Implementation of European Society of Gastrointestinal Endoscopy (ESGE) recommendations for small-bowel capsule endoscopy into clinical practice: Results of an official ESGE survey.
Journal
Endoscopy
ISSN: 1438-8812
Titre abrégé: Endoscopy
Pays: Germany
ID NLM: 0215166
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
pubmed:
29
7
2021
medline:
14
9
2021
entrez:
28
7
2021
Statut:
ppublish
Résumé
We aimed to document international practices in small-bowel capsule endoscopy (SBCE), measuring adherence to European Society of Gastrointestinal Endoscopy (ESGE) technical and clinical recommendations. Participants reached through the ESGE contact list completed a 52-item web-based survey. 217 responded from 47 countries (176 and 41, respectively, from countries with or without a national society affiliated to ESGE). Of respondents, 45 % had undergone formal SBCE training. Among SBCE procedures, 91 % were performed with an ESGE recommended indication, obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia (IDA), and suspected/established Crohn's disease being the commonest and with higher rates of positive findings (49.4 %, 38.2 % and 53.5 %, respectively). A watchful waiting strategy after a negative SBCE for OGIB or IDA was preferred by 46.7 % and 70.3 %, respectively. SBCE was a second-line exam for evaluation of extent of new Crohn's disease for 62.2 % of respondents. Endoscopists adhered to varying extents to ESGE technical recommendations regarding bowel preparation ( > 60 %), use in those with pacemaker holders (62.5 %), patency capsule use (51.2 %), and use of a validated scale for bowel preparation assessment (13.3 %). Of the respondents, 67 % read and interpreted the exams themselves and 84 % classified exams findings as relevant or irrelevant. Two thirds anticipated future increase in SBCE demand. Inability to obtain tissue (78.3 %) and high cost (68.1 %) were regarded as the main limitations, and implementation of artificial intelligence as the top development priority (56.2 %). To some extent, endoscopists follow ESGE guidelines on using SBCE in clinical practice. However, variations in practice have been identified, whose implications require further evaluation.
Sections du résumé
BACKGROUND
We aimed to document international practices in small-bowel capsule endoscopy (SBCE), measuring adherence to European Society of Gastrointestinal Endoscopy (ESGE) technical and clinical recommendations.
METHODS
Participants reached through the ESGE contact list completed a 52-item web-based survey.
RESULTS
217 responded from 47 countries (176 and 41, respectively, from countries with or without a national society affiliated to ESGE). Of respondents, 45 % had undergone formal SBCE training. Among SBCE procedures, 91 % were performed with an ESGE recommended indication, obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia (IDA), and suspected/established Crohn's disease being the commonest and with higher rates of positive findings (49.4 %, 38.2 % and 53.5 %, respectively). A watchful waiting strategy after a negative SBCE for OGIB or IDA was preferred by 46.7 % and 70.3 %, respectively. SBCE was a second-line exam for evaluation of extent of new Crohn's disease for 62.2 % of respondents. Endoscopists adhered to varying extents to ESGE technical recommendations regarding bowel preparation ( > 60 %), use in those with pacemaker holders (62.5 %), patency capsule use (51.2 %), and use of a validated scale for bowel preparation assessment (13.3 %). Of the respondents, 67 % read and interpreted the exams themselves and 84 % classified exams findings as relevant or irrelevant. Two thirds anticipated future increase in SBCE demand. Inability to obtain tissue (78.3 %) and high cost (68.1 %) were regarded as the main limitations, and implementation of artificial intelligence as the top development priority (56.2 %).
CONCLUSIONS
To some extent, endoscopists follow ESGE guidelines on using SBCE in clinical practice. However, variations in practice have been identified, whose implications require further evaluation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
970-980Informations de copyright
European Society of Gastrointestinal Endoscopy. All rights reserved.
Déclaration de conflit d'intérêts
X. Dray is a co-founder of and shareholder in Augmented Endoscopy (from July 2019, ongoing); he has provided consultancy to Norgine (January to December 2020); he holds a patent for a device and method for classifying the quality of digestive capsule endoscopy image. R. Eliakim has provided consultancy to Medtronic (from 2016, ongoing). M. Keuchel has provided consultancy to and received speaker’s fees from Medtronic; he has received a speaker’s fee from Olympus; he is the co-editor of a book on capsule endoscopy. A. Koulaouzidis is a consultant for Jinshan (from March 2021, ongoing); he is a co-director of iCERV (from June 2020, ongoing); he is a co-founder of and a stakeholder in AJM Medicaps (from March 2021, ongoing). S. Panter has provided consultancy for and has received support for research projects from Medtronic. E. Rondonotti has received speaker honoraria from Fujifilm. B. Rosa has provided consultancy for and has received sponsorship from Medtronic (from 2020, ongoing). C. Spada has provided consultancy to Medtronic (from 2017 to 2021). E. Toth has provided consultancy to and received a lecture fee from Medtronic (2017 to 2021) and Norgine 2018 to 2021). H. Beaumont, P. Bhandari, P. Ellul, I. Fernandez-Urien, R. Jover, L.-D. Lazaridis, K. Triantafyllou, and G. Tziatzios, declare no competing interests.