A meta-analysis of the diagnostic accuracy of esophageal capsule endoscopy for Barrett's esophagus in patients with gastroesophageal reflux disease

OBJECTIVES:To evaluate the diagnostic accuracy of esophageal capsule endoscopy (ECE) for Barrett's esophagus (BE) in patients with gastroesophageal reflux disease (GERD).METHODS:Literature was searched for blinded studies evaluating the diagnostic accuracy of ECE for BE in patients with GERD. Meta-analysis was carried out to calculate pooled sensitivity and specificity of ECE for diagnosis of BE. Subgroup analysis was also carried out based on the reference standard used.RESULTS:Nine studies comprising a total of 618 patients met the inclusion criteria. The pooled sensitivity and specificity of ECE for the diagnosis of BE for all studies were 77 and 86 respectively. The pooled sensitivity and specificity of ECE for the diagnosis of BE using esophagogastroduodenoscopy (EGD) as the reference standard were 78 and 90, respectively; using histologically confirmed intestinal metaplasia (IM) as the reference standard pooled sensitivity and specificity were 78 and 73, respectively. Statistical heterogeneity was not evident among studies for sensitivity results (P0.270, I²19), but heterogeneity was present for specificity results (P<0.001, I²74). There was no evidence of publication bias. The ECE was found to be safe and had a high rate of patient preference.CONCLUSIONS:Capsule endoscopy of esophagus has a moderate sensitivity and specificity for the diagnosis of BE in patients with GERD. The EGD remains the modality of choice for evaluation of suspected BE.