Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring
Abstract Background and Aim Point‐of‐care ultrasound (POCUS) is a noninvasive alternative to ileocolonoscopy for monitoring disease activity in inflammatory bowel disease (IBD) but is underutilized in practice. Accuracy data are needed to engender clinician confidence in POCUS and increase uptake. T...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-04-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12269 |
| _version_ | 1819071440199090176 |
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| author | Dharshan Sathananthan Arvind Rajagopalan Lucinda Van De Ven Serena Martin James Fon Samuel Costello Robert V Bryant |
| author_facet | Dharshan Sathananthan Arvind Rajagopalan Lucinda Van De Ven Serena Martin James Fon Samuel Costello Robert V Bryant |
| author_sort | Dharshan Sathananthan |
| collection | DOAJ |
| description | Abstract Background and Aim Point‐of‐care ultrasound (POCUS) is a noninvasive alternative to ileocolonoscopy for monitoring disease activity in inflammatory bowel disease (IBD) but is underutilized in practice. Accuracy data are needed to engender clinician confidence in POCUS and increase uptake. The aim of this study was to evaluate the accuracy of POCUS compared to ileocolonoscopy in detecting active disease and extent in patients with IBD. Methods A prospective, blinded study was performed at a single tertiary center in South Australia between May 2017 and May 2018. Consecutive patients with a formal diagnosis of IBD who underwent both POCUS and ileocolonoscopy within 30 days of one another, performed to evaluate IBD disease activity, were eligible for participation. The accuracy of POCUS compared to ileocolonoscopy was assessed using sensitivity, specificity, and Cohen's kappa coefficient analyses. Results A total of 74 patients were included in the final analysis, 35 (47%) of whom had Crohn's disease and 39 (53%) ulcerative colitis; 37 subjects (50%) underwent a POCUS and ileocolonoscopy on the same day. POCUS demonstrated 91% sensitivity and 83% specificity for detecting endoscopically active IBD, correlating with a positive predictive value (PPV) of 89%, a negative predictive value (NPV) of 86%, and a kappa coefficient of 0.74 (88%). POCUS defined disease extent with 87% sensitivity and 81% specificity, correlating with a PPV of 85% and NPV of 83% and a kappa coefficient of 0.70 (85%). Conclusion POCUS is accurate in defining disease activity and extent in IBD compared to ileocolonoscopy. POCUS represents an appealing, noninvasive alternative to ileocolonoscopy for monitoring disease activity in IBD. |
| first_indexed | 2024-12-21T17:21:52Z |
| format | Article |
| id | doaj.art-c6de3ff79c6e4d458216e6a5d7c66d86 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-12-21T17:21:52Z |
| publishDate | 2020-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-c6de3ff79c6e4d458216e6a5d7c66d862022-12-21T18:56:08ZengWileyJGH Open2397-90702020-04-014227327910.1002/jgh3.12269Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoringDharshan Sathananthan0Arvind Rajagopalan1Lucinda Van De Ven2Serena Martin3James Fon4Samuel Costello5Robert V Bryant6Gastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaGastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaGastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaGastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaGastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaGastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaGastroenterology Department Queen Elizabeth Hospital Adelaide South Australia AustraliaAbstract Background and Aim Point‐of‐care ultrasound (POCUS) is a noninvasive alternative to ileocolonoscopy for monitoring disease activity in inflammatory bowel disease (IBD) but is underutilized in practice. Accuracy data are needed to engender clinician confidence in POCUS and increase uptake. The aim of this study was to evaluate the accuracy of POCUS compared to ileocolonoscopy in detecting active disease and extent in patients with IBD. Methods A prospective, blinded study was performed at a single tertiary center in South Australia between May 2017 and May 2018. Consecutive patients with a formal diagnosis of IBD who underwent both POCUS and ileocolonoscopy within 30 days of one another, performed to evaluate IBD disease activity, were eligible for participation. The accuracy of POCUS compared to ileocolonoscopy was assessed using sensitivity, specificity, and Cohen's kappa coefficient analyses. Results A total of 74 patients were included in the final analysis, 35 (47%) of whom had Crohn's disease and 39 (53%) ulcerative colitis; 37 subjects (50%) underwent a POCUS and ileocolonoscopy on the same day. POCUS demonstrated 91% sensitivity and 83% specificity for detecting endoscopically active IBD, correlating with a positive predictive value (PPV) of 89%, a negative predictive value (NPV) of 86%, and a kappa coefficient of 0.74 (88%). POCUS defined disease extent with 87% sensitivity and 81% specificity, correlating with a PPV of 85% and NPV of 83% and a kappa coefficient of 0.70 (85%). Conclusion POCUS is accurate in defining disease activity and extent in IBD compared to ileocolonoscopy. POCUS represents an appealing, noninvasive alternative to ileocolonoscopy for monitoring disease activity in IBD.https://doi.org/10.1002/jgh3.12269gastrointestinal ultrasoundileocolonoscopyinflammatory bowel diseasepoint‐of‐care ultrasound |
| spellingShingle | Dharshan Sathananthan Arvind Rajagopalan Lucinda Van De Ven Serena Martin James Fon Samuel Costello Robert V Bryant Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring JGH Open gastrointestinal ultrasound ileocolonoscopy inflammatory bowel disease point‐of‐care ultrasound |
| title | Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring |
| title_full | Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring |
| title_fullStr | Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring |
| title_full_unstemmed | Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring |
| title_short | Point‐of‐care gastrointestinal ultrasound in inflammatory bowel disease: An accurate alternative for disease monitoring |
| title_sort | point of care gastrointestinal ultrasound in inflammatory bowel disease an accurate alternative for disease monitoring |
| topic | gastrointestinal ultrasound ileocolonoscopy inflammatory bowel disease point‐of‐care ultrasound |
| url | https://doi.org/10.1002/jgh3.12269 |
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