S733 Comparing the Histological Quality of Endoscopic Biopsy Samples Obtained Using a Novel Multiple Sample Forceps vs Conventional Forceps
Bibliographic record
Abstract
Introduction: Endoscopy is a common investigation used to obtain tissue samples for diagnostic purposes. Diagnostic certainty requires tissue samples of high quality from multiple sites. Presently, the forceps that are typically used in endoscopic procedures can extract up to two biopsies at a given time. For diseases requiring more than two biopsies for diagnostic certainty, such as celiac disease, there is a considerable temporal burden placed on the endoscopist as they must pass the forceps in and out of the endoscope multiple times. Increases in endoscopy time have been associated with low adherence to diagnostic guidelines. In porcine gastric samples Multicroc® single use multisampling biopsy forceps provided tissue samples of equal histological quality between the first and last (sixth) biopsy. The goal of the present study was to assess whether a novel forceps device that can obtain six biopsies at a given time can provide non-inferior quality of biopsy specimens while shortening endoscopy time relative to conventional forceps that can store only two biopsies. Methods: This was a prospective, randomized, non-inferiority study. Adult patients referred for an outpatient upper endoscopy to investigate for celiac disease or H. Pylori infection were enrolled. At the time of biopsy, patients were randomized to either have six biopsies retrieved with the conventional double bite forceps or Multicroc® forceps. The biopsy times and overall time of the procedure were recorded. Two pathologists, blinded to which forceps were used, assessed the histological quality of each biopsy on a four-point scale. Results: 100 patients were randomized (n=68 duodenal and n=32 gastric sampling), with 5 endoscopists participating. Agreement between pathologists was good (Pearson correlation 0.44). Mean number of total specimens was less in the Multicroc® group (3.3 vs. 4.7, P< 0.01). Specimen quality, as measured by total score, was non-inferior using Multicroc® forceps (3.41 vs. 3.40, P=0.9) and total biopsy time was significantly less using the Multicroc® forceps (83 vs 109 seconds P< 0.001). No differences were seen between the duodenal and gastric sampling sub-groups. Conclusion: Use of a new multiple sampling biopsy forceps results in non-inferior specimen quality and was associated with efficiency in obtaining samples. Although the Multicroc® forceps group had more lost specimens, this did not affect diagnostic quality and could possibly be accounted for in future practice.
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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 | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
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".