Colon capsule endoscopy polyp detection rate vs colonoscopy polyp detection rate: Systematic review and meta-analysis

Table 1 Population, intervention, comparator, and outcome criteria for inclusion of studies

Parameter	Inclusion criteria
Population	Adult patients over the age of 18 requiring lower gastrointestinal investigation
Intervention	Diagnostic testing
Comparison	Colonoscopy vs colon capsule endoscopy polyp detection rates
Outcomes	Data providing evidence of the superior test in relation to polyp detection

Table 2 Risk of bias

Ref.	Patient selection	Index test	Reference standard	Floe and timing
Koback-Larsen et al[24]	Low	Low	Low	Low
Spada et al[27]	High	Low	Low	Low
Eliakim et al[29]	High	Low	Low	Low
Pilz et al[30]	High	Low	Low	Low
Hagel et al[25]	Low	Low	Unclear	Low
Holleran et al[26]	Low	Low	Low	Low
Sacher-Huvelin et al[31]	High	Low	Low	Low
Akyüz et al[32]	Unclear	High	High	Low
Eliakim et al[28]	High	Low	Low	Low

Table 3 Applicability

Ref.	Patient selection	Index test	Reference standard
Koback-Larsen et al[24]	Low	Low	Low
Spada et al[27]	Low	Low	Low
Eliakim et al[29]	Low	Low	Low
Pilz et al[30]	Low	Low	Low
Hagel et al[25]	Low	Low	Low
Holleran et al[26]	Low	Low	Low
Sacher-Huvelin et al[31]	Low	Low	Low
Akyüz et al[32]	Unclear	Low	Low
Eliakim et al[28]	Low	Low	Low

Table 4 Characteristics of included studies

Ref.	Aims	Patient selection criteria stated in their paper
Koback-Larsen et al[24]	To determine the polyp detection rate for polyps > 9 mm by colon capsule endoscopy compared with colonoscopy, as well as the diagnostic accuracy of CCE	Individuals who had a positive immuno-fecal-occult blood test during screening
Spada et al[27]	To assess the feasibility, accuracy, and safety of CCE-2 in a head-to-head comparison with colonoscopy	Patients aged 18-80 who were scheduled to undergo colonoscopy for either known or suspected colonic disease
Eliakim et al[29]	To compare the second-generation PillCam with colonoscopy as an update on their earlier paper (first generation)	Patients aged 18-57, who were scheduled to undergo colonoscopy for either known or suspected colonic disease
Pilz et al[30]	To compare the efficacy of CCE against routine screening colonoscopy	Men and women above the age of 50 years without symptoms, or with lower- gastrointestinal signs and symptoms; and individuals 18-50 years with positive family history for CRC
Hagel et al[25]	To assess the PillCam Colon 2 capsule regarding feasibility, sensitivity, and specificity for the detection of colonic pathologies and additional recorded extracolonic findings	Patients scheduled to undergo CCE for known or suspected colonic diseases
Holleran et al[26]	To assess the sensitivity, specificity, and negative and positive predictive values of CCE compared with optical colonoscopy in a FIT-positive CRC screening cohort	Participants with a positive FIT result
Sacher-Huvelin et al[31]	To conduct a prospective, multi-center trial to compare CCE and colonoscopy in asymptomatic subjects enrolled in screening or surveillance program for the detection of colorectal neoplasia	Healthy, asymptomatic individual with a personal or family history of CRC or polyps
Akyüz et al[32]	To evaluate both the optimal cleaning regimen for CCE and the diagnostic value of test in the study group	Unclear. States 28 patients. Discounted patients with: “gastrointestinal dysmotility, suspected/known strictures, pregnancy, abdomen surgery in the past 6 months, life-threatening conditions.”
Eliakim et al[28]	Comparing PillCam (first-generation) colon capsule endoscopy with conventional colonoscopy for the detection of colonic disease	Patients aged 18-75 who were either suspected of having colonic disease and had been referred for conventional colonoscopy or who were being referred for colonoscopy for colorectal cancer screening

CCE: Colon capsule endoscopy; FIT: Fecal immunochemical testing; CRC: Colorectal cancer.

Table 5 Main findings of included studies

Ref.	CCE patients	Colonoscopy patients	Positive CCE	Positive colonoscopy
Koback-Larsen et al[24]	253	253	187	162
Spada et al[27]	109	109	88	92
Eliakim et al[29]	98	98	45	43
Pilz et al[30]	56	56	35	28
Hagel et al[25]	23	23	14	16
Holleran et al[26]	62	62	43	36
Sacher-Huvelin et al[31]	545	545	251	311
Akyüz et al[32]	28	28	6	7
Eliakim et al[28]	84	84	64	67

CCE: Colon capsule endoscopy.