Is Focused Training Adequate or is Prior Endoscopy Experience Needed for Reliable Capsule Endoscopy Reporting?

Abstract

AIM: The aim of this study is to compare the accuracy of VCE reports by trained gastrointestinal physiologists (TP) to a consultant gastroenterologist (CG) in a tertiary referral centre. METHODS: VCEs performed between November 2010 and March 2011 were prospectively reported by both CG and TP. Both were blinded to each other’s results. Results were compared in terms of clinical findings, small bowel transit, and quality of preparation noted. Correlation was calculated using Cohen’s κ coefficient. CG findings were considered gold standard. RESULTS: Sixty dual reports were identified, 32 (52%) female, age 16 to 81 years; median 53 years. Indications were; 29 anaemia, 19 suspected or known Crohn’s disease (CD), 5 overt GI bleeding, and 7 other. Complete SB transit occurred in 85% (n=51), TP reported as 70% (n=42), κ 0.58. Overall positivity was 38% (n=23), TP reported as 55% (n=33), κ 0.54. Preparation quality correlation occurred in 88% (n=53). Improved correlation was noted over time; caecal transit and positivity rates for the first 30 vs second 30 studies were 0.42, 0.39 and 0.79, 0.66 respectively. Indication did not affect correlation. CONCLUSION: This study suggests that reliable VCE reporting improves with experience and reliable TP reporting is appropriate only after sufficient training. Approved Multidisciplinary CE training programs in line with recognised / established endoscopy protocols should be developed.