THE ROLE OF THE ENDOSCOPIC DOPPLER PROBE IN NON VARICEAL UPPER GASTROINTESTINAL BLEEDING: A SYSTEMATIC REVIEW AND META-ANALYSIS
Bibliographic record
Abstract
Aims The effectiveness of the Doppler Endoscopic Probe (DEP) inserted through the operating channel in non-variceal upper gastrointestinal bleeding (NVUGIB). We aimed to perform a systematic review characterizing the effectiveness of DEP in patients with NVUGIB. Methods A literature search until July 2021 using OVID MEDLINE, EMBASE, and ISI Web of Knowledge identified studies addressing DEP in NVUGIB. A series of meta-analyses were performed assessing outcomes amongst observational and intervention studies for DEP signal positive and negative lesions as well as DEP-assisted versus standard endoscopies. The primary outcome was “overall rebleeding”; secondary outcomes included all-cause mortality, bleeding-related mortality, need for surgery, length of stay, ICU stay and angiography. Results Fourteen studies were included from 1911 citations identified. Observational studies compared bleeding lesions with DEP positive versus DEP negative signals 11 studies, n=800 pre-hemostasis that includes 5 studies, n=148 with post-hemostasis data. Three interventional studies (n=308) compared DEP-assisted to standard endoscopy management. DEP signal positive versus negative lesions both prior to or following any possible hemostasis were at greater risk of overall rebleeding (OR=6.54; 95%CI 2.36; 18.11,I2=46% and OR=25.96; 95%CI 6.74; 100.0, I2=0%respectively). The use of DEP during endoscopy significantly reduced overall rebleeding rates (OR=0.27; 95%CI 0.14; 0.54). When removing outcomes analysis for which only one study was available, all evaluable outcomes were improved with DEP characterization of management guidance except for all-cause mortality. Fig. 1 Conclusions DEP-related information improves on sole visual determination of the rebleeding risk of a NVUGIB lesion with DEP-guided management resulting in decreased overall rebleeding, bleeding-related mortality and need for surgery. Publication History Article published online: 14 April 2022 © 2022. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.024 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.018 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".