Diagnostic accuracy of magnetically controlled capsule endoscopy for gastric conditions: a systematic review and meta-analysis

Magnetically controlled capsule endoscopy (MCE) has emerged as a noninvasive alternative to esophagogastroduodenoscopy (EGD) for diagnosing gastric conditions. This review aimed to evaluate the diagnostic accuracy of MCE compared to EGD. A comprehensive search of multiple databases was conducted to identify studies assessing the diagnostic accuracy of MCE against the reference standard of EGD. Ten studies comprising 1667 diagnostic units were included. Pooled sensitivity, specificity, likelihood ratios, and the diagnostic odds ratio (DOR) were calculated using a random-effects model. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated using Deek's funnel plot asymmetry test. The pooled sensitivity and specificity of MCE were both 0.92 [95% confidence interval (CI): 0.84-0.96 and 0.69-0.98, respectively]. The area under the receiver operating characteristic curve was 0.96 (95% CI: 0.94-0.97), indicating excellent diagnostic performance. The pooled positive likelihood ratio was 11.3, and the negative likelihood ratio was 0.09. The DOR was 129 (95% CI: 18-941). Substantial heterogeneity was observed ( I2 = 97%). No publication bias was detected ( P = 0.18). MCE demonstrates high diagnostic accuracy comparable to EGD for detecting gastric conditions, suggesting it could be an effective noninvasive alternative in specific clinical settings. However, significant interstudy variability in specificity warrants further investigation and standardization. Future research should focus on optimizing its clinical use and assessing its cost-effectiveness.