Diagnostic yield of small-bowel capsule endoscopy in patients with iron-deficiency anemia: a systematic review Anastasios Koulaouzidis, MD, MRCP, Emanuele.

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Diagnostic yield of small-bowel capsule endoscopy in patients with iron-deficiency anemia: a systematic review Anastasios Koulaouzidis, MD, MRCP, Emanuele Rondonotti, MD, PhD, Andry Giannakou, MSc, John N. Plevris, MD, PhD, FRCP Gastrointestinal Endoscopy Volume 76, Issue 5, Pages 983-992 (November 2012) DOI: 10.1016/j.gie.2012.07.035 Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Flow chart of the systematic review and study selection. DBE, double-balloon enteroscopy; DY, diagnostic yield; SBCE, small-bowel capsule endoscopy; Hb, hemoglobin; IDA, iron-deficiency anemia. Gastrointestinal Endoscopy 2012 76, 983-992DOI: (10.1016/j.gie.2012.07.035) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Forest plot of diagnostic yield (DY) given as separate study subsets (subset 1, studies focusing solely on IDA patients in the first part of the figure) and cumulative (at the bottom of the figure). D+L, the random-effects meta-analysis estimate; IDA, iron-deficiency anemia; I-V, fixed effect meta-analysis estimate; SBCE, small-bowel capsule endoscopy. Gastrointestinal Endoscopy 2012 76, 983-992DOI: (10.1016/j.gie.2012.07.035) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Funnel plot of studies not focused on iron-deficiency anemia (subset 2). There are some studies outside the pseudo 95% confidence limits indicating the presence of heterogeneity and selection bias. There is also asymmetry caused by a lack of small studies with high diagnostic yield (DY). SE, standard error. Gastrointestinal Endoscopy 2012 76, 983-992DOI: (10.1016/j.gie.2012.07.035) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Plot of the diagnostic yield (DY) versus standard error (SE) presented by study subsets (focusing on iron-deficiency anemia [IDA] patients or not). Triangle, studies focusing on IDA; circles, studies not focusing on IDA. It is obvious that subset 1 studies (ie, those focusing exclusively on IDA patients) have a higher DY. Gastrointestinal Endoscopy 2012 76, 983-992DOI: (10.1016/j.gie.2012.07.035) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Forest plot of diagnostic yield (DY) given as separate study subsets (subset 1, studies focusing solely on IDA patients in the first part of the figure) and cumulative (at the bottom of the figure); subgroup analysis per findings category. D+L, random-effects meta-analysis estimate; DY, diagnostic yield; IDA, iron-deficiency anemia; I-V, fixed-effects meta-analysis estimate. Gastrointestinal Endoscopy 2012 76, 983-992DOI: (10.1016/j.gie.2012.07.035) Copyright © 2012 American Society for Gastrointestinal Endoscopy Terms and Conditions