AI Article Synopsis
- CCE (Colon Capsule Endoscopy) has been found to have a significant false negative rate, with a study revealing that 22.2% of CCEs missed polyps compared to follow-up colonoscopies.
- The analysis of 532 CCEs showed that the majority of missed polyps were diminutive (69.2%) and that technical and reader errors accounted for most of the missed pathologies, with expert reviews confirming these mistakes.
- These findings suggest that the false negative rates of CCE should be considered when making clinical decisions, as they can impact patient care and treatment outcomes.
Article Abstract
Background: CCE is a diagnostic tool lacking clinical data on false negative rates. We aimed to assess this rate and the reader/technical error breakdown.
Methods: False negative CCEs were identified after comparing to a colonoscopy database. Missed pathology characteristics and study indications/quality were collated. Cases were re-read by experts and newly identified lesions/pathologies were verified by an expert panel and categorised as reader/technical errors.
Results: Of 532 CCEs, 203 had an adequately reported comparative colonoscopy, 45 (22.2%) had missed polyps, and 26/45 (57.8%) reached the colonic section with missed pathology. Of the cases, 22 (84.6%) had adequate bowel preparation. Indications included 13 (50%) polyp surveillance, 12 (46%) GI symptoms, 1 (4%) polyp screening. CCE missed 18 (69.2%) diminutive polyps and 8 (30.8%) polyps ≥ 6 mm, 18/26 (69.2%) of these were adenomas. Excluding incomplete CCE correlates, colonoscopy total and significant polyp yield were 97/184 (52.7%) and 50/97 (51.5%), respectively. CCE total polyp and significant polyp false negative rate was 26.8% (26/97) and 16% (8/50), respectively. Following re-reading, reader and technical error was 20/26 (76.9%) and 6/26 (23.1%). Total and significant missed polyp rates were 20.6% (20/97) and 14% (7/50) for reader error, 6.2% (6/97) and 2% (1/50) for technical error.
Conclusions: False negative CCE rate is not insubstantial and should be factored into clinical decision making.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9818729 | PMC |
| http://dx.doi.org/10.3390/diagnostics13010056 | DOI Listing |
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