Authors' objectives:

The objective of this report is to evaluate the current available literature regarding the use of endoscopic video capsule in the diagnosis of small bowel disorders.

Authors' results and conclusions: Our systematic review of the capsule endoscopy literature suggests that the diagnostic yield in patients with comparable characteristics to those studied in the literature (patients with recurrent, severe gastrointestinal bleeding suspected to be located in the small bowel), is increased from approximately 30% with conventional diagnostic modalities to approximately 50% (Risk Difference 0.21 95% CI (0.12 0.31). Moreover, the video capsule has good performance standards (5% failure rate), excellent patient tolerability and a good safety profile (risk of intestinal obstruction < 1%, providing a small bowel series is initially performed). Study limitations have precluded providing estimates of improved patients outcomes either in the short or long-term or estimates of decreased resource utilization or associated savings. At present, the video capsule appears unlikely to replace current diagnostic modalities. Because of this lack of demonstrated benefit, evaluations carried by the The Comit dvaluation et de Diffusion des Innovations Technologiques (CDIT), and the American Society for Gastrointestinal Endoscopy Technology Assessment Committee did not endorse the use of the capsule for routine clinical use. No other report on the capsule endoscopy carried out by other technology assessment agencies was found. Finally, the small number of MUHC patients who might benefit, the acquisition cost ($62,000) and the substantial physician time required for interpretation are additional impediments to recommending this technology. However, the potential of this innovative technology is recognized and a later re-evaluation in light of more data may be performed. Moreover, the acquisition of this technology through research programs or private donations to help in better defining its future role could be considered.

Authors' recommendations: Based on the above considerations TAU, while recognizing the innovative characteristics of the capsule endoscopy does not feel that there is sufficient evidence to recommend either the hospital purchase of this technology or its incorporation into routine clinical practice.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.mcgill.ca/tau/publications/2003

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Technology Assessment Unit of the McGill University Health Centre (MUHC)

Contact Address: Technology Assessment Unit of the MUHC, Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, 5252 boul. de Maisonneuve, Bureau 3F.50, Montreal, Quebec H4A 3S5

Contact Name: nandini.dendukuri@mcgill.ca

Contact Email: nandini.dendukuri@mcgill.ca

Copyright: Technology Assessment Unit of the McGill University Health Centre (MUHC)