Seventeen studies (n=526) were included.
The quality scores ranged from 8 to 15.
All studies (17 studies).
The pooled RD was 40.8% (95% CI: 35.6, 45.9, p<0.0001). CE significantly increased the odds of a positive finding compared with the control techniques (OR 4.9, 95% CI: 3.9, 6.4, p<0.001). The NND was 2 (95% CI: 2, 3): for every two patients investigated CE provided one more diagnosis compared with control techniques.
Studies of obscure GIB (9 studies).
The pooled RD was 36.9% (95% CI: 29.6, 44.1, p<0.0001). The odds of a positive finding was significantly increased in studies of CE compared with those of push enteroscopy (OR 4.3, 95% CI: 3.1, 6.0, p<0.001). The NND was 3 (95% CI: 3, 5).
Studies of patients with suspected or known CD (8 studies).
The pooled RD was 44.5% (95% CI: 30.9, 58.0, p<0.001). The odds of a positive finding were significantly higher among those who received CE compared with those who received enteroclysis (OR 5.4, 95% CI: 3.0, 9.9) and small bowel follow through (OR 13.0, 95% CI: 2.3, 71.4). The NND was 2 (95% CI: 2, 3).
In terms of safety, a failure to visualise the caecum occurred in 68 of the 526 patients submitted to CE.
Adverse events occurred in 29 patients. Among patients with obscure GIB, 15 adverse events were related to CE: these included technical defect, obscured vision due to active bleeding, blocked capsule, long oesophageal transit, capsule retention, temporary electrical disconnection, battery dysfunction and error to transfer data. One adverse event was related to push enteroscopy; this was due to no advance beyond the duodenal bulb. There were seven adverse events in patients with CD; these were all the result of capsule retention.