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  • Title: A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barrett's esophagus in patients with gastroesophageal reflux disease.
    Author: Bhardwaj A, Hollenbeak CS, Pooran N, Mathew A.
    Journal: Am J Gastroenterol; 2009 Jun; 104(6):1533-9. PubMed ID: 19491867.
    Abstract:
    OBJECTIVES: To evaluate the diagnostic accuracy of esophageal capsule endoscopy (ECE) for Barrett's esophagus (BE) in patients with gastroesophageal reflux disease (GERD). METHODS: Literature was searched for blinded studies evaluating the diagnostic accuracy of ECE for BE in patients with GERD. Meta-analysis was carried out to calculate pooled sensitivity and specificity of ECE for diagnosis of BE. Subgroup analysis was also carried out based on the reference standard used. RESULTS: Nine studies comprising a total of 618 patients met the inclusion criteria. The pooled sensitivity and specificity of ECE for the diagnosis of BE for all studies were 77 and 86% respectively. The pooled sensitivity and specificity of ECE for the diagnosis of BE using esophagogastroduodenoscopy (EGD) as the reference standard were 78 and 90%, respectively; using histologically confirmed intestinal metaplasia (IM) as the reference standard pooled sensitivity and specificity were 78 and 73%, respectively. Statistical heterogeneity was not evident among studies for sensitivity results (P=0.270, I(2)=19), but heterogeneity was present for specificity results (P<0.001, I(2)=74). There was no evidence of publication bias. The ECE was found to be safe and had a high rate of patient preference. CONCLUSIONS: Capsule endoscopy of esophagus has a moderate sensitivity and specificity for the diagnosis of BE in patients with GERD. The EGD remains the modality of choice for evaluation of suspected BE.
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