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DOI: 10.1055/s-0040-1704123
A GUIDE FOR INTERPRETATION OF THE PERTINENCY OF SMALL BOWEL CAPSULE ENDOSCOPY FINDINGS: ANALYSIS OF 8064 ANSWERS OF INTERNATIONAL EXPERTS TO AN ILLUSTRATED SCRIPT QUESTIONNAIRE
Publikationsverlauf
Publikationsdatum:
23. April 2020 (online)
Aims The interpretation of small bowel (SB) capsule endoscopy (CE) findings remains subjective and depends on readers’ opinion and experience. In case of obscure gastrointestinal bleeding (OGIB), the ESGE suggests the use of a score for assessing the pertinency of lesions seen in SB-CE . However, this score (P0-P1-P2) lacks of scientific validation. Moreover, there is currently no evaluation of the pertinency of ulcerative and inflammatory lesions found in CE in patients with suspicion of Crohn´s disease (CD). The aim of this study was to evaluate the pertinency of the most frequent SB-CE findings through an illustrated script questionnaire.
Methods The pertinency of 16 different types of findings was evaluated in three different settings: occult/overt OGIB and suspicion of CD. Each lesion was illustrated four times in the three above-mentioned settings, and with a variable number (n=1/n=2-5/n≥6). In total, the questionnaire consisted of 576 illustrated questions. Fifteen international experts were asked to rate pertinency on a Likert scale from -2 to 2. The lesion pertinency depending on the context and number was considered low (P0), questionable (P1) or high (P2), referring to the following average scores obtained, ≤ -1, between -1 and 1, or ≥1, respectively.
Results The participation rate was 93%. The answers rate was 100%. 8064 answers were analyzed. In case of occult/overt OGIB, the P2 lesions were: angiectasia, superficial and deep ulceration, stenosis, blood or fresh clots. In case of suspicion of CD, the P2 lesions were: superficial and deep ulcerations, and stenosis. These results varied with the number of lesions seen (n=1/n=2-5/n≥6).
Conclusions This study establishes a guide for the evaluation of SB-CE findings pertinency. It represents a step forward for SB-CE interpretation and is intended to be used as a tool for teaching and for academic research.
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