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CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(01): 022-029
DOI: 10.1055/s-0043-1762574
Research Article

Development of a Low-Cost Gastroscope Prototype (GP) for Potential Cost-Effective Gastric Cancer Screening in Prevalent Regions

James Xu
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
2   Department of Internal Medicine, Kaiser Permanente San Francisco Medical Center, University of California-San Francisco, and University of California-Berkeley, United States
,
Mark E. Benson
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Liam M. Granlund
3   Morgridge Institute for Research, Madison, Wisconsin, United States
,
Seth Gehrke 
3   Morgridge Institute for Research, Madison, Wisconsin, United States
,
Dylan Stanfield
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Jennifer Weiss
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Patrick Pfau
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Anurag Soni
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Ben L. Cox
3   Morgridge Institute for Research, Madison, Wisconsin, United States
,
George Petry
3   Morgridge Institute for Research, Madison, Wisconsin, United States
,
Robert A. Swader
3   Morgridge Institute for Research, Madison, Wisconsin, United States
,
Mark Reichelderfer
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Zhanhai Li
4   Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Wisconsin, United States
,
Tenzin Atrukstang
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Nyah Banik
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
,
Kevin W. Eliceiri
3   Morgridge Institute for Research, Madison, Wisconsin, United States
5   Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Wisconsin, United States
,
Deepak V. Gopal
1   Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
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Abstract

Background Screening for gastric cancer is known to be associated with reduced mortality in populations with high prevalence. However, many countries with high prevalence do not screen, with high costs being a significant reason for this.

Aims To describe, develop, and assess the potential for a low-cost gastroscope for early cancer screening and patient risk stratification.

Methods Our interdisciplinary team used both off-the-shelf and fabricated components to create multiple gastroscope prototypes (GP) in iterative fashion based off clinician feedback. Clinician endoscopists were surveyed using Likert scales regarding device potential, video quality, and handling when testing on a GI training device. Video quality comparison to clinically standard high-definition white light endoscopy (HD-WLE) was done using the absolute categorical ratings (ACR) method.

Results A candidate cost-effective GP with clinical potential was developed. Although initial versions were scored as inferior via ACR on all views tested when compared to HD-WLE (p < 0.001), participants agreed the concept may be beneficial (M = 4.52/5, SD = 0.72). In testing improved versions, participants agreed the device had the ability to identify discrete (M = 4.62/5, SD = 0.51) and subtle lesions (M = 4/5, SD = 0.7) but most felt video quality, although improved, was still less than HD-WLE. Sufficiency of maneuverability of device to visualize gastric views was rated as equivocal (M = 2.69/5, SD = 1.25).

Conclusion The presented low-cost gastroscopic devices have potential for clinical application. With further device development and refinement including the possible addition of technologies in telemedicine and artificial intelligence, we hope the GP can help expand gastric cancer screening for populations in need.

Keywords

endoscopy - gastric cancer - screening

Abstract Presented in part as e-Poster/e-Presentation DDW 2020, ASGE Tu 1568-2020.




Publication History

Article published online:
01 March 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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