Table BSummary of the SOE and main findings of studies comparing WMC alone (KQ 3) or in combination (KQ 4) with other diagnostic tests for the evaluation of slow-transit constipation

KQComparisonOutcomeSOE*Number of StudiesMain Findings
KQ 3WMC vs. ROMDiagnostic accuracyLow5Diagnostic accuracy of WMC is similar to ROM. Concordance between ROM and WMC was approximately 80% in 3 larger studies. The sensitivity for WMC compared with clinical suspicion ranged from 32 to 46% and specificity ranged from 95 to 100%. The sensitivity of day-5 ROM ranged from 28 to 37% and specificity ranged from 95 to 100%.
KQ 3WMC vs. ROMMotility assessment: TransitLow3WMC was comparable with ROM in judgment of colonic transit time and identification of slow-transit constipation.
KQ 3WMC vs. ROMTreatment decisionsLow2Very small numbers made comparison difficult for treatment decisions. Studies reported 7.1% change in nutrition, 21% referral to surgery, and 4% change in nutritional and behavioral therapies with WMC.
KQ 3WMC vs. ROMResource utilizationLow4WMC testing may reduce the need for other tests, but this conclusion is based on one study with a high risk of bias. WMC does not replace anorectal manometry.
KQ 3WMC vs. ROMHarmsLow5Harms and adverse events were infrequently reported for WMC or ROM. WMC is comparable to ROM with regard to harms.
ROM involves exposure to at least one x ray. Day 21 x ray was required in a small proportion of patients who received WMC by protocol if the capsule had not spontaneously passed. Technical failures were reported in prototype devices the range of 3 to 10% in some series.11
KQ 3WMC vs. ROMPatient-centered outcomesInsufficient0No studies addressed this outcome.
KQ 3WMC vs. colonic scintigraphyDiagnostic accuracyInsufficient0No studies assessed the role of WMC versus these other modalities in the population of interest for this outcome.
KQ 4WMC in combination with other diagnostic tests vs. other tests aloneDiagnostic accuracyInsufficient0No studies addressed this question.

KQ = Key Question; ROM = radiopaque markers; WMC = wireless motility capsule

*

The SOE was defined as follows: High = High confidence that the evidence reflects the true effect. Further research is unlikely to change our confidence in the estimate of the effect. Moderate = Moderate confidence that the evidence reflects the true effect. Further research may change our confidence in the estimate of the effect and may change the estimate. Low = Low confidence that the evidence reflects the true effect. Further research is likely to change our confidence in the estimate of the effect and is likely to change the estimate. Insufficient = Evidence is unavailable or does not permit a conclusion.

Findings were based on observational studies that did not include a direct comparison of WMC with ROM.

From: Executive Summary

Cover of Wireless Motility Capsule Versus Other Diagnostic Technologies for Evaluating Gastroparesis and Constipation: A Comparative Effectiveness Review
Wireless Motility Capsule Versus Other Diagnostic Technologies for Evaluating Gastroparesis and Constipation: A Comparative Effectiveness Review [Internet].
Comparative Effectiveness Reviews, No. 110.
Stein E, Berger Z, Hutfless S, et al.

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