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The detection of oesophageal varices using a novel, disposable, probe‐based transnasal endoscope: a prospective diagnostic pilot study
Author(s) -
Sami Sarmed S.,
Ragunath Krish,
Wilkes Emilie A.,
James Martin,
MansillaVivar Rodrigo,
OrtizFernándezSordo Jacobo,
White Jonathan,
Khanna Amardeep,
Coletta Marina,
Samuel Sunil,
Aithal Guruprasad P.,
Guha Indra Neil
Publication year - 2016
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13152
Subject(s) - medicine , endoscope , tolerability , prospective cohort study , confidence interval , adverse effect , varices , endoscopy , cohort , cirrhosis , visual analogue scale , surgery , nuclear medicine
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.