title: Suspected blood indicator in capsule endoscopy: a valuable tool for gastrointestinal bleeding diagnosis.
abstract: BACKGROUND
  Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI) is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy.
  
  
  OBJECTIVE
  - We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding. Methods - Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years. The investigators marked lesions with high bleeding potential (P2), such as angioectasias, ulcers and tumours, as well as active bleeding during regular small bowel capsule endoscopy viewing with PillCam SB2(r). All small bowel capsule endoscopy were independently reviewed by another central reader using SBI.
  
  
  RESULTS
  - Among the 281 patients, 29 (10.3%) presented with active haemorrhage while 81 (28.9%) presented with a P2 lesion. The most frequently observed P2 lesions were angioectasias (52), ulcers (15), polyps (7) and ulcerated neoplasias (7). SBI showed a 96.6% (28/29) sensitivity for active small bowel bleeding, with a 97.7% negative predictive value. Regarding P2 lesions, the SBI displayed an overall sensitivity of 39.5%, being highest for ulcerated neoplasias (100%), but significantly lower for angioectasias (38.5%) or ulcers (20.0%).
  
  
  CONCLUSIONS
  Although SBI sensitivity for the automatic detection of potentially bleeding lesions was low, it effectively detected active small bowel bleeding with very high sensitivity and negative predictive value.
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Boal Carvalho
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Magalhães
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Francisca
authors.initials: F
authors.lastname: Dias DE Castro
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Sara
authors.initials: S
authors.lastname: Monteiro
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Bruno
authors.initials: B
authors.lastname: Rosa
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Moreira
authors.affiliation: Hospital Senhora da Oliveira, Guimarães, Portugal.|Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho. Campus Gualtar, Braga, Portugal.|ICVS/3B's, PT Government Associate Laboratory, Guimarães, Braga, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Cotter
mesh_terms: D000328:Adult; D053704:Capsule Endoscopy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity