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Original research
Clinical utility of small bowel ultrasound assessment of Crohn’s disease in adults: a systematic scoping review
  1. Shellie Jean Radford1,
  2. Chris Clarke2,
  3. Bethany Shinkins3,
  4. Paul Leighton4,
  5. Stuart Taylor5,
  6. Gordon Moran1
  1. 1NIHR Nottingham Biomedical Research Centre—Gastrointestinal and Liver Research Theme, School of Medicine, Nottingham, UK
  2. 2Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, Nottingham, UK
  3. 3University of Leeds Faculty of Medicine and Health, Leeds, West Yorkshire, UK
  4. 4School of Medicine, University of Nottingham, Nottingham, UK
  5. 5Medical Imaging, UCL, London, UK
  1. Correspondence to Shellie Jean Radford, NIHR Nottingham Biomedical Research Centre - Gastrointestinal and Liver research theme, School of Medicine, Nottingham NG7 2RD, UK; shelliejean{at}hotmail.co.uk

Abstract

Background Ultrasound (US) is an alternative to magnetic resonance enterography, and has the potential to significantly reduce waiting times, expedite clinical decision-making and improve patient experience. Point of care US is an advantage of the US imaging modality, where same day scanning, interpretation and treatment decisions can be made.

Aim To systematically scope the literature on point of care US use in small bowel Crohn’s disease, generating a comprehensive list of factors relating to the current understanding of clinical utility of this imaging modality.

Methods Searches included MEDLINE, EMBASE, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, clinicaltrial.gov,‘TRIP’ and Epistemonikos. Reference lists of included studies were hand searched. Search terms were searched for as both keywords and subject headings (MeSH) as appropriate. Searches were performed with the ‘suggested search terms’ and ‘explode’ selection, and restricted to ‘human’, ‘adult’ and ‘English language’ publications. No date limits were applied to be as inclusive as possible. Two investigators conducted abstract and full-text review. No formal quality appraisal process was undertaken; however, quality of sources was considered when reporting findings. A narrative synthesis was conducted.

Results The review included 42 sources from the UK, Europe, Japan, Canada and the USA. Small bowel ultrasound (SBUS) has been shown to be as accurate in detecting the presence of small bowel Crohn’s disease, is quicker, safer and more acceptable to patients, compared with magnetic resonance enterography. SBUS is used widely in central Europe and Canada but has not been embraced in the UK. Further research considering economic evaluation, clinical decision-making and exploration of perceived barriers to future implementation of SBUSs is required.

  • inflammatory bowel disease
  • Crohn's disease
  • ultrasonography
  • clinical decision making
  • IBD clinical

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Footnotes

  • Twitter @Shellie_Jean

  • Contributors SJR is acting as the submission’s guarantor. All coauthors have approved this final version of the manuscript for submission. SJR undertook the literature searches, read and analysed the data, conducted a narrative review, wrote the manuscript and collated reviews from coauthors. GM was second author, reading and analysing the data, contributed to the narrative review of the data, whole manuscript review and final editing. CC was appointed as third reviewer, however no discrepancies occurred. PL, BS and professor ST offer expert overview and whole manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer This study is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

  • Competing interests SJR, BS, PL and CC—nil to declare GWM has received educational support from Abbvie, Janssen, NAPP, Takeda Pharmaceuticals, Merck Sharp & Dohme Ltd, Ferring and Dr Falk. He has received speaker honoraria from Merck Sharp & Dohme Ltd, Abbvie, Janssen, Ferring and Takeda Pharmaceuticals. He attended advisory boards for Abbvie, Celgene, Takeda Pharmaceuticals, Janssen, Medtronic, Phebra Pharmaceuticals, Servertus Associates Ltd and Dr Falk. Dr Moran is a consultant for Alimentiv. SAT is consultant to Alimentiv and has share options in Motilent.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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