Systematic Evaluation Of The Diagnostic Value Of Capsule Endoscopy For Small Bowel Disease

Objective:The diagnostic value of capsule endoscopy(CE),Computed Tomography Enterography and Magnetic Resonance Enterography(CTE/MRE)in small bowel diseases(SBDs)was compared in Meta-analysis,and the clinical application value of CE in SBDs was evaluated.Methods:Literature on the diagnostic value of CE and CTE/MRE to SBDs published in PubMed,EMBASE Cochrane Library,cnki wanfang and other databases from 2000 to July 2018 was searched in English and Chinese.According to the preset into standard,into the eligible studies,QUADAS-2 assessment bias risk application Meta-Disk software and software Stata,sensitivity to specific positive likelihood ratio and negative likelihood ratio 95%confidence interval(are)being diagnosed as a reaction,calculate the area under the ROC curve,using the Cochrane Q and I~2 estimates published statistical heterogeneity assessment funnel figure inspection migration in the end,by comparing with Z test CE and CTE/MRE SBDs diagnostic value.Results:In the end,17 studies were included which was Including 15 English and 2Chinese documents,and which were of high quality.In the random effect model,the pooled sensitivity of CE diagnosis of SBDs was 0.85[95%CI(0.75,0.91)],the combined specificity was 0.76[95%CI(0.58,0.87)],The combined positive likelihood ratio was 3.5[95%CI(1.9,6.4)],and the negative likelihood ratio was 0.20[95%CI(0.12,0.36)],and the combined diagnostic odds ratio was 17[95%CI(6,49)].AUC under the fitting SROC curve=0.88[95%CI(0.85,0.91)].The combined sensitivity of CTE diagnosis of SBDs was 0.79[95%CI(0.67,0.87)],the combined specificity was0.88[95%CI(0.78,0.94)],the combined positive likelihood ratio was 6.6[95%CI(3.1,13.9)],and the combined negative likelihood ratio was 0.24[95%CI(0.14,0.41)],and the combined diagnostic odds ratio was 27[95%CI(8,92)].AUC under the fitting SROC curve=0.90[95%CI(0.87,0.92)].The combined sensitivity of MRE diagnosis of SBDs was 0.83[95%CI(0.74,0.90)],the combined specificity was 0.87[95%CI(0.78,0.93)],the combined positive likelihood ratio was 6.4[95%CI(3.6,11.6)],and the combined negative likelihood ratio was 0.19[95%CI(0.12,0.31)],and the diagnostic ratio was 34[95%CI(14,83)].AUC under the fitting SROC curve=0.92[95%CI(0.89,0.94)].P value>0.05 was obtained by calculating Z value and looking up P value table,and the accuracy difference between CE,CTE and MRE was not statistically significant.Conclusions:The sensitivity of CE in the diagnosis of small bowel disease is high,and the specificity of MRE in the diagnosis of small bowel disease is high.There was no significant difference in the diagnostic accuracy of CE and CTE/MRE for small bowel disease.It shows that CE examination has its advantages in clinical practice,but image inspection can make up for its deficiency.CTE and MRE can be used as a supplement to CE inspection,but not a substitute for CE.