The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: A prospective diagnostic pilot study

Sarmed S. Sami, Krish Ragunath, Emilie A. Wilkes, Martin James, Rodrigo Mansilla-Vivar, Jacobo Ortiz-Fernández-Sordo, Jonathan White, Amardeep Khanna, Marina Coletta, Sunil Samuel, Guruprasad P. Aithal, Indra Neil Guha

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background & Aims: Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C-OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office-based transnasal endoscope (EG Scan) compared to C-OGD as the reference standard. Methods: This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10-point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures. Results: Forty-five of 50 patients (90%) completed both interventions. Mean age was 59 years and OV prevalence was 49%. Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C-OGD on day 0 (76.5% vs. 23.5%, P <0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8% vs. 22.2%, P <0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95% confidence interval (CI) 0.60-0.95), and 0.78 (95% CI 0.56-0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95% CI 0.62-1.0), 0.97 (95% CI 0.84-1.0) respectively. No serious adverse events occurred. Conclusions: EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C-OGD 14 days after procedures.

Original languageEnglish
Pages (from-to)1639-1648
Number of pages10
JournalLiver International
Volume36
Issue number11
DOIs
Publication statusPublished - 2016

Fingerprint

Esophageal and Gastric Varices
Endoscopes
Digestive System Endoscopy
Confidence Intervals
Patient Preference
Visual Analog Scale
Decontamination
Fibrosis
Cohort Studies
Prospective Studies
Sensitivity and Specificity

Keywords

  • Endoscopy
  • Screening
  • Transnasal
  • Varices

ASJC Scopus subject areas

  • Hepatology

Cite this

Sami, S. S., Ragunath, K., Wilkes, E. A., James, M., Mansilla-Vivar, R., Ortiz-Fernández-Sordo, J., ... Guha, I. N. (2016). The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: A prospective diagnostic pilot study. Liver International, 36(11), 1639-1648. https://doi.org/10.1111/liv.13152

The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope : A prospective diagnostic pilot study. / Sami, Sarmed S.; Ragunath, Krish; Wilkes, Emilie A.; James, Martin; Mansilla-Vivar, Rodrigo; Ortiz-Fernández-Sordo, Jacobo; White, Jonathan; Khanna, Amardeep; Coletta, Marina; Samuel, Sunil; Aithal, Guruprasad P.; Guha, Indra Neil.

In: Liver International, Vol. 36, No. 11, 2016, p. 1639-1648.

Research output: Contribution to journalArticle

Sami, SS, Ragunath, K, Wilkes, EA, James, M, Mansilla-Vivar, R, Ortiz-Fernández-Sordo, J, White, J, Khanna, A, Coletta, M, Samuel, S, Aithal, GP & Guha, IN 2016, 'The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope: A prospective diagnostic pilot study', Liver International, vol. 36, no. 11, pp. 1639-1648. https://doi.org/10.1111/liv.13152
Sami, Sarmed S. ; Ragunath, Krish ; Wilkes, Emilie A. ; James, Martin ; Mansilla-Vivar, Rodrigo ; Ortiz-Fernández-Sordo, Jacobo ; White, Jonathan ; Khanna, Amardeep ; Coletta, Marina ; Samuel, Sunil ; Aithal, Guruprasad P. ; Guha, Indra Neil. / The detection of oesophageal varices using a novel, disposable, probe-based transnasal endoscope : A prospective diagnostic pilot study. In: Liver International. 2016 ; Vol. 36, No. 11. pp. 1639-1648.
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abstract = "Background & Aims: Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C-OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office-based transnasal endoscope (EG Scan™) compared to C-OGD as the reference standard. Methods: This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10-point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures. Results: Forty-five of 50 patients (90{\%}) completed both interventions. Mean age was 59 years and OV prevalence was 49{\%}. Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C-OGD on day 0 (76.5{\%} vs. 23.5{\%}, P <0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8{\%} vs. 22.2{\%}, P <0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95{\%} confidence interval (CI) 0.60-0.95), and 0.78 (95{\%} CI 0.56-0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95{\%} CI 0.62-1.0), 0.97 (95{\%} CI 0.84-1.0) respectively. No serious adverse events occurred. Conclusions: EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C-OGD 14 days after procedures.",
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T2 - A prospective diagnostic pilot study

AU - Sami, Sarmed S.

AU - Ragunath, Krish

AU - Wilkes, Emilie A.

AU - James, Martin

AU - Mansilla-Vivar, Rodrigo

AU - Ortiz-Fernández-Sordo, Jacobo

AU - White, Jonathan

AU - Khanna, Amardeep

AU - Coletta, Marina

AU - Samuel, Sunil

AU - Aithal, Guruprasad P.

AU - Guha, Indra Neil

PY - 2016

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N2 - Background & Aims: Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C-OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office-based transnasal endoscope (EG Scan™) compared to C-OGD as the reference standard. Methods: This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10-point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures. Results: Forty-five of 50 patients (90%) completed both interventions. Mean age was 59 years and OV prevalence was 49%. Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C-OGD on day 0 (76.5% vs. 23.5%, P <0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8% vs. 22.2%, P <0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95% confidence interval (CI) 0.60-0.95), and 0.78 (95% CI 0.56-0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95% CI 0.62-1.0), 0.97 (95% CI 0.84-1.0) respectively. No serious adverse events occurred. Conclusions: EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C-OGD 14 days after procedures.

AB - Background & Aims: Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C-OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office-based transnasal endoscope (EG Scan™) compared to C-OGD as the reference standard. Methods: This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10-point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures. Results: Forty-five of 50 patients (90%) completed both interventions. Mean age was 59 years and OV prevalence was 49%. Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C-OGD on day 0 (76.5% vs. 23.5%, P <0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8% vs. 22.2%, P <0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95% confidence interval (CI) 0.60-0.95), and 0.78 (95% CI 0.56-0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95% CI 0.62-1.0), 0.97 (95% CI 0.84-1.0) respectively. No serious adverse events occurred. Conclusions: EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C-OGD 14 days after procedures.

KW - Endoscopy

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