Magnetic endoscopic imaging vs standard colonoscopy: Meta-analysis of randomized controlled trials

doi:10.3748/wjg.v19.i41.7197

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World Journal of Gastroenterology

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Meta-Analysis

World J Gastroenterol. Nov 7, 2013; 19(41): 7197-7204
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.7197

Table 1 Characteristics of the included studies comparing use of the magnetic endoscopic imaging colonoscope and standard colonoscope

Study	Number ofpatients (n)	Endoscopists' experience level	Colonos-cope type	Cecal intubation rate	Cecal intubation time	Sedation dose	Pain score	Ancillary maneuvers
Shah et al[16]	296 (male 138, female 158)	Trainees, skilled endoscopists	MEI, SC	Total MEI: 100% (150/150) SC: 90.4% (132/146) Trainees: MEI: 100% (58/58) SC: 89% (49/55) P = 0.0115 Skilled endoscopists: MEI: 100% (92/92) SC: 91% (83/91) P = 0.0032	Trainees: Median, min MEI: 11.8 (4.3-31.5) SC: 15.3 (4-67) P = 0.0092 Skilled endoscopists: MEI: 8.0 (2.6-40.8) SC: 9.3 (2.5-52.6) P = 0.0484	Trainees: Mean (SD) Midazolam, mg MEI: 1.2 (0.4) SC: 1.2 (0.4) P = 0.4013 Pethidine, mg MEI: 26 (14.5) SC: 30 (15.5) P = 0.1674 Skilled endoscopists Mean (SD) Midazolam, mg MEI: 1.3 (1.1) SC: 1.6 (1.0) P = 0.0724 pethidine, mg MEI: 30 (23.9) SC: 34 (25.6) P = 0.2036	Trainees: Mean (SD) 0-100 VAS MEI: 28.5 (20.2) SC: 30.1 (24.4) P = 0.553 Skilled endoscopists: MEI: 28.6 (23.1) SC: 24.8 (24.2) P = 0.30	Abdominal hand pressure used: Trainees: MEI: 78 SC: 61 Skilled endoscopists: MEI: 93 SC: 147
Shah et al[17]	122 (male 62, female 60)	Experienced	MEI, SC	MEI: 97% (61/62) SC: 95% (57/60) P = 0.3606	Median, min MEI: 10.6 (7.6-17.03) SC: 13.1 (9.01-26.47) P = 0.0664	Midazolam (mg), median MEI: 0.44 (0-1.48) SC: 0.88 (0-1.47) P = 0.2875 Meperidine (mg), median MEI: 16.75 (0-59) SC: 32.5 (0-59) P = 0.2643	Patient pain score (100 mm VAS) MEI: 19 (9-29) SC: 29 (10-50) P = 0.0662	Not stated
Cheung et al[18]	120 (male, 64 female 56)	Experienced	MEI, SC	MEI: 95% (57/60) SC: 93% (56/60) P = 1.0	Median, min MEI: 5 (2-46) SC: 5 (3-15) P = 0.32	Not stated	Median (range), pain score from patients MEI: 5 (0-10) SC: 4 (0-10) P = 0.13	Abdominal hand pressure MEI: 0 SC: 0 Position change made MEI: 6.7% SC: 0% P = 0.12
Hoff et al[15]	419 (male 202, female 217)	Experienced, inexperienced	MEI, SC	MEI: 90% (190/212) SC: 74% (153/207) P < 0.001 experienced: MEI: 90% (137/152) SC: 78% (115/148) P =0.003 Inexperienced: MEI: 88%(53/60) SC: 64%(38/59) P = 0.002	Mean (95%CI), min MEI: 19.1 (17.2-21.0) SC: 17.6 (15.8-19.5) P = 0.28	Not stated	Severe pain during Examination: experienced MEI: 7.3% (10/137) SC: 16% (21/132) P = 0.03 Inexperienced MEI: 14% (8/56) SC: 15% (7/47) P = 0.93	Not stated
Franciosi et al[19]	40 (male 16, female 24)	Experienced	MEI, SC	MEI: 95% (19/20) SC: 94.4% (17/18) P = ns	Mean (range), min MEI: 16.5 (6-52) SC: 12 (6-33) P = ns	Not stated	Median, 0-10 pointscale MEI: 7 (2-10) SC: 19 (3-10) P = ns	Not stated
Dechêne et al[20]	1000 (male 550, female 450)	Experienced, inexperienced	MEI, SC	MEI: 98.2% (481/490) SC: 98.0% (500/510) P = ns	Mean time, (s) MEI: 507 ± 384 (8.45 ± 6.4) SC: 538 ± 428 (8.97 ± 7.13) P = ns Inexperienced: MEI: 613 ± 435 (225) SC: 660 ± 458 (245) P = ns Experienced: MEI: 415 ± 304 (256) SC: 421 ± 361 (255) P = ns	Not stated	Not stated	Position change made MEI: 1.5% (7/481) SC: 3.0% (15/500) P = ns Manual pressure used MEI: 4.2% (20/481) SC: 6.4% (32/500) P = ns
Holme et al[21]	810 (male 378, female 432)	Experienced, inexperienced	MEI, SC	MEI: 91.9% (385/419) SC: 89.5% (350/391) P = 0.28 Inexperienced: MEI: 77.8% (42/54) SC: 56.0% (28/51) P = 0.022 Experienced: MEI: 94.0% (343/365) SC: 96.0% (321/340) P = 0.87	Mean ± SD MEI: 14.0 ± 12.2 SC: 15.3 ± 14.2 P = 0.67 Experienced: MEI: 11.4 ± 7.2 SC: 12.3 ± 9.4 P = 0.78 Inexperienced: MEI: 31.7 ± 21.3 SC: 35.7 ± 22.1 P = 0.42	Not stated	No pain during examination: MEI: 24% (82/341) SC: 20.8% (66/318) Severe pain during examination: MEI: 0 SC: 0	Need for assistance experienced: MEI: 1.1% (4/365) SC: 1.5% (5/340) P = 0.75 Inexperienced: MEI: 18.5% (10/54) SC: 40% (20/51) P = 0.018
Shergill et al[23]	160 (male 156, female 4)	Experienced	MEI, SC	MEI: 100% (65/65) SC: 97% (73/75) P = 0.19	Mean ± SD MEI: 9.4 ± 5.7 SC: 8.5 ± 5.4 P = 0.31	Not stated	Mean (SD) MEI: 3.06 (1.13) SC: 3.12 (1.22) P = 0.60	Not stated

