GuidelineClinical Practice Guidelines for the Use of Video Capsule Endoscopy
Section snippets
Scope and Purpose
This consensus was focused on specific questions regarding the use of CE as identified and discussed by the participants. Development of this clinical practice guideline was initiated in November 2014, with a meeting of the full consensus group held in November 2015. The entire process took approximately 20 months, with the final manuscript being submitted for publication in July 2016.
Sources and Searches
The Editorial Office of the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group at McMaster
Recommendation Statements
The individual recommendation statements are provided and include the GRADE of supporting evidence and the voting results, after which, a discussion of the evidence considered for the specific statement is presented. For the majority of statements the quality of evidence was determined to be very low, largely because of high risk of bias, indirectness, and imprecision. For some statements in which lower quality of evidence exists, a strong recommendation was made based on other factors such as
Future Directions
Although CE has advanced substantially as an important procedure to visualize the small-bowel mucosa, certain knowledge gaps have an important impact on the use of CE. Standardized criteria should be developed for documenting CE findings, as well as for training and credentialing. More information is needed on the extent of bowel preparation that should be recommended for CE, and on the role of CE in patients with CD recurrence after surgery, those with polyposis syndromes, and patients with
Summary
These guidelines present recommendations for the use of small-bowel CE and CCE in the context of CD, celiac disease, and gastrointestinal bleeding. These 21 statements on the use of small-bowel CE and CCE also include recommendations pertaining to training, reporting, and informed consent.
The quality of evidence supporting these consensus statements was often very low owing to high risk of bias, indirectness, and imprecision. However, in many cases strong recommendations were made based on
Acknowledgments
The consensus group would like to thank Pauline Lavigne and Steven Portelance (unaffiliated), who provided medical writing services on their behalf, supported by funds from the Canadian Association of Gastroenterology.
The CAG would like to thank Allergan, Covidien, and Olympus for their generous support of the guideline process. The consensus group would like to thank the following people for their contributions: Paul Sinclair and Lesley Marshall (CAG representatives, administrative and
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Conflicts of interest These authors disclose the following: Charles Bernstein has performed consulting for Mylan Pharmaceuticals, has served on the advisory board for AbbVie, Janssen, Pfizer, and Takeda, has received research or educational grants/clinical trial funding from AbbVie, Janssen, Shire, and Takeda, and has served on the speaker’s bureau for AbbVie and Shire; David Armstrong has served on the advisory board for AbbVie, Allergan, Janssen, Pfizer, and Lupin, has received research or educational grants/clinical trial funding from AbbVie, and has served on the speaker’s bureau for AbbVie, Allergan, Mylan, Pendopharm, Pentax, Pfizer, Shire, and Takeda; Robert A. Enns has served on the speaker’s bureau for AbbVie, Actavis, Boston Medical, Conmed, Cook, Covidien, Ferring, Gilead, Janssen, Merck, Olympus, Pendopharm, Pentax, Roche, Shire, Takeda, and Vantage; and Lawrence Hookey has received research or educational grants/clinical trial funding from Given Imaging, and served on the speaker’s bureau for Ferring. The remaining authors disclose no conflicts.
Funding This guideline was supported through unrestricted grants to the Canadian Association of Gastroenterology by Allergan Canada, Covidien Canada ULC, a Medtronic company, and Olympus Canada Inc. who had no involvement in any aspect of the guideline development.