Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract: Systematic review and meta-analysis

Sarmed S. Sami, Venkataraman Subramanian, Jacobo Ortiz-Fernández-Sordo, Alhussain Saeed, Siddharth Singh, Indra N. Guha, Prasad G Iyer, Krish Ragunath

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Abstract

Background and Aims Reports on the performance of unsedated ultrathin endoscopy via the transnasal (uTNE) and transoral (uTOE) routes are conflicting. We aimed to estimate the technical success rate, patient preference, and acceptability of uTNE and uTOE alone and in comparison with conventional EGD (cEGD; with or without sedation). Methods A systematic review and meta-analysis was performed on all primary studies reporting the outcomes of interest. Electronic databases (Cochrane library, MEDLINE, EMBASE) were searched on February 1, 2014. Results Thirty-four studies met the inclusion criteria with 6659 patients in total. The pooled technical success rate was 94.0% for uTNE (95% confidence interval [CI], 91.6-95.8; 30 studies) and 97.8% for uTOE (95% CI, 95.6-98.9; 16 studies). The difference in proportion of success for uTNE compared with cEGD was -2.0% (95% CI, -4.0 to -1.0; 18 studies), but that difference was not significant when uTNE <5.9 mm in diameter was used (-1.0%; 95% CI, -3.0 to.0; 9 studies). There was no significant difference in success rate between uTOE and cEGD (.0%; 95% CI, -1.0 to 2.0; 10 studies). The pooled difference in proportion of patients who preferred uTNE over cEGD was 63.0% (95% CI, 49.0-76.0; 10 studies), whereas preference for uTOE versus cEGD was not significantly different (38.0%; 95% CI, -4.0 to 80.0; 2 studies). Acceptability was high for both uTNE (85.2%; 95% CI, 79.1-89.9; 16 studies) and uTOE (88.7%; 95% CI, 82.4-92.9; 10 studies). Conclusions Technical success rate for uTNE <5.9 mm is equivalent to cEGD. uTNE has high patient acceptability, with better patient preference, and therefore could be a useful alternative to cEGD for screening purposes. uTOE had a similar technical success rate but an equivocal preference to cEGD.

Original languageEnglish (US)
Pages (from-to)782-792
Number of pages11
JournalGastrointestinal Endoscopy
Volume82
Issue number5
DOIs
StatePublished - Nov 1 2015

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Upper Gastrointestinal Tract
Endoscopy
Meta-Analysis
Confidence Intervals
Patient Preference
MEDLINE
Libraries
Outcome Assessment (Health Care)
Databases

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract : Systematic review and meta-analysis. / Sami, Sarmed S.; Subramanian, Venkataraman; Ortiz-Fernández-Sordo, Jacobo; Saeed, Alhussain; Singh, Siddharth; Guha, Indra N.; Iyer, Prasad G; Ragunath, Krish.

In: Gastrointestinal Endoscopy, Vol. 82, No. 5, 01.11.2015, p. 782-792.

Research output: Contribution to journalArticle

Sami, Sarmed S. ; Subramanian, Venkataraman ; Ortiz-Fernández-Sordo, Jacobo ; Saeed, Alhussain ; Singh, Siddharth ; Guha, Indra N. ; Iyer, Prasad G ; Ragunath, Krish. / Performance characteristics of unsedated ultrathin video endoscopy in the assessment of the upper GI tract : Systematic review and meta-analysis. In: Gastrointestinal Endoscopy. 2015 ; Vol. 82, No. 5. pp. 782-792.
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abstract = "Background and Aims Reports on the performance of unsedated ultrathin endoscopy via the transnasal (uTNE) and transoral (uTOE) routes are conflicting. We aimed to estimate the technical success rate, patient preference, and acceptability of uTNE and uTOE alone and in comparison with conventional EGD (cEGD; with or without sedation). Methods A systematic review and meta-analysis was performed on all primary studies reporting the outcomes of interest. Electronic databases (Cochrane library, MEDLINE, EMBASE) were searched on February 1, 2014. Results Thirty-four studies met the inclusion criteria with 6659 patients in total. The pooled technical success rate was 94.0{\%} for uTNE (95{\%} confidence interval [CI], 91.6-95.8; 30 studies) and 97.8{\%} for uTOE (95{\%} CI, 95.6-98.9; 16 studies). The difference in proportion of success for uTNE compared with cEGD was -2.0{\%} (95{\%} CI, -4.0 to -1.0; 18 studies), but that difference was not significant when uTNE <5.9 mm in diameter was used (-1.0{\%}; 95{\%} CI, -3.0 to.0; 9 studies). There was no significant difference in success rate between uTOE and cEGD (.0{\%}; 95{\%} CI, -1.0 to 2.0; 10 studies). The pooled difference in proportion of patients who preferred uTNE over cEGD was 63.0{\%} (95{\%} CI, 49.0-76.0; 10 studies), whereas preference for uTOE versus cEGD was not significantly different (38.0{\%}; 95{\%} CI, -4.0 to 80.0; 2 studies). Acceptability was high for both uTNE (85.2{\%}; 95{\%} CI, 79.1-89.9; 16 studies) and uTOE (88.7{\%}; 95{\%} CI, 82.4-92.9; 10 studies). Conclusions Technical success rate for uTNE <5.9 mm is equivalent to cEGD. uTNE has high patient acceptability, with better patient preference, and therefore could be a useful alternative to cEGD for screening purposes. uTOE had a similar technical success rate but an equivocal preference to cEGD.",
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T2 - Systematic review and meta-analysis

