Is Capsule Endoscopy Accurate Enough to Screen Cirrhotics for High Risk Varices & Other Lesions? A Blinded Comparison of EGD & PillCam ESO

Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices

“…In Eisen's and Smith's studies, the sensitivity was both as high as 100% [10,15] . The diagnostic specificity of these seven studies varied significantly, the specificity was lowest in Jensen's study, only 8.3%, and the accuracy of capsule for detecting esophageal varices was modest [19] . However, in Lapalus's [14] and Pena's [16] studies, the specificity was both 100%.…”

“…The pooled data of screened patients may be confused by Jensen's study, which had the largest number of patients in the screening studies and with a specificity of 8.3% [19] . In studies with screening/ surveillance patients, the detailed results cannot be extracted, so the pooled data of surveillance patients cannot be obtained.…”

“…Of these, five met our inclusion criteria [10,[14][15][16][17] . Two studies were identified by hand search in DDW 2008 meeting abstracts and reference lists respectively [18,19] . In total, seven studies, involving 446 patients were appropriate for meta-analysis.…”

“…In the seven studies, CE type was PillCam ESO without string and they were all published in English. One study was performed in western Europe [14] , one in Australia [15] , two were international multi-center studies [10,17] and three in the USA [16,18,19] . The patient inclusion/exclusion criteria were all reported in these studies.…”

“…Only in Pena's study, the endoscopists were those with more than 5 years of experience in reading SBCE but no experience in reading ECE [16] . In two studies, ECE images were reviewed by two independent investigators [14,19] , and one investigator in an other five studies [10,19] .…”