title: A rapid and accurate method to detect active small bowel gastrointestinal bleeding on video capsule endoscopy.
abstract: BACKGROUND
  Video capsule endoscopy (VCE) is indicated to evaluate for suspected small bowel bleeding, but "standard view" (SV) evaluation is time-consuming. Rapid Reader 6.0 software (Given Imaging, Duluth GA) contains two computer algorithmic systems: (1) "Quickview" (QV) which automatically skips similar images and (2) a pixel analysis program that identifies suspected blood (SBI). Combining the two modalities (QV + SBI) may provide a faster modality to assess for active small bowel bleeding.
  
  
  OBJECTIVE
  This study was designed to assess the accuracy of QV + SBI for small bowel bleeding compared to SV findings.
  
  
  METHODS
  This is a retrospective, case-control study at a single tertiary care referral hospital including all patients with VCE performed for suspected small bowel bleeding from 4/2007 to 3/2011. All studies were previously read using SV by one of two experienced faculty (CS, DR). The primary outcome was diagnostic accuracy of QV + SBI in assessing for active small bowel bleeding compared to SV.
  
  
  RESULTS
  A total of 116 VCE were included, 28 with active small bowel bleeding identified by original SV. Using QV + SBI, all 28 VCEs with active small bowel bleeding were identified. The sensitivity of QV + SBI to detect active bleeding was 100%, while the specificity was 93-94%. The mean time to identify landmarks and read the entire study was 3 min 20 s.
  
  
  CONCLUSIONS
  The QV + SBI reading format of VCE is an efficient, highly sensitive modality to assess for potential small bowel bleeding.
authors.affiliation: Section of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, University of Chicago Medicine, 5841 S. Maryland Ave., MC 4076, Chicago, IL, 60637, USA.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Stein
authors.forename: Anoop
authors.initials: A
authors.lastname: Appannagari
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Habib
authors.forename: Carol E
authors.initials: CE
authors.lastname: Semrad
authors.forename: David T
authors.initials: DT
authors.lastname: Rubin
mesh_terms: D053704:Capsule Endoscopy / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D012189:Retrospective Studies