AU - Sami, Sarmed S.

AU - Subramanian, Venkataraman

AU - Ortiz-Fernández-Sordo, Jacobo

AU - Saeed, Alhussain

AU - Singh, Siddharth

AU - Guha, Indra N.

AU - Iyer, Prasad G

AU - Ragunath, Krish

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N2 - Background and Aims Reports on the performance of unsedated ultrathin endoscopy via the transnasal (uTNE) and transoral (uTOE) routes are conflicting. We aimed to estimate the technical success rate, patient preference, and acceptability of uTNE and uTOE alone and in comparison with conventional EGD (cEGD; with or without sedation). Methods A systematic review and meta-analysis was performed on all primary studies reporting the outcomes of interest. Electronic databases (Cochrane library, MEDLINE, EMBASE) were searched on February 1, 2014. Results Thirty-four studies met the inclusion criteria with 6659 patients in total. The pooled technical success rate was 94.0% for uTNE (95% confidence interval [CI], 91.6-95.8; 30 studies) and 97.8% for uTOE (95% CI, 95.6-98.9; 16 studies). The difference in proportion of success for uTNE compared with cEGD was -2.0% (95% CI, -4.0 to -1.0; 18 studies), but that difference was not significant when uTNE <5.9 mm in diameter was used (-1.0%; 95% CI, -3.0 to.0; 9 studies). There was no significant difference in success rate between uTOE and cEGD (.0%; 95% CI, -1.0 to 2.0; 10 studies). The pooled difference in proportion of patients who preferred uTNE over cEGD was 63.0% (95% CI, 49.0-76.0; 10 studies), whereas preference for uTOE versus cEGD was not significantly different (38.0%; 95% CI, -4.0 to 80.0; 2 studies). Acceptability was high for both uTNE (85.2%; 95% CI, 79.1-89.9; 16 studies) and uTOE (88.7%; 95% CI, 82.4-92.9; 10 studies). Conclusions Technical success rate for uTNE <5.9 mm is equivalent to cEGD. uTNE has high patient acceptability, with better patient preference, and therefore could be a useful alternative to cEGD for screening purposes. uTOE had a similar technical success rate but an equivocal preference to cEGD.

AB - Background and Aims Reports on the performance of unsedated ultrathin endoscopy via the transnasal (uTNE) and transoral (uTOE) routes are conflicting. We aimed to estimate the technical success rate, patient preference, and acceptability of uTNE and uTOE alone and in comparison with conventional EGD (cEGD; with or without sedation). Methods A systematic review and meta-analysis was performed on all primary studies reporting the outcomes of interest. Electronic databases (Cochrane library, MEDLINE, EMBASE) were searched on February 1, 2014. Results Thirty-four studies met the inclusion criteria with 6659 patients in total. The pooled technical success rate was 94.0% for uTNE (95% confidence interval [CI], 91.6-95.8; 30 studies) and 97.8% for uTOE (95% CI, 95.6-98.9; 16 studies). The difference in proportion of success for uTNE compared with cEGD was -2.0% (95% CI, -4.0 to -1.0; 18 studies), but that difference was not significant when uTNE <5.9 mm in diameter was used (-1.0%; 95% CI, -3.0 to.0; 9 studies). There was no significant difference in success rate between uTOE and cEGD (.0%; 95% CI, -1.0 to 2.0; 10 studies). The pooled difference in proportion of patients who preferred uTNE over cEGD was 63.0% (95% CI, 49.0-76.0; 10 studies), whereas preference for uTOE versus cEGD was not significantly different (38.0%; 95% CI, -4.0 to 80.0; 2 studies). Acceptability was high for both uTNE (85.2%; 95% CI, 79.1-89.9; 16 studies) and uTOE (88.7%; 95% CI, 82.4-92.9; 10 studies). Conclusions Technical success rate for uTNE <5.9 mm is equivalent to cEGD. uTNE has high patient acceptability, with better patient preference, and therefore could be a useful alternative to cEGD for screening purposes. uTOE had a similar technical success rate but an equivocal preference to cEGD.

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