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Wireless capsule endoscopy in Italy: Adding context-specific data to the review of the evidence from literature

Published online by Cambridge University Press:  21 July 2009

Alessandra Lo Scalzo ,
Marco Ratti ,
Tom Jefferson ,
Fabio Bernardini  and
Marina Cerbo
Alessandra Lo Scalzo
Affiliation:
Agenzia Nazionale per i Servizi Sanitari Regionali (Age.na.s)
Marco Ratti
Affiliation:
Agenzia Nazionale per i Servizi Sanitari Regionali (Age.na.s)
Tom Jefferson
Affiliation:
Agenzia Nazionale per i Servizi Sanitari Regionali (Age.na.s)
Fabio Bernardini
Affiliation:
Agenzia Nazionale per i Servizi Sanitari Regionali (Age.na.s)
Marina Cerbo
Affiliation:
Agenzia Nazionale per i Servizi Sanitari Regionali (Age.na.s)
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Abstract

Objectives: The aim of this study was to assess the evidence of diagnostic accuracy of the wireless capsule for endoscopy (WCE) for the diagnosis of obscure gastrointestinal bleeding (OGIB) and small bowel disease in adults and translate it to the context of the Italian National Health Service.

Methods: We performed a systematic review of secondary and primary literature. We reviewed WCE diagnostic accuracy, safety, economic evaluations for OGIB. Context-specific data about WCE diffusion, costs, appropriateness of WCE use were collected by means of a national survey involving all Italian gastroenterological departments.

Results: We updated the systematic review of the most recent health technology assessment report (2006). Our review shows lack of robust comparative evidence of diagnostic accuracy of WCE. The studies' design do not allow collection of reliable evidence due to the uncertainty surrounding morphological variability of bleeding vascular gut lesions. The national survey reported widespread WCE use and data on appropriateness and costs.

Conclusions: Evidence of WCE diagnostic accuracy is of low quality, and there is a requirement for randomized comparisons. Our findings raise the issue of technology governance and show the importance of an assessment before the technology being widely commercialized.

