BACKGROUND: Acute upper gastrointestinal (GI) hemorrhage is a common emergency department (ED) presentation whose severity ranges from benign to life-threatening and the best tool to risk stratify the disease is an upper endoscopy, either by scope or by capsule, a procedure performed almost exclusively by gastroenterologists. Unfortunately, on-call gastroenterology specialists are often unavailable, and emergency physicians (EPs) currently lack an alternative method to endoscopically visualize a suspected acute upper GI hemorrhage. Recent reports have shown that video capsule endoscopy is well tolerated by ED patients and has similar sensitivity and specificity to endoscopy for upper GI hemorrhage. OBJECTIVES: The study objective was to determine if EPs can detect upper GI bleeding on capsule endoscopy after a brief training session. METHODS: A survey study was designed to demonstrate video examples of capsule endoscopy to EPs and determine if they could detect upper GI bleeding after a brief training session. All videos were generated from a prior ED-based study on patients with suspected acute upper GI hemorrhage. The training session consisted of less than 10 minutes of background information and capsule endoscopy video examples. EPs were recruited at the American College of Emergency Physicians Scientific Assembly in Denver, Colorado, from October 8, 2012, to October 10, 2012. Inclusion criteria included being an ED resident or attending physician and the exclusion criteria included any formal endoscopy training. The authors analyzed the agreement between the EPs and expert adjudicated capsule endoscopy readings for each capsule endoscopy video. For the outcome categories of blood (fresh or coffee grounds type) or no blood detected, the sensitivity and specificity were calculated. RESULTS: A total of 126 EPs were enrolled. Compared to expert gastroenterology-adjudicated interpretation, the sensitivity to detect blood was 0.94 (95% confidence interval [CI] = 0.91 to 0.96) and specificity was 0.87 (95% CI = 0.80 to 0.92). CONCLUSIONS: After brief training, EPs can accurately interpret video capsule endoscopy findings of presence of gross blood or no blood with high sensitivity and specificity.
BACKGROUND: Acute upper gastrointestinal (GI) hemorrhage is a common emergency department (ED) presentation whose severity ranges from benign to life-threatening and the best tool to risk stratify the disease is an upper endoscopy, either by scope or by capsule, a procedure performed almost exclusively by gastroenterologists. Unfortunately, on-call gastroenterology specialists are often unavailable, and emergency physicians (EPs) currently lack an alternative method to endoscopically visualize a suspected acute upper GI hemorrhage. Recent reports have shown that video capsule endoscopy is well tolerated by ED patients and has similar sensitivity and specificity to endoscopy for upper GI hemorrhage. OBJECTIVES: The study objective was to determine if EPs can detect upper GI bleeding on capsule endoscopy after a brief training session. METHODS: A survey study was designed to demonstrate video examples of capsule endoscopy to EPs and determine if they could detect upper GI bleeding after a brief training session. All videos were generated from a prior ED-based study on patients with suspected acute upper GI hemorrhage. The training session consisted of less than 10 minutes of background information and capsule endoscopy video examples. EPs were recruited at the American College of Emergency Physicians Scientific Assembly in Denver, Colorado, from October 8, 2012, to October 10, 2012. Inclusion criteria included being an ED resident or attending physician and the exclusion criteria included any formal endoscopy training. The authors analyzed the agreement between the EPs and expert adjudicated capsule endoscopy readings for each capsule endoscopy video. For the outcome categories of blood (fresh or coffee grounds type) or no blood detected, the sensitivity and specificity were calculated. RESULTS: A total of 126 EPs were enrolled. Compared to expert gastroenterology-adjudicated interpretation, the sensitivity to detect blood was 0.94 (95% confidence interval [CI] = 0.91 to 0.96) and specificity was 0.87 (95% CI = 0.80 to 0.92). CONCLUSIONS: After brief training, EPs can accurately interpret video capsule endoscopy findings of presence of gross blood or no blood with high sensitivity and specificity.
Authors: Sebastian Schostek; Melanie Zimmermann; Jan Keller; Mario Fode; Michael Melbert; Ruediger L Prosst; Thomas Gottwald; Marc O Schurr Journal: Surg Endosc Date: 2019-05-28 Impact factor: 4.584
Authors: Andrew C Meltzer; Alexander T Limkakeng; Nina T Gentile; Jincong Q Freeman; Nicole C Hall; Nataly Montano Vargas; David E Fleischer; Zubair Malik; Samuel J Kallus; Marie L Borum; Yan Ma; Anita B Kumar Journal: J Am Coll Emerg Physicians Open Date: 2021-10-25
Authors: Joseph Jy Sung; Philip Wy Chiu; Francis K L Chan; James Yw Lau; Khean-Lee Goh; Lawrence Hy Ho; Hwoon-Young Jung; Jose D Sollano; Takuji Gotoda; Nageshwar Reddy; Rajvinder Singh; Kentaro Sugano; Kai-Chun Wu; Chun-Yin Wu; David J Bjorkman; Dennis M Jensen; Ernst J Kuipers; Angel Lanas Journal: Gut Date: 2018-04-24 Impact factor: 23.059
Authors: Hey-Long Ching; Ailish Healy; Victoria Thurston; Melissa F Hale; Reena Sidhu; Mark E McAlindon Journal: World J Gastroenterol Date: 2018-07-14 Impact factor: 5.742