Systematic review and meta-analysisClinical outcomes of negative small-bowel capsule endoscopy for small-bowel bleeding: a systematic review and meta-analysis
Section snippets
Study selection
This study was constructed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria.8 A comprehensive literature search was conducted using the PubMed and Embase databases (January 2000 to November 2015). The search was performed on November 12, 2015. To capture as many articles and abstracts as possible, a broad search strategy was used by combining the terms “capsule endoscopy,” “negative OR normal,” “obscure gastrointestinal bleeding,” “iron
Results
The process of selection of studies for inclusion in this meta-analysis is detailed in the flow diagram in Figure 1. In total, 61 titles were initially identified with the aforementioned search strategy; no further articles were identified from reference list review. Of those, 28 studies were excluded after preliminary review of the titles and/or abstracts, leaving 33 articles for further detailed evaluation. Seven more articles were excluded after full-text review.
Discussion
The use of SBCE has changed the clinical management of patients with OGIB.1, 3 However, there are limitations in the use of SBCE related to the uncontrollable movement of the capsule and the amount of mucosal coverage any type of single-headed capsule model can provide.37, 38 Therefore, over the last few years, there has been an accumulating body of evidence that significant SB lesions can be missed during SBCE, only to be found by cross-sectional imaging or other complementary modalities such
Acknowledgments
We express our gratitude to the following authors who kindly provided further information on their studies included in the analysis: Periklis Apostolopoulos, Elizabeth Carey, Tiago Cúrdia Gonçalves, Pieter Hindryckx, Pedro Magalhães Costa, Ryoto Niikura, Bruno Rosa, Eduardo Redondo-Cerezo, Cedric Van de Bruaene, Nikos Viazis, and Atsuo Yamada. We also thank the IASGO Head Office for their assistance in retrieving 1 of the manuscripts required for our meta-analysis.
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DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: A. Koulaouzidis: Grant recipient from Given Imaging; material support for research from Symmed UK; M. Pennazio: Speaker for Given Imaging; R. Eliakim: Consultant for Given Imaging; Rami Eliakim, E. Toth: Speaker for Given Imaging. All other authors disclosed no financial relationships relevant to this publication.
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