Dag A Sangnes1,2, Eirik Søfteland2,3, Mattis Bekkelund4,5, Jakub Frey1, Martin Biermann2,6, Odd Helge Gilja2,7, Georg Dimcevski2,7. 1. Department of Medicine, Haukeland University Hospital, Bergen, Norway. 2. Department of Clinical Medicine, University of Bergen, Bergen, Norway. 3. Hormone Laboratory, Haukeland University Hospital, Bergen, Norway. 4. The National Centre for Functional Gastrointestinal Disorders, Haukeland University Hospital, Bergen, Norway. 5. Department of Clinical Medicine, University of Oslo, Oslo, Norway. 6. Centre for Nuclear Medicine and PET, Department of Radiology, Haukeland University Hospital, Bergen, Norway. 7. National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.
Abstract
BACKGROUND: Gastroparesis is a potentially severe late complication of diabetes mellitus. Today, delayed gastric emptying (GE) is mandatory for establishing the diagnosis. In this study, we compared wireless motility capsule (WMC) with gastric emptying scintigraphy (GES). METHODS: Seventy-two patients (49 women) with diabetes mellitus (59 type 1) and symptoms compatible with gastroparesis were prospectively included between 2014 and 2018. Patients were simultaneously examined with GES and WMC. Symptoms were assessed with the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) questionnaire. All patients were on intravenous glucose-insulin infusion during testing. KEY RESULTS: WMC and GES correlated r = .74, P < .001. Compared to GES, WMC at ordinary cutoff for delayed GE (300 minutes) had a sensitivity of 0.92, specificity 0.73, accuracy 0.80, and Cohen's kappa κ = 0.61 (P < .001). By receiver operating characteristics (ROC), the area under the curve was 0.95 (P < .001). A cutoff value for delayed GE of 385 minutes produced sensitivity 0.92, specificity 0.83, accuracy 0.86, and Cohen's kappa κ = 0.72 (P < .001). Inter-rater reliability for GE time with WMC was r = .996, κ = 0.97, both P < .001. There was no difference in symptom severity between patients with normal and delayed GE. CONCLUSIONS & INFERENCES: Our findings demonstrate the applicability of WMC as a reliable test to assess gastric emptying in diabetic gastroparesis showing very high inter-observer correlation. By elevating the cutoff value for delayed emptying from 300 to 385 minutes, we found higher specificity without reducing sensitivity.
BACKGROUND:Gastroparesis is a potentially severe late complication of diabetes mellitus. Today, delayed gastric emptying (GE) is mandatory for establishing the diagnosis. In this study, we compared wireless motility capsule (WMC) with gastric emptying scintigraphy (GES). METHODS: Seventy-two patients (49 women) with diabetes mellitus (59 type 1) and symptoms compatible with gastroparesis were prospectively included between 2014 and 2018. Patients were simultaneously examined with GES and WMC. Symptoms were assessed with the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) questionnaire. All patients were on intravenous glucose-insulin infusion during testing. KEY RESULTS: WMC and GES correlated r = .74, P < .001. Compared to GES, WMC at ordinary cutoff for delayed GE (300 minutes) had a sensitivity of 0.92, specificity 0.73, accuracy 0.80, and Cohen's kappa κ = 0.61 (P < .001). By receiver operating characteristics (ROC), the area under the curve was 0.95 (P < .001). A cutoff value for delayed GE of 385 minutes produced sensitivity 0.92, specificity 0.83, accuracy 0.86, and Cohen's kappa κ = 0.72 (P < .001). Inter-rater reliability for GE time with WMC was r = .996, κ = 0.97, both P < .001. There was no difference in symptom severity between patients with normal and delayed GE. CONCLUSIONS & INFERENCES: Our findings demonstrate the applicability of WMC as a reliable test to assess gastric emptying in diabetic gastroparesis showing very high inter-observer correlation. By elevating the cutoff value for delayed emptying from 300 to 385 minutes, we found higher specificity without reducing sensitivity.
Authors: Anne-Marie Langmach Wegeberg; Christian Stevns Hansen; Adam D Farmer; Jesper Scott Karmisholt; Asbjorn M Drewes; Poul Erik Jakobsen; Birgitte Brock; Christina Brock Journal: United European Gastroenterol J Date: 2020-05-09 Impact factor: 4.623
Authors: Mattis Bekkelund; Dag A Sangnes; Eirik Søfteland; Lars Aabakken; Martin Biermann; Elisabeth K Steinsvik; Trygve Hausken; Georg Dimcevski; Jan Gunnar Hatlebakk Journal: Clin Exp Gastroenterol Date: 2021-04-28
Authors: Dag A Sangnes; Katarina Lundervold; Mattis Bekkelund; Hilde L von Volkmann; Birgitte Berentsen; Odd Helge Gilja; Georg Dimcevski; Eirik Søfteland Journal: United European Gastroenterol J Date: 2021-10-23 Impact factor: 4.623