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Capsule Endoscopy: Is There a Role for Nurses as Physician Extenders?

Sidhu, Reena MRCP; Sanders, David S. MD, FRCP, FACG; Kapur, Kapil FRCP; Marshall, Laura RGN; Hurlstone, David P. MD, MRCP; McAlindon, Mark E. BMedSCi, DM, FRCP


Capsule endoscopy is a novel technique for examining the small bowel; however, data interpretation is time consuming and requires expertise. This study aimed to compare the interpretation of capsule endoscopy between an experienced gastroenterologist and a nurse. A total of 50 consecutive videos were viewed independently by a nurse and a physician, both blinded to the referral indications. The nurse had no prior experience with capsule endoscopy. Possible pathology was graded in a pre-agreed standardized manner, with findings described as “relevant,” “uncertain,” or “irrelevant.” Another gastroenterologist, who had knowledge of all the cases including follow-up data and clinical outcomes, independently arbitrated. Findings showed no difference in the number of relevant or uncertain pathologies identified. The nurse reader was more likely to record irrelevant findings (4.7 vs. 2.0 lesions; p < .01) and required more time to read the videos than the physician (mean = 73 vs. 58 min; p < .01). This study shows that a nurse capsule endoscopy reader is as capable as an experienced physician in identifying small bowel mucosal abnormalities on capsule endoscopy. Capsule endoscopy is an area in which nurses could develop as physician extenders.

Reena Sidhu, MRCP, is Specialist Registrar in Gastroenterology; David S. Sanders, MD, FRCP, FACG, is Consultant Gastroenterologist; Kapil Kapur, FRCP, is Consultant Gastroenterologist; Laura Marshall, RGN, is Staff Nurse; David P. Hurlstone, MD, MRCP, is Consultant Gastroenterologist; and Mark E. McAlindon, BMedSCi, DM, FRCP, is Consultant Gastroenterologist, Gastroenterology & Liver Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.

Correspondence to: Reena Sidhu, MRCP, 15 Barncliffe Road, Fulwood, Sheffield S10 4DF, United Kingdom (e-mail:

Requests for reprints to: Mark E. McAlindon, BMedSCi, DM, FRCP (e-mail:

Received July 1, 2006; accepted August 26, 2006.

© 2007 by the Society of Gastroenterology Nurses and Associates, Inc.