A guide for assessing the clinical relevance of findings in small bowel capsule endoscopy: analysis of 8064 answers of international experts to an illustrated script questionnaire - 11/11/21
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Highlights |
• | Small bowel capsule endoscopy findings car be categorize as of low (P0) / intermediate (P1) / high (P2) relevance, but this classification is currently based on a low level of knowledge. |
• | The answers of 14 small bowel capsule endoscopy European experts to a 576-question illustrated script questionnaire establishe a guide for the evaluation of relevance of SBCE findings. |
• | Red spots/dots, erythematous patch, phlebectasia, lymphangiectasia and chylous cysts are of low clinical relevance (P0), and may be considered as normal variants in most cases. |
• | In overt or occult OGIB, resultant P2 findings were ‘typical angiectasia’, ‘deep ulceration’, ‘stenosis’, and ‘blood’, whatever their numbers, and ‘superficial ulcerations’ when multiple. |
• | In suspected CD, consensus P2 lesions were ‘deep ulceration’ and ‘stenosis’ whatever their numbers, and ‘aphthoid erosions’ and ‘superficial ulcerations’ when multiple. |
Abstract |
Background and aim |
Although recommended, the P-score used for assessing the pertinence / relevance of findings seen in small bowel (SB) capsule endoscopy (CE) is based on a low level of knowledge. The aim of this study was to evaluate the clinical relevance of the most frequent SBCE findings through an illustrated script questionnaire.
Materials and Methods |
Sixteen types of SBCE findings were illustrated four times each in three different settings (occult and overt obscure gastrointestinal bleeding and suspected Crohn's disease), and with a variable number (n = 1/n = 2–5/n ≥ 6), thus providing a questionnaire with 192 scenarios and 576 illustrated questions. Fifteen international experts were asked to rate the finding's relevance for each question as very unlikely (−2) / unlikely (−1) / doubtful (0) / likely (+1) / very likely (+2). The median score (≤−0.75, between -0.75 and 0.75, or ≥0.75) obtained for each scenario determined a low (P0), intermediate (P1) or high (P2) relevance, respectively.
Results |
8064 answers were analyzed. Participation and completion rates were 93% and 100%, respectively. In overt or occult OGIB, resultant P2 findings were 'typical angiectasia', 'deep ulceration', 'stenosis', and'blood', whatever their numbers, and 'superficial ulcerations' when multiple. While in suspected CD, consensus P2 lesions were 'deep ulceration' and 'stenosis' whatever their numbers, and 'aphthoid erosions' and 'superficial ulcerations' when multiple.
Conclusion |
This study establishes a guide for the evaluation of relevance of SBCE findings. It represents a step forward for SB-CE interpretation and is intended to be used as a tool for teaching and academic research.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Capsule endoscopy, Inflammatory bowel disease, Small bowel bleeding, Small bowel endoscopy
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Vol 45 - N° 6
Articolo 101637- Novembre 2021 Ritorno al numero
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