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Wireless Capsule Endoscopy Practice Makes Perfect? A Survey of Capsule Endoscopy Viewing Practices in the United States

2009; Elsevier BV; Volume: 69; Issue: 5 Linguagem: Inglês

10.1016/j.gie.2009.03.444

1097-6779

Jordan H. Wolff, Lance Uradomo, Eric M. Goldberg,

Gastric Cancer Management and Outcomes

Introduction: Wireless capsule endoscopy (WCE) is commonly the initial diagnostic test to evaluate the small intestine. While studies have addressed performance of the capsule itself, very few have examined viewing practices of the capsule endoscopist. Despite the availability of multiple viewing modes, speeds and software tools, no data exists regarding the best combination of settings, and no association has been made with training, practice setting or experience in WCE and the optimal viewing technique. Aim: To examine viewing practices of capsule endoscopists in the United States. Methods: A 15-question survey was created using an online survey. A total of 5550 surveys were e-mailed to the current membership of the American College of Gastroenterology (ACG). The survey was distributed in 3 separate mailings and data were automatically collected through the survey website. Descriptive statistics were computed and Pearson's χ2 was used to assess differences between groups. Results: Of the 5550 surveys sent, 901 were undeliverable, resulting in 4649 surveys received by ACG members. 530 surveys (11.4%) were completed; 187 members (4.0%) chose to opt out of the survey because they did not perform WCE. Gastroenterologists practicing in academic settings comprised 29.2% (155) of the completed surveys. At their preferred viewing mode, academicians viewed images at slow rates (5-10 frames/sec in single or 5-15 frames/sec in dual or quad view) or fast rates (16-20 frames/sec in single or 26-40 frames/sec in dual or quad view), while non-academic physicians viewed at moderate rates (11-15 frames/sec in single or 16-25 frames/sec in dual or quad) (p=0.039). Pre-reading by physician extenders (RN's, PA's, NP's, fellows) was more common among academicians (p<0.001). Those who had studies pre-read more often had average reading times of less than 30 minutes (p=0.0078). Respondents who were self-taught (150 respondents or 28.3%) were more likely to have practiced gastroenterology longer (p<0.001) and viewed images at higher viewing rates (p = 0.028). There was no association between number of WCE exams performed in a career and viewing rate or software utilization. Viewing mode (single, dual, or quad) was not different among groups. Conclusions: In this population, WCE practices varied widely. Significant differences were found between multiple parameters of viewing. To ensure the highest quality of WCE interpretation, a standardized approach to training and viewing methods may be beneficial. Prospective studies comparing different viewing practices may be necessary to increase the accuracy of WCE viewing and interpretation.