rondonotti

2017

WJG

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AIMTo define the role of small-bowel transit time in the detection rate of significant small-bowel lesions.METHODSSmall-bowel capsule endoscopy records, prospectively collected from 30 participating centers in the Lombardy Registry from October 2011 to December 2013, were included in the study if the clinical indication was obscure gastrointestinal bleeding and the capsule reached the cecum. Based on capsule findings, we created two groups: P2 (significant findings) and P0-1 (normal/negligible findings). Groups were compared for age, gender, small-bowel transit time, type of instrument, modality of capsule performance (outpatients vs inpatients), bowel cleanliness, and center volume.RESULTSWe retrieved and scrutinized 1,433 out of 2,295 capsule endoscopy records (62.4%) fulfilling the inclusion criteria. Patients were 67 ± 15 years old, and 815 (57%) were males. In comparison with patients in the P0-1 group, those in the P2 group (n = 776, 54%) were older (P < 0.0001), had a longer small-bowel transit time (P = 0.0015), and were more frequently examined in low-volume centers (P < 0.001). Age and small-bowel transit time were correlated (P < 0.001), with age as the sole independent predictor on multivariable analysis. Findings of the P2 group were artero-venous malformations (54.5%), inflammatory (23.6%) and protruding (10.4%) lesions, and luminal blood (11.5%).CONCLUSIONIn this selected, prospectively collected cohort of small-bowel capsule endoscopy performed for obscure gastrointestinal bleeding, a longer small-bowel transit time was associated with a higher detection rate of significant lesions, along with age and a low center volume, with age serving as an independent predictor.

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Section: Discussionmentioning

confidence: 99%

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding

Girelli

Soncini

Rondonotti

2017

WJG

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“…In an Italian study, 75 consecutive video segments of capsule endoscopy were prospectively evaluated by 8 investigators. 1 Agreement with the gold standard of an external investigator was moderate for lesion detection (kappa 0.48) and for final diagnosis (kappa 0.45). Endoscopists with a higher yearly number of capsule endoscopies had a better agreement.…”

Section: Introductionmentioning

confidence: 91%

A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses

et al. 2015

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Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse.Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course.Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P < 0.001, Wilcoxon), and for correct classification of relevance of the lesions from 5.0 (IQR 3) to 7.0 (IQR 3) (P < 0.001), respectively. Improvement was not dependent on experience, profession, SBCE system, or course setting. Previous experience in SBCE was associated with higher baseline scores for correct diagnosis (P < 0.001; Kruskal–Wallis). Additionally, independent nonparametric partial correlation with experience in gastroscopy (rho 0.33) and colonoscopy (rho 0.27) was observed (P < 0.001).A simple ET-CET demonstrated significant improvement of diagnostic skills on completion of formal basic SBCE courses with hands-on training, regardless of preexisting experience, profession, and course setting. Baseline scores for correct diagnoses show a plateau after interpretation of 25 SBCE before courses, supporting this number as a compromise for credentialing. Experience in flexible endoscopy may be useful before attending an SBCE course.

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“…163,164 The Capsule Endoscopy Structured Terminology can be used to report the indications for performing CE and to describe the findings. [165][166][167] Although the Smooth, Protruding lesion Index on Capsule Endoscopy score may have clinically useful applications, 168 it does not appear to be adequately validated and was not recommended.…”

Section: Reporting and Trainingmentioning

confidence: 99%

“…In CE, greater interobserver agreement in describing CE findings was seen among more experienced endoscopists who perform a greater number of CE procedures per year. 167 Specific measures for competency in CE have not yet been developed. A study to determine minimum training requirements, including a structured CE training program with supervised CE interpretation, determined that trainees should perform a minimum of 20 supervised procedures to achieve competence in CE.…”

Section: Reporting and Trainingmentioning

confidence: 99%

Clinical Practice Guidelines for the Use of Video Capsule Endoscopy

et al. 2017

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Interobserver agreement in describing video capsule endoscopy findings: A multicentre prospective study

Cited by 35 publications

References 36 publications

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding

Implications of small-bowel transit time in the detection rate of capsule endoscopy: A multivariable multicenter study of patients with obscure gastrointestinal bleeding

A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses

Clinical Practice Guidelines for the Use of Video Capsule Endoscopy

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