Quality of Capsule Endoscopy Reporting in Patients Referred for Double Balloon Enteroscopy.

Abstract

Abnormal video capsule endoscopy (VCE) findings often require intervention with double balloon enteroscopy (DBE). Accurate VCE reporting is important for procedural planning. In 2017 the American Gastroenterological Association (AGA) published a guideline that included recommended elements for VCE reporting. The aim of this study was to examine adherence to the AGA reporting guidelines for VCE. The medical records of all patients who underwent DBE at a tertiary academic center between February 1, 2018, and July 1, 2019, were retrospectively reviewed to identify the VCE report that prompted DBE. Data were collected on the presence of each reporting element recommended by the AGA. Differences in reporting between academic and private practices were compared. A total of 129 VCE reports were reviewed (84 private practice and 45 academic practice). Reports consistently included indication, date, endoscopist, findings, diagnosis, and management recommendations. Timing of anatomic landmarks and abnormalities were included in only 87.6% of reports and preparation quality in only 26.2%. Reports from private practice groups were significantly more likely to include the type of capsule (P < 0.001). VCE reports from academic centers were more likely to include adverse outcomes (P < 0.001), pertinent negatives (P = 0.0015), extent of exam (P = 0.009), previous investigations (P = 0.045), medications (P < 0.001), and document communication to patient/referring physician (P = 0.001). Most VCE reports in both private and academic settings included the important elements recommended by the AGA; however only 87% listed the times of landmarks and abnormal findings, which are crucial in determining the type and direction of approach for subsequent interventions. It is unclear whether the quality of VCE reporting influences the outcome of subsequent DBE.