Development and validation of a new scoring system to determine the necessity of small-bowel endoscopy in obscure gastrointestinal bleeding

Genta Uchida, Masanao Nakamura, Osamu Watanabe, Takeshi Yamamura, Takuya Ishikawa, Kazuhiro Furukawa, Kohei Funasaka, Eizaburo Ohno, Hiroki Kawashima, Ryoji Miyahara, Hidemi Goto, Yoshiki Hirooka

Research output: Contribution to journalArticlepeer-review

Abstract

Background Small bowel capsule endoscopy (SBCE) is the recommended first-line procedure for obscure gastrointestinal bleeding (OGIB). However, a method for predicting the necessity of subsequent double-balloon endoscopy (DBE) has not been established. Aims We aimed to develop a new scoring system that predicts the necessity of DBE in OGIB. Methods A retrospective study was performed in 330 patients who underwent SBCE for OGIB at Nagoya University Hospital. The enrolled patients were randomly assigned to either a development or a validation dataset. The former was used to construct a prediction scoring system to assess the necessity of DBE using independent predictors selected by logistic regression. The diagnostic yield of the prediction model was assessed using the validation dataset. Results Multivariate logistic regression analysis of the development dataset identified OGIB type, blood transfusion, and SBCE findings as independent predictors of the necessity of DBE. A prediction score gave an area under the receiver operating characteristics curve of 0.77. The sensitivity, specificity, positive predictive value, and negative predictive value at a cutoff ≥2.5 points were 72.5%, 74.6%, 72.6%, and 74.5%, respectively. Conclusion Our scoring system may aid clinicians in deciding when to recommend DBE for patients with OGIB.

Original languageEnglish
Pages (from-to)1218-1224
Number of pages7
JournalDigestive and Liver Disease
Volume49
Issue number11
DOIs
Publication statusPublished - 11-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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