MEI: Magnetic endoscopic imaging; SC: Standard colonoscopy VAS: Visual Analogue Scale.

Table 2 Summary of findings for the main comparison of magnetic endoscopic imaging colonoscope and standard colonoscope

Outcomes	Illustrative comparative risks¹ (95%CI)		Relative effect (95%CI)	No of Participants (studies)	Quality of the evidence (GRADE)	Comments
	Assumed risk	Corresponding risk
	Standard colonoscope	Magnetic endoscope imaging colonoscope
Cecal intubation rate	Study population			OR = 1.92 (1.13-3.27)	2945 (8 studies)	+ + + -Moderate¹
	912 per 1000	952 per 1000(921 to 971)		OR = 1.92 (1.13-3.27)	2945 (8 studies)	+ + + -Moderate¹
	Moderate
	939 per 1000	967 per 1000(946 to 981)
Cecal intubation time		The mean cecal intubation time in the intervention groups was 0.43 lower(0.13 lower to 0.28 higher)		1934 (3 studies)	+ + + +High¹

¹The basis for the assumed risk (e.g., the median control group risk across studies) is provided in the footnotes. The corresponding risk (and its 95%CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95%CI). GRADE: Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of the effect; Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of the effect and may change the estimate; Low quality: Further research is very likely to have an important impact on our confidence in the estimate of the effect and is likely to change the estimate; Very low quality: We are very uncertain about the estimate.

Citation: Chen Y, Duan YT, Xie Q, Qin XP, Chen B, Xia L, Zhou Y, Li NN, Wu XT. Magnetic endoscopic imaging vs standard colonoscopy: Meta-analysis of randomized controlled trials. World J Gastroenterol 2013; 19(41): 7197-7204
URL: https://www.wjgnet.com/1007-9327/full/v19/i41/7197.htm
DOI: https://dx.doi.org/10.3748/wjg.v19.i41.7197