{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T18:07:02Z","timestamp":1790273222478,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the diagnostic algorithm of Crohn\u2019s disease (CD), video capsule endoscopy (VCE) is used as a subsequent investigation when initial assessments are inconclusive (ileocolonoscopy and computed tomography\/magnetic resonance enterography). The long-term clinical significance of a negative VCE remains uncertain. Therefore, we evaluated long-term clinical outcomes in patients with suspected CD and inconclusive standard investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of adults with inconclusive standard investigation for suspected CD who were referred for VCE at a tertiary inflammatory bowel diseases center between 2008 and 2017. VCE studies were scored using the Lewis score. Patients with a Lewis score &amp;lt;135 were defined as \u201cnegative VCE.\u201d Patients with negative VCE were followed for subsequent CD or alternative diagnoses. Final CD diagnosis was verified by review of electronic clinical charts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 615 consecutive patients (median age 36\u2009years; 57.5% female), 192 (31.2%) were identified with a positive VCE suggestive of small bowel CD. Overall, 18 (4.3%) of 423 patients with a negative VCE had a subsequent diagnosis of CD over a median follow-up of 11\u2009years (interquartile range: 10-13 years; 4665 patient-years); median time to diagnosis was 1.5\u2009years (interquartile range: 1-3 years). An alternative diagnosis was established in \u223c70% of patients with negative VCE (mostly functional disorders and noninflammatory conditions). The negative predictive value for a negative VCE to exclude CD was 95.7%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A negative VCE confers a very low likelihood of subsequent CD diagnosis in patients with suspected CD after nondiagnostic standard evaluation. Diagnostic efforts should instead focus on functional evaluation and dietary intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag188","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:23:41Z","timestamp":1788521021000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of patients with negative small bowel video capsule endoscopy for Crohn\u2019s disease: A cohort study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2698-0492","authenticated-orcid":false,"given":"Hadar","family":"Edelman-Klapper","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irit","family":"Avni-Biron","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7954-0699","authenticated-orcid":false,"given":"Jacob E","family":"Ollech","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shani","family":"Hegger","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]},{"name":"Department of General Intensive Care, Rabin Medical Center , Petah Tikva,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zohar","family":"Levi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Dotan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Rabin Medical Center , Petah Tikva,","place":["Israel"]},{"name":"Gray Faculty of Medical and Health Sciences, Tel Aviv University , Tel 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