Keywords

Wireless capsule endoscopyBudget analysisOGIBSmall bowel disease
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 3 , July 2009 , pp. 297 - 304
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1. AGENAS, National Agency for Regional Healthcare. Wireless capsule endoscopy in the diagnosis of the small bowel disease, 2009. http://www.ministerosalute.it/imgs/C_17_pagineAree_1202_listaFile_itemName_3_file.pdf.Google Scholar
2. Adler, DG, Knipschield, M, Cristopher, G, A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin. Gastrointest Endosc. 2004;59:492–498.CrossRefGoogle ScholarPubMed
3. Albert, JG, Martiny, F, Krummenerl, A, et al. Diagnosis of small bowel Crohn's disease: A prospective comparison of capsule endoscopy with magnetic resonance imaging and fluoroscopic enteroclysis. Gut. 2005;54:1721–1727.CrossRefGoogle ScholarPubMed
4. Buchman, AL, Miller, FH, Wallin, A, et al. Videocapsule endoscopy versus barium contrast studies for diagnosis of CD recurrence involving the small intestine. Am J Gatroenterol. 2004;99:2171–2177.CrossRefGoogle ScholarPubMed
5. Caspari, R, Falkenhausen, M, Krautmacher, C, et al. Comparison of capsule endoscopy and magnetic resonance imaging for the detection of polyps of the small intestine in patients with familial adenomatous polyposis or with peutz-jeghers' syndrome. Endoscopy. 2004;36:1054–1059.CrossRefGoogle ScholarPubMed
6. Chong, AK, Taylor, A, Miller, A, et al. Capsule endoscopy vs. push enteroscopy and enteroclysis in suspected small-bowel Crohn's disease. Gastrointest Endosc. 2005;61:255–261.CrossRefGoogle ScholarPubMed
7. Costamagna, G, Shah, S, Riccioni, ME, et al. , A prospective trial comparing small bowel radiographs and wireless capsule endoscopy for suspected small bowel disease. Gastroenterology. 2002;123:999–1005.CrossRefGoogle ScholarPubMed
8. De Leusse, A, Vahedi, K, Edery, J, et al. Capsule endoscopy or push enteroscopy for first-line exploration of obscure gastrointestinal bleeding? Gastroenterology. 2007;132:855–862; quiz 1164–1165.CrossRefGoogle ScholarPubMed
9. Eliakim, R, Suissa, A, Yassin, K, Katz, D, Fischer, D. Wireless capsule video endoscopy compared to barium follow-through and computerised tomography in patients with suspected Crohn's disease–final report. Dig Liver Dis. 2004;36:519–522.CrossRefGoogle ScholarPubMed
10. Gay, G, Delvaux, M, Fassler, I. Outcome of capsule endoscopy in determining indication and route for push-and-pull enteroscopy. Endoscopy. 2006;38:49–58.CrossRefGoogle ScholarPubMed
11. Gölder, SK, Schreyer, AG, Endlicher, E, et al. Comparison of capsule endoscopy and magnetic resonance (MR) enteroclysis in suspected small bowel disease. Int J Colorectal Dis. 2006;21:97–104.CrossRefGoogle ScholarPubMed
12. Hadithi, M, Heine, GD, Jacobs, MA, van Bodegraven, AA, Mulder, CJ. A prospective study comparing wireless capsule endoscopy with double-balloon enteroscopy in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2006;101:52–57.CrossRefGoogle ScholarPubMed
13. Hara, AK, Leighton, AJ, Sharma, VK, Fleischer, DE. Small bowel: Preliminary comparison of capsule endoscopy with barium study and CT. Radiology. 2003;230:260–265.CrossRefGoogle ScholarPubMed
14. Hartmann, D, Schmidt, H, Bolz, G, et al. A prospective two-centre study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding. Gastrointest Endosc. 2005;61:826–832.CrossRefGoogle Scholar
15. KCE. Endoscopie par capsule. Centre Federal d'Expertise des Soins de Santè - KCE; 2006:25B.Google Scholar
16. Li, XB, Ge, ZZ, Dai, J, et al. The role of capsule endoscopy combined with double-balloon enteroscopy in diagnosis of small bowel diseases. Chin Med J (Engl). 2007;120:30–35.CrossRefGoogle ScholarPubMed
17. Marmo, R, Rotondano, G, Piscopo, R, et al. Meta-analysis: Capsule enteroscopy vs. conventional modalities in diagnosis of small bowel diseases. Aliment Pharmacol Ther. 2005;22:595–604.CrossRefGoogle ScholarPubMed
18. Mata, A, Bordas, M, Feu, F, Bianco, MA, Cipolletta, L. Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: A comparative study with push enteroscopy. Aliment Pharmacol Ther. 2004;20:189–194.CrossRefGoogle ScholarPubMed
19. Matsumoto, T, Esaki, M, Moriyama, T, et al. Comparison of capsule endoscopy and enteroscopy with the double-balloon method in patients with obscure bleeding and polyposis. Endoscopy. 2005;37:827–832.CrossRefGoogle ScholarPubMed
20. Moher, D, Cook, DJ, Eastwood, S, et al. Improving the quality of reports of meta-analyses of randomised controlled trial: The QUOROM statement. Lancet. 1999;354:1896–1900.CrossRefGoogle ScholarPubMed
21. Mylonaki, M, Fritscher-Ravens, A, Swain, P. Wireless capsule endoscopy: A comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding. Gut. 2003;52:1122–1126.CrossRefGoogle ScholarPubMed
22. MSAC. M2A(R) capsule endoscopy for the evaluation of obscure gastrointestinal bleeding in adult patients. Medical Services Advisory Committee 2003 (MSAC Application 1507); 2003:159.Google Scholar
23. Nakamura, M, Niwa, Y, Miyahara, R, et al. Preliminary comparison of capsule endoscopy and double-balloon enteroscopy in patients with suspected small-bowel bleeding. Endoscopy. 2006;38:59–66.CrossRefGoogle ScholarPubMed
24. Neu, B, Ell, C, May, A, et al. Capsule endoscopy versus standard tests in influencing management of obscure digestive bleeding: Results from a German multicentre trial. Am J Gastroenterol. 2005;100:1736–1742.CrossRefGoogle Scholar
25. NICE. Wireless capsule endoscopy. For investigation of the small bowel. National Institute for Clinical Excellence. Interventional Procedure Guidance 101.2004. http://www.nice.org.uk.Google Scholar
26. Saperas, E, Dot, J, Videla, S, et al. Capsule endoscopy versus computed tomographic or standard angiography for the diagnosis of obscure gastrointestinal bleeding. Am J Gastroenterol. 2007;102:731–737.CrossRefGoogle ScholarPubMed
27. Saurin, JC, Delvaux, M, Vahedi, K, et al. Clinical impact of capsule endoscopy compared to push enteroscopy: 1 year follow up study. Endoscopy. 2005;37:318–323.CrossRefGoogle ScholarPubMed
28. Schulmann, K, Hollerbach, S, Kraus, K. Feasibility and diagnostic utility of wireless capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes. Am J Gastroenterol. 2005;100:27–37.CrossRefGoogle ScholarPubMed
29. Triester, SL, Leighton, JA, Leontiadis, GI, et al. A meta-analysis of the yield of capsule endoscopy compared to other diagnostic modalities in patients with obscure gastrointestinal bleeding. Am J Gastroenterol. 2005;100:2407–2418.CrossRefGoogle ScholarPubMed
30. Van Gossum, A, Hittelet, A, Schmit, A, Francois, E, Devière, J. A prospective comparative study of push and wireless-capsule enteroscopy in patients with obscure digestive bleeding. Acta Gastroenterol Belg. 2003;66:199–205.Google ScholarPubMed
31. Voderholzer, WA, Beinhoelzl, J, Rogalla, P, et al. Small bowel involvement in Crohn's disease: A prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis. Gut. 2005;54:369–373.CrossRefGoogle ScholarPubMed
32. Whiting, P, Rutjes, AWS, Reitsma, JB, Bossuyt, PMM, Kleijnen, J. The development of QUADAS: A tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;3:25 http://www.biomedcentral.com/1471-2288/3/25.CrossRefGoogle ScholarPubMed
33. Wong, RF, Tuteja, AK, Haslem, DS, et al. Wireless capsule endoscopy compared with standard endoscopy for the evaluation of small-bowel polyps in persons with familial adenomatous polyposis (with video). Gastrointest Endosc. 2006;64:530–537.CrossRefGoogle ScholarPubMed