{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T10:18:03Z","timestamp":1784715483453,"version":"3.55.0"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T00:00:00Z","timestamp":1557100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Haemorrhage from ruptured oesophageal varices is a common cause of death in people with cirrhosis. Guidelines recommend screening for varices at time of cirrhosis diagnosis and throughout the course of the disease. Conventional gastroscopy is the criterion standard for variceal screening; however, is invasive, costly, and carries risks related to use of sedation. Ultra\u2010thin gastroscopy (using endoscopes with a shaft diameter \u22646\u00a0mm) has been proposed as an alternative method of variceal screening that mitigates these risks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the diagnostic accuracy of ultra\u2010thin gastroscopy compared to conventional gastroscopy for the diagnosis of varices in people with cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, EMBASE and Cochrane library databases were searched for studies that evaluated the accuracy of ultra\u2010thin gastroscopy compared to conventional gastroscopy in the diagnosis of oesophageal varices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten studies, 7 in known cirrhosis, with 752 participants were included in this systematic review. The overall prevalence of oesophageal varices was 42%. On bivariate modelling, pooled estimates of sensitivity and specificity were 98% (95% CI 93%\u201099%) and 96% (95% CI 91%\u201099%) respectively. The positive and negative likelihood ratios were 28 (95% CI 10.7\u201073.2) and 0.02 (95% CI 0.01\u20100.72) respectively. Kappa coefficient for inter\u2010observer agreement for any varices ranged from 0.45 to 0.90. No serious adverse events related to ultra\u2010thin gastroscopy were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ultra\u2010thin gastroscopy is accurate in the diagnosis of oesophageal varices, safe and well tolerated. It is a valid alternative to conventional gastroscopy for the screening and surveillance of varices in people with cirrhosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15282","type":"journal-article","created":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T22:24:01Z","timestamp":1557181441000},"page":"1464-1473","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Systematic review with meta\u2010analysis: ultra\u2010thin gastroscopy compared to conventional gastroscopy for the diagnosis of oesophageal varices in people with cirrhosis"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0700-9801","authenticated-orcid":false,"given":"Tehara","family":"Wickremeratne","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Sunshine Coast University Hospital Birtinya Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Turner","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Sunshine Coast University Hospital Birtinya Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3400-2816","authenticated-orcid":false,"given":"James","family":"O'Beirne","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology Sunshine Coast University Hospital Birtinya Qld Australia"},{"name":"Hepatology University of the Sunshine Coast Sippy downs Qld Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1089-3261(05)70253-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198810133191505"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(02)00420-8"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.313"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.10.018"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12778-X"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21907"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28906"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.05.022"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250608"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1976.03260350032023"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(99)70283-X"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.06.021"},{"key":"e_1_2_7_15_1","first-page":"CD008760","article-title":"Capsule endoscopy for the diagnosis of oesophageal varices in people with chronic liver disease or portal vein thrombosis","author":"Colli A","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(94)70068-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(99)70002-7"},{"key":"e_1_2_7_18_1","unstructured":"Group DTAW.Handbook for DTA reviews. 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