Evidence map›Paper›PMID 39592951›Full record

ArticleBMC gastroenterology2024

Clinical application of capsule sponge testing in symptomatic reflux disease: a national prospective cohort study.

Siobhan Chien, Paul Glen, Gavin Bryce, Neil Cruickshank, Ian Penman, Kevin Robertson, Perminder Phull, Andrew Crumley, Ivan Gunjaca, Jeyakumar Apollos and 3 more

Abstract read
In one paragraph

Article in BMC gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Siobhan ChienSchool of Cancer Sciences, University of Glasgow, Garscube Estate, Switchback Road, Bearsden, Glasgow, G61 1QH, UK. siobhan.chien6@nhs.scot.
Paul GlenDepartment of General Surgery, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK.
Gavin BryceDepartment of General Surgery, University Hospital Wishaw, Wishaw, ML2 0DP, UK.
Neil CruickshankDepartment of General Surgery, Victoria Hospital, Kirkcaldy, KY2 5AH, UK.
Ian PenmanCentre for Liver & Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK.
Kevin RobertsonDepartment of General Surgery, University Hospital Crosshouse, Kilmarnock, KA2 0BE, UK.
Perminder PhullDepartment of Gastroenterology, Aberdeen Royal Infirmary, Aberdeen, AB25 2ZN, UK.
Andrew CrumleyDepartment of General Surgery, Forth Valley Royal Hospital, Larbert, FK5 4WR, UK.
Ivan GunjacaDepartment of Gastroenterology, Raigmore Hospital, Inverness, IV2 3UJ, UK.
Jeyakumar ApollosDepartment of General Surgery, Dumfries & Galloway Royal Infirmary, Dumfries, DG2 8RX, UK.
Michael MillerDepartment of Gastroenterology, Ninewells Hospital, Dundee, DD2 1SG, UK.
Jonathan FletcherDepartment of Gastroenterology, Borders General Hospital, Melrose, TD6 9BS, UK.
Grant FullartonCentre for Sustainable Delivery, Golden Jubilee National Hospital, Clydebank, Glasgow, G81 4DN, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCapsule sponge testing, using an oesophageal cell collection device with biomarkers, was implemented nationally across Scotland in 2020 for symptomatic reflux patients referred to secondary care for non-urgent endoscopy. The aim was to use capsule sponge testing as a triage tool to reduce pressures on the endoscopy service during COVID-19, focus endoscopy resources on those most likely to have pathology and streamline the patient pathway. This prospective cohort study presents the first real-world results and evaluates the clinical application of capsule sponge testing in symptomatic reflux disease based on endoscopic biopsy results.

methodsOver a 32-month period, all patients undergoing capsule sponge testing for investigation of reflux symptoms across 11 Scottish health boards were identified from prospectively maintained databases. Individual patient records were interrogated to collect baseline demographics, capsule sponge test result (TFF3/atypia/p53) and ongoing clinical management. Further analysis was performed on patients who subsequently underwent upper gastrointestinal (UGI) endoscopy.

results1385 tests were performed for reflux symptoms in 1305 patients. The median follow-up time was 20 months (IQR 12-27). 1103/1385 tests (79.6%) were negative for biomarkers. 913/1305 (70.0%) patients were discharged with no additional investigation required. 355/1305 patients (27.2%) underwent UGI endoscopy due to a positive or insufficient result or ongoing symptoms. With insufficient tests excluded, 52/314 patients (16.6%) had intestinal metaplasia (IM) on endoscopic biopsies, which strongly correlated with positive biomarkers (88.5% vs. 11.5%; p < 0.001), including 1 case of dysplasia. 10/1103 sponge negative patients (0.9%) had biopsies demonstrating IM (n = 6) or malignancy (n = 4): 1 patient was diagnosed with oesophageal adenocarcinoma 27 months later and 3 patients had gastric malignancy, which relies on symptom assessment to direct to endoscopy since the capsule sponge is an oesophageal test.

conclusionsCapsule sponge testing is effectively at identifying the 30% of symptomatic reflux patients requiring further investigation with UGI endoscopy and aiding the diagnosis of Barrett's oesophagus in clinical practice. Judicious follow-up of the discharged group will be critical to validate the ongoing use of capsule sponge testing long-term.

Indexed as

Gastroesophageal RefluxAdultAgedBarrett EsophagusBiomarkersBiopsyCapsule EndoscopyCOVID-19EsophagusFemaleHumansMaleMiddle AgedProspective StudiesScotlandBiomarkersBarrett’s oesophagusCapsule sponge testingGastro-oesophageal reflux diseaseReflux

Identifiers

PMID39592951
PMCPMC11590222

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.