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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

Leenhardt, R. ; Koulaouzidis, A. LU ; McNamara, D. ; Keuchel, M. ; Sidhu, R. ; McAlindon, M. E. ; Saurin, J. C. ; Eliakim, R. ; Fernandez-Urien Sainz, I. and Plevris, J. N. , et al. (2021) In Clinics and Research in Hepatology and Gastroenterology 45(6).
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Capsule endoscopy, Inflammatory bowel disease, Small bowel bleeding, Small bowel endoscopy
in
Clinics and Research in Hepatology and Gastroenterology
volume
45
issue
6
article number
101637
publisher
Elsevier Masson SAS
external identifiers
  • scopus:85101737512
  • pmid:33662785
ISSN
2210-7401
DOI
10.1016/j.clinre.2021.101637
language
English
LU publication?
yes
id
35078d75-b357-4668-b430-ae9762cfce0f
date added to LUP
2021-12-22 08:31:40
date last changed
2024-06-15 23:02:26
@article{35078d75-b357-4668-b430-ae9762cfce0f,
  abstract     = {{<p>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.</p>}},
  author       = {{Leenhardt, R. and Koulaouzidis, A. and McNamara, D. and Keuchel, M. and Sidhu, R. and McAlindon, M. E. and Saurin, J. C. and Eliakim, R. and Fernandez-Urien Sainz, I. and Plevris, J. N. and Rahmi, G. and Rondonotti, E. and Rosa, B. and Spada, C. and Toth, E. and Houdeville, C. and Li, C. and Robaszkiewicz, M. and Marteau, P. and Dray, X.}},
  issn         = {{2210-7401}},
  keywords     = {{Capsule endoscopy; Inflammatory bowel disease; Small bowel bleeding; Small bowel endoscopy}},
  language     = {{eng}},
  number       = {{6}},
  publisher    = {{Elsevier Masson SAS}},
  series       = {{Clinics and Research in Hepatology and Gastroenterology}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.1016/j.clinre.2021.101637}},
  doi          = {{10.1016/j.clinre.2021.101637}},
  volume       = {{45}},
  year         = {{2021}},
}