ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds.

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Presentation transcript:

ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging–assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett’s esophagus Nirav Thosani, MD, Barham K. Abu Dayyeh, MD, MPH, Prateek Sharma, MD, FASGE, Harry R. Aslanian, MD, FASGE, Brintha K. Enestvedt, MD, MBA, Sri Komanduri, MD, FASGE, Michael Manfredi, MD, Udayakumar Navaneethan, MD, John T. Maple, DO, FASGE, Rahul Pannala, MD, MPH, FASGE, Mansour A. Parsi, MD, FASGE, Zachary L. Smith, DO, Shelby A. Sullivan, MD, Subhas Banerjee, MD, FASGE Gastrointestinal Endoscopy Volume 83, Issue 4, Pages 684-698.e7 (April 2016) DOI: 10.1016/j.gie.2016.01.007 Copyright © 2016 Terms and Conditions

Figure 1 Flow diagram depicting included studies selection for the meta-analysis. CINAHL, Cumulative Index to Nursing and Allied Health Literature; BE, Barrett's esophagus; CLE, confocal laser endomicroscopy; NBI, narrow-band imaging; eCLE, endoscope-based CLE; pCLE, probe-based CLE; PIVI, ASGE Preservation and Incorporation of Valuable Endoscopic Innovations. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Figure 2 A, Forest plot of studies evaluating sensitivity. B, Forest plot of studies evaluating negative predictive value. C, Forest plot of studies evaluating specificity of chromoendoscopy-guided targeted biopsy against current standard biopsy protocol during surveillance of nondysplastic Barrett’s esophagus. NPV, negative predictive value. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Figure 2 A, Forest plot of studies evaluating sensitivity. B, Forest plot of studies evaluating negative predictive value. C, Forest plot of studies evaluating specificity of chromoendoscopy-guided targeted biopsy against current standard biopsy protocol during surveillance of nondysplastic Barrett’s esophagus. NPV, negative predictive value. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Figure 3 A, Forest plot of studies evaluating sensitivity. B, Forest plot of studies evaluating negative predictive value. C, Forest plot of studies evaluating specificity of narrow-band imaging–guided targeted biopsy against current standard biopsy protocol during surveillance of nondysplastic Barrett’s esophagus. NBI, narrow-band imaging; NPV, negative predictive value. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Figure 3 A, Forest plot of studies evaluating sensitivity. B, Forest plot of studies evaluating negative predictive value. C, Forest plot of studies evaluating specificity of narrow-band imaging–guided targeted biopsy against current standard biopsy protocol during surveillance of nondysplastic Barrett’s esophagus. NBI, narrow-band imaging; NPV, negative predictive value. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Figure 4 A, Forest plot of studies evaluating sensitivity. B, Forest plot of studies evaluating negative predictive value. C, Specificity of confocal laser endomicroscopy–guided targeted biopsy against current standard biopsy protocol during surveillance of nondysplastic Barrett’s esophagus. CLE, confocal laser endomicroscopy; eCLE, endoscope-based confocal laser endomicroscopy; pCLE, probe-based confocal laser endomicroscopy; NPV, negative predictive value. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Figure 4 A, Forest plot of studies evaluating sensitivity. B, Forest plot of studies evaluating negative predictive value. C, Specificity of confocal laser endomicroscopy–guided targeted biopsy against current standard biopsy protocol during surveillance of nondysplastic Barrett’s esophagus. CLE, confocal laser endomicroscopy; eCLE, endoscope-based confocal laser endomicroscopy; pCLE, probe-based confocal laser endomicroscopy; NPV, negative predictive value. Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Supplemental Figure 1 Publication bias funnel plot for chromoendoscopy (A), narrow-band imaging (B), autofluorescence imaging with NBA (C), and confocal laser endomicroscopy (D). Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions

Supplemental Figure 1 Publication bias funnel plot for chromoendoscopy (A), narrow-band imaging (B), autofluorescence imaging with NBA (C), and confocal laser endomicroscopy (D). Gastrointestinal Endoscopy 2016 83, 684-698.e7DOI: (10.1016/j.gie.2016.01.007) Copyright © 2016 Terms and Conditions