The validity of suspected blood indicator software in capsule endoscopy: a systematic review and meta-analysis

ABSTRACT

Introduction: Software tools have been developed as capsule endoscopy (CE) reading aids. The suspected blood indicator (SBI) tags possible areas of haemorrhage in the gastrointestinal (GI) tract. This meta-analysis aims to investigate the diagnostic accuracy of SBI in CE.

Areas covered: A systematic literature search was conducted for studies on the use of SBI in CE. Sensitivity, specificity and diagnostic odds ratio (DOR) of SBI in diagnosing GI bleeding was evaluated. 2040 patients from 16 studies underwent 2049 CE examinations. The overall sensitivity of SBI for bleeding or potentially bleeding lesions was 0.553, specificity 0.578, DOR 12.354. The sensitivity of SBI for active bleeding was 0.988, specificity 0.646, DOR 229.89.

Expert commentary: Currently, SBI has limited validity in CE reading. However, in active GI bleeding, it has good sensitivity, supporting its use in the acute setting.

KEYWORDS:

• Capsule endoscopy
• suspected blood indicator
• meta-analysis
• systematic review
• small bowel bleeding
• obscure gastrointestinal bleeding

Acknowledgement

We thank Dr Emanuele Rondonotti for his invaluable critical comments during the final preparation phase of this manuscript. We would like to wholeheartedly thank all authors of included studies who took the time to reply to our queries.

Declaration of interest

A. Koulaouzidis received a grant from Given Imaging/ESGE(2011), research support from SynMed UK, travel support from Dr Falk Pharma UK and is an honoraria and member of the advisory board for Dr Falk Pharma. D. E. Yung received a grant and travel support from Core/Dr Falk Pharma. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.

Notes on contributors

Diana E. Yung

D. E. Yung and A. Koulaouzidis designed the study, performed data collection and wrote up the study. C. Sykes performed data extraction. D. E. Yung performed statistical analyses. All authors reviewed and approved the final version of the manuscript.

Catherine Sykes

D. E. Yung and A. Koulaouzidis designed the study, performed data collection and wrote up the study. C. Sykes performed data extraction. D. E. Yung performed statistical analyses. All authors reviewed and approved the final version of the manuscript.

Anastasios Koulaouzidis

D. E. Yung and A. Koulaouzidis designed the study, performed data collection and wrote up the study. C. Sykes performed data extraction. D. E. Yung performed statistical analyses. All authors reviewed and approved the final version of the manuscript.