Evidence map›Paper›PMID 42568228›Full record

SynthesisJournal of gastroenterology and hepatology2026

Diagnostic and Clinical Performance of Single-Use Versus Reusable Gastrointestinal Endoscopes: A Systematic Review and Meta-Analyses.

Natalie Tyldesley-Marshall, Yen-Fu Chen, Jefferson Buendia, Anna Brown, Thomas Matthews, Janette Parr, Shivashri Chockalingam, Adel Elfeky, Amy Grove, Lazaros Andronis and 6 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Journal of gastroenterology and hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

16 authors.

Natalie Tyldesley-MarshallCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-0576-3459
Yen-Fu ChenCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-9446-2761
Jefferson BuendiaDepartment of Pharmacology and Toxicology, University of Antioquia, Medellin, Colombia.ORCID https://orcid.org/0000-0003-2404-6612
Anna BrownCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-4541-6232
Thomas MatthewsEvidence Synthesis Ireland, University of Galway, Galway, Republic of Ireland.ORCID https://orcid.org/0000-0001-8562-5963
Janette ParrCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-0629-1596
Shivashri ChockalingamCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.
Adel ElfekyCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.
Amy GroveCentre for Evidence and Implementation Science, University of Birmingham, Birmingham, UK.ORCID https://orcid.org/0000-0002-8027-7274
Lazaros AndronisCentre for Health Economics at Warwick, University of Warwick, Coventry, UK.ORCID https://orcid.org/0000-0001-7998-7431
Stuart R ColesWarwick Manufacturing Group, University of Warwick, Coventry, UK.ORCID https://orcid.org/0000-0003-2034-8488
Mandana ZanganehCentre for Health Economics at Warwick, University of Warwick, Coventry, UK.ORCID https://orcid.org/0000-0003-3934-6044
Bu HayeeDepartment of Gastroenterology, King's College Hospital NHS Foundation Trust, London, UK.
Anjan DharDepartment of Gastroenterology, County Durham and Darlington NHS Foundation Trust, Darlington, UK.ORCID https://orcid.org/0000-0001-8964-2031
Shaji SebastianInflammatory Bowel Disease Unit, Hull University Teaching Hospitals, Hull, UK.ORCID https://orcid.org/0000-0002-3670-6545
Ramesh ArasaradnamInstitute of Precision Diagnostics for Translational Medicine, University Hospital of Coventry & Warwickshire NHS Trust, Coventry, UK.ORCID https://orcid.org/0000-0002-2231-3062

Funding

Evidence Synthesis Ireland ESI-2021-001National Institute for Health and Care Research NIHR152311
6 · The paper itself

Abstract

backgroundEndoscopic procedures are fundamental in the diagnosis and management of gastrointestinal disorders. However, concerns over pathogen transmission have driven the development of single-use and partially single-use endoscopes (reusable endoscopes with disposable components). A comprehensive synthesis of comparative evidence is essential to inform decisions regarding clinical adoption.

methodsWe systematically searched MEDLINE, EMBASE, Web of Science, Cochrane Library, and trial registries for randomized controlled trials, non-randomized comparative studies, diagnostic accuracy studies, and case series. Outcomes assessed included technical performance, diagnostic accuracy, infection risk, and adverse events. We also included systematic reviews estimating infection risk associated with exogenous pathogens for reusable gastrointestinal endoscopes. Summary data were pooled using a random-effects model where appropriate, and other findings synthesized narratively. The protocol was registered prospectively on PROSPERO (CRD42024496913).

resultsOf 6979 records screened, 50 studies (965 960 patients) were included. Our meta-analyses demonstrated that in endoscopic retrograde cholangiopancreatography (ERCP), crossover from single-use (EXALT Model D) to reusable duodenoscopes occurred in 7% of cases (95% CI 6-9). Across endoscope types, single-use and partially single-use devices demonstrated similar or slightly reduced technical performance and diagnostic accuracy compared with reusable counterparts. Estimated infection risks from contaminated reusable endoscopes ranged from 0.01% to 0.8%, although these figures are limited by high risk of detection and reporting bias.

conclusionsThe current evidence does not support wholesale replacement of reusable gastrointestinal endoscopes with single-use or partially single-use models. More robust and standardized data are needed to quantify infection risks from reusable endoscopes and inform evidence-based policy and procurement decisions.

Indexed as

Disposable EquipmentEndoscopes, GastrointestinalEquipment ReuseGastrointestinal DiseasesCholangiopancreatography, Endoscopic RetrogradeEquipment ContaminationHumanscomparative effectivenessduodenoscopeslower gastrointestinalrisk of biasupper gastrointestinal

Identifiers

PMID42568228
PMCPMC13534234

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.