Esophageal capsule endoscopy is an alternative to esophagogastroduodenoscopy for Barrett's esophagus screening.
A multicenter study found esophageal capsule endoscopy to be safe, well tolerated, and accurate.
However, a post hoc adjudication process was used that may have biased results.
|Esophageal capsule endoscopy was 67% sensitive|
Dr Otto Lin and colleagues from the USA assessed the accuracy of esophageal capsule endoscopy for the diagnosis of Barrett's esophagus.
The team undertook a prospective and blinded study, with no adjudication.
The researchers enrolled 96 subjects, including 66 screening and 24 surveillance patients.
Of these, 90 completed the study.
The research team screened patients with chronic gastroesophageal reflux, and surveillance patients with known Barrett's esophagus.
The researchers undertook esophageal capsule endoscopy followed by esophagogastroduodenoscopy in each subject.
The team assessed sensitivity, specificity, and positive and negative predictive values of esophageal capsule endoscopy for Barrett's esophagus.
The team used esophagogastroduodenoscopy results, with histologic confirmation as the criterion standard.
Esophageal capsule endoscopy was 67% sensitive, and 84% specific for identifying Barrett's esophagus.
The team diagnosed 14 of 21 cases of biopsy-confirmed Barrett's esophagus.
Positive and negative predictive values were 22% and 98%, respectively.
The researchers found that sensitivity for short- and long-segment Barrett's esophagus was similar.
Dr Lin's team concluded, “Our blinded, unadjudicated study shows that esophageal capsule endoscopy had only moderate sensitivity and specificity for identifying Barrett's esophagus.”
“Esophageal capsule endoscopy in its present form is not suitable as a primary screening tool for Barrett's esophagus but may be used in patients unwilling to undergo esophagogastroduodenoscopy.”
“Inadequate visualization of the gastroesophageal junction may be the cause of suboptimal esophageal capsule endoscopy accuracy.”
“This may be improved by advances in ingestion protocol and capsule calibration.”