Exploring the feasibility of home-delivered capsule endoscopy with 5G support: innovations and carbon footprint insights.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY BMJ Open Gastroenterology Pub Date : 2024-10-31 DOI:10.1136/bmjgast-2024-001500
Gohar Jalayeri Nia, Cassie Conway, Frances Ward, Sheena Dungey, Linda Streames, Bei Bei Liu, Ian Lo Lei, James Cameron, Hagen Wenzek, Chander Shekhar, Sally Eason, Ramesh P Arasaradnam
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Abstract

Introduction: Colorectal cancer (CRC) poses a significant global health threat, necessitating early detection. Traditional diagnostic tools like optical colonoscopy have limitations prompting our '5G-SUCCEEDS' initiative to explore a novel approach involving remote colon capsule endoscopy (CCE).

Methods: This prospective feasibility study was conducted at a single hospital in England. Between December 2022 and September 2023, we introduced a remote CCE service within the 5G-SUCCEEDS framework. We undertook a feasibility study of CCE in patients with low-risk/moderate-risk CRC stratified by faecal haemoglobin. Outcomes included carbon footprint analysis (outlined through three potential clinical pathways) and patient-reported outcomes through structured questionnaires and interviews.

Results: Among 25 participants, 88% expressed satisfaction with remote CCE. 82% were willing to have remote CCE if clinically indicated in future. CCE findings included adenomatous polyps (58%), normal results (17%) and diverticulosis (21%), with no cancers identified in this pilot. Notably, we found that the carbon footprint associated with delivery of CCE at home (pathway 3) was lower compared with CCE delivered in a clinical setting (pathway 2). A fully optimised, automated scaled-up pathway would combine the delivery and collection of CCE equipment within a local area to reduce the carbon footprint of the travel element by 75%. Moreover, the conversion rate into a colonoscopy pathway is not static and clinicians acknowledge that this could be as low as 28%. Carbon footprint is more favourable for home-delivered CCE in the optimised scenario, while less so when considering the need for additional procedures (colonoscopy conversion).

Conclusion: The 5G-SUCCEEDS initiative highlights the feasibility and advantages of home-based diagnostics using CCE.

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探索在 5G 支持下进行上门胶囊内窥镜检查的可行性:创新和碳足迹见解。
简介结肠直肠癌(CRC)对全球健康构成重大威胁,必须及早发现。光学结肠镜等传统诊断工具存在局限性,这促使我们的 "5G-SUCCEEDS "计划探索一种涉及远程结肠胶囊内镜(CCE)的新方法:这项前瞻性可行性研究在英国一家医院进行。2022 年 12 月至 2023 年 9 月期间,我们在 5G-SUCCEEDS 框架内引入了远程 CCE 服务。我们对按粪便血红蛋白分层的低风险/中度风险 CRC 患者进行了 CCE 可行性研究。研究结果包括碳足迹分析(通过三种可能的临床路径进行概述)以及通过结构化问卷和访谈进行的患者报告结果:结果:在 25 名参与者中,88% 的人对远程 CCE 表示满意。结果:在 25 名参与者中,88% 的人对远程 CCE 表示满意,82% 的人愿意在将来有临床需要时进行远程 CCE。CCE 结果包括腺瘤性息肉(58%)、正常结果(17%)和憩室(21%),本次试验未发现癌症。值得注意的是,我们发现在家进行 CCE(路径 3)与在临床环境中进行 CCE(路径 2)相比,碳足迹更低。经过全面优化的自动化扩大路径将把在当地提供和收集 CCE 设备结合起来,从而将旅行环节的碳足迹减少 75%。此外,结肠镜检查路径的转换率并不是一成不变的,临床医生承认转换率可能低至 28%。在优化方案中,碳足迹更有利于家庭交付的 CCE,而在考虑到需要额外程序(结肠镜检查转换)时,碳足迹就不那么有利了:5G-SUCCEEDS计划凸显了使用CCE进行家庭诊断的可行性和优势。
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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