Evidence map›Paper›PMID 39884722›Full record

ArticleBMJ open quality2025

Impact of introducing transnasal endoscopy on expanding diagnostic endoscopy services.

Ben Thomas Crosby, Laura Munglani, Karen Wright, Kay Charles, Wendy Evans, Megan Mathias, Stevie Davies, Badr Abdalla, Jeff Turner, Tom Crosby and 2 more

Abstract read
In one paragraph

Article in BMJ open quality, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Duodenal Biopsies for Coeliac Disease: Does Size Matter?Diagnostics (Basel, Switzerland) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ben Thomas CrosbyVelindre Cancer Centre, Cardiff, UK.ORCID http://orcid.org/0000-0003-2174-8360
Laura MunglaniCwmbran, The Grange University Hospital, Cwmbran, Wales, UK.
Karen WrightDepartment of Gastroenterology, University Hospital Llandough, Llandough, South Glamorgan, UK.
Kay CharlesDepartment of Gastroenterology, University Hospital Llandough, Llandough, South Glamorgan, UK.
Wendy EvansMoondance Cancer Initiative, Cardiff, UK.
Megan MathiasMoondance Cancer Initiative, Cardiff, UK.
Stevie DaviesYsbyty Glan Clwyd, Rhyl, Denbighshire, UK.
Badr AbdallaDepartment of Gastroenterology, University Hospital Llandough, Llandough, South Glamorgan, UK.
Jeff TurnerDepartment of Gastroenterology, University Hospital Llandough, Llandough, South Glamorgan, UK.
Tom CrosbyVelindre Cancer Centre, Cardiff, UK.
Nigel TrudgillDepartment of Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Hasan HaboubiDepartment of Gastroenterology, University Hospital Llandough, Llandough, South Glamorgan, UK Hasan.N.Haboubi@wales.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDemand for endoscopic services is outstripping capacity in the UK. Transnasal endoscopy (TNE) utilises a narrow calibre endoscope to pass through the nasal passages, thereby reducing retching and discomfort. It is better tolerated compared with standard transoral endoscopy (TOE) but is still rarely used as a diagnostic modality. There is still uncertainty about how well it performs against TOE in diagnostic ability, cost and efficiency.

methodsWe explored utilising TNE to deal with the growing demand for endoscopy. We compared findings to TOE procedures undertaken during the same time period. We evaluated cost differences, duration/time in the department for procedures as well as quality of procedures (both in terms of performance indicators as well as image quality using the validated POLPREP score).

resultsA total of 241 upper gastrointestinal endoscopy procedures were evaluated (100 TNE and 141 matched TOE) between December 2021 and February 2022. TNE outperformed TOE in obtaining >95% success rate in nationally approved key performance indicators (retroflexion and duodenal intubation, both p=0.026). It also was associated with better image quality in the oesophagus with a POLPREP A3 Score (excellent image quality) in 36/98 available images compared with 26/136 TOE (p=0.028) and was equivalent to TOE in the stomach and duodenum. TNE was identified as having a key role in facilitating complex cases, previously failed via the TOE route with a success rate in 11/12 (91.7%) of such cases. TNE also shows promise in correcting misdiagnoses of short-segment Barrett's oesophagus (39%) compared with TOE (14.8%) (p=0.087).

conclusionTNE is an emerging endoscopic modality, which shows great promise in replacing TOE in most diagnostic circumstances. In a modern healthcare service, TNE is cheaper, better tolerated and outperforms TOE in multiple domains.

Indexed as

Diagnostic ServicesEndoscopyNatural Orifice Endoscopic SurgeryFemaleHumansMaleUnited KingdomDiagnosisHealthcare quality improvementWaiting Lists

Identifiers

PMID39884722
PMCPMC11784182

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.