Gastrointestinal and Liver Unit, Faculty of Nursing, Kifissia General and Oncology Hospital, Agioi Anargyroi, Athens, Greece.
Eur J Gastroenterol Hepatol. 2011 Feb;23(2):166-70. doi: 10.1097/meg.0b013e3283433abf.
Complete review of wireless capsule endoscopy (WCE) recordings by a physician is time-consuming and laborious and may be perceived as a limitation to perform WCE. The aim of this study was to evaluate the efficacy of a nurse in interpreting WCE.
A total of 102 WCE videos were evaluated by a single gastroenterologist and a nurse experienced as an assistant in diagnostic and interventional endoscopy and trained in WCE. After independently reviewing WCE videos, the two readers discussed their findings and came to a consensus.
The mean capsule reading time was significantly longer for the nurse compared with the gastroenterologist (117.3+/-24.8 vs. 63.8+/-8.5 min, P<0.001). No statistical differences were observed regarding the correct recognition of first gastric, duodenal and caecal images between the two readers. For the gastroenterologist, both sensitivity and specificity in detecting abnormal findings were 100% except for angiodysplasia [sensitivity 88.5%, 95% confidence interval (CI): 70-97.4]. For the nurse, the lowest sensitivity rates were in detecting polyps (70%, 95% CI: 34.9-92.3) and angiodysplasias (92.3%, 95% CI: 74.8-98.9). The interobserver agreement as determined by Cohen's κ coefficient was excellent except for polyps (k=0.71, 95% CI: 0.46-0.96).
A trained nurse is highly accurate in detecting abnormal findings and interpreting WCE recordings. Physician's role could be limited to consider and confirm thumbnails created by a nurse.
由医生完成无线胶囊内镜（WCE）记录的全面审查既耗时又费力，可能被认为是进行 WCE 的限制。本研究旨在评估护士解读 WCE 的效果。
一名胃肠病学家和一名具有诊断和介入内镜经验的护士对总共 102 个 WCE 视频进行了评估，并接受了 WCE 方面的培训。两位读者在独立审查 WCE 视频后，讨论了他们的发现并达成了共识。
护士的胶囊阅读时间明显长于胃肠病学家（117.3+/-24.8 分钟比 63.8+/-8.5 分钟，P<0.001）。两位读者对胃、十二指肠和盲肠图像的首次正确识别率没有统计学差异。对于胃肠病学家，除了血管畸形外，检测异常发现的敏感性和特异性均为 100%[敏感性 88.5%，95%置信区间（CI）：70-97.4]。对于护士，检测息肉（70%，95% CI：34.9-92.3）和血管畸形（92.3%，95% CI：74.8-98.9）的敏感性最低。通过 Cohen κ 系数确定的观察者间一致性除了息肉（k=0.71，95% CI：0.46-0.96）外，均为优秀。
经过培训的护士在检测异常发现和解释 WCE 记录方面具有高度准确性。医生的角色可以仅限于考虑和确认护士创建的缩略图。
