Wireless Motility Capsule Versus Other Diagnostic Technologies for Evaluating Gastroparesis and Constipation: A Comparative Effectiveness Review: Comparative Effectiveness Review Number 110
Wireless Motility Capsule Versus Other Diagnostic Technologies for Evaluating Gastroparesis and Constipation: A Comparative Effectiveness Review: Comparative Effectiveness Review Number 110
Overview
Gastroparesis is a condition in which patients experience symptoms of delayed gastric emptying in the absence of an actual physical blockage. The most common symptoms are nausea, vomiting, early satiety, bloating, abdominal pain, and postprandial fullness. Assessing gastric emptying delay is essential to diagnosing gastroparesis. In clinical research, the definition of gastroparesis is delayed gastric emptying as detected by clinical testing and the presence of symptoms of nausea and/or vomiting, postprandial fullness, early satiety, bloating, or epigastric pain for more than 3 months. The etiologies of gastroparesis are most often idiopathic, diabetic, or postsurgical, but can also be autoimmune, paraneoplastic, or neurologic. The condition is generally assessed in the outpatient setting, but some patients become severely ill with intractable vomiting and dehydration and are hospitalized. Hospitalizations for gastroparesis increased by 158 percent between 1995 and 2004. In individuals with diabetes and gastroparesis, digestion of food is unpredictable, and wild swings in blood glucose can increase morbidity and necessitate medical care. Constipation is common, occurring in 15 to 20 percent of the U.S. population. Multiple professional societies define constipation (with slight variation) as fewer than two bowel movements per week or a decrease in a person's normal frequency of stools accompanied by straining, difficulty passing stool, or passage of hard solid stools. Physicians must assess patients with symptoms of constipation via their medical history and a physical examination to exclude malignant or organic causes of constipation. Clinicians should ask about warning signs such as new onset of symptoms, obstructive symptoms, rectal bleeding, unintentional weight loss, or family history of early colon cancer. A rectal examination can help to delineate rectal function and tone and exclude a low rectal cancer. Clinicians should perform a colonoscopy on all patients over 50 who have never received a screening colonoscopy, and those who have fecal occult blood, iron deficiency anemia, or any other warning signs. However, the yield of colonoscopy in patients with constipation with warning signs is low. Once a physician has eliminated all organic causes for constipation, a diagnosis of functional constipation is appropriate. Our objective was to summarize the evidence on how useful current testing modalities for gastric and colonic motility are for diagnosing disease. Key Questions addressed include: KQ 1. In the evaluation of gastric dysmotility, how does the WMC alone compare with gastric scintigraphy, antroduodenal manometry, and endoscopy, in terms of diagnostic accuracy of gastric emptying delay, accuracy of motility assessment, effect on treatment decisions, effect on patient-centered outcomes, harms, and effect on resource utilization? KQ 2. When gastric scintigraphy, antroduodenal manometry, or endoscopy is used in the evaluation of gastric dysmotility, what is the incremental value of also using WMC, in terms of diagnostic accuracy of gastric emptying delay, accuracy of motility assessment, effect on treatment decisions, effect on patient-centered outcomes, harms, and effect on resource utilization? KQ 3. In the evaluation of colonic dysmotility, how does WMC alone compare with ROM and scintigraphy in terms of diagnostic accuracy of slow-transit constipation, accuracy of motility assessment, effect on treatment decisions, effect on patient-centered outcomes, harms, and effect on resource utilization? KQ 4. When an ROM or scintigraphy is used in the evaluation of colonic dysmotility, what is the incremental value of also using WMC, in terms of diagnostic accuracy of slow-transit constipation, accuracy of motility assessment, effect pm treatment decisions, effect on patient centered outcomes, harms, and effect on resource utilization?Description
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- Used - Acceptable: All pages and the cover are intact, but shrink wrap, dust covers, or boxed set case may be missing. Pages may include limited notes, highlighting, or minor water damage but the text is readable. Item may but the dust cover may be missing. Pages may include limited notes and highlighting, but the text cannot be obscured or unreadable.
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To complete your return, we require a tracking number, which shows the items which you already returned to us.
There are certain situations where only partial refunds are granted (if applicable)
- Book with obvious signs of use
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Depending on where you live, the time it may take for your exchanged product to reach you, may vary.
If you are shipping an item over $75, you should consider using a trackable shipping service or purchasing shipping insurance. We don’t guarantee that we will receive your returned item.
Overview
Gastroparesis is a condition in which patients experience symptoms of delayed gastric emptying in the absence of an actual physical blockage. The most common symptoms are nausea, vomiting, early satiety, bloating, abdominal pain, and postprandial fullness. Assessing gastric emptying delay is essential to diagnosing gastroparesis. In clinical research, the definition of gastroparesis is delayed gastric emptying as detected by clinical testing and the presence of symptoms of nausea and/or vomiting, postprandial fullness, early satiety, bloating, or epigastric pain for more than 3 months. The etiologies of gastroparesis are most often idiopathic, diabetic, or postsurgical, but can also be autoimmune, paraneoplastic, or neurologic. The condition is generally assessed in the outpatient setting, but some patients become severely ill with intractable vomiting and dehydration and are hospitalized. Hospitalizations for gastroparesis increased by 158 percent between 1995 and 2004. In individuals with diabetes and gastroparesis, digestion of food is unpredictable, and wild swings in blood glucose can increase morbidity and necessitate medical care. Constipation is common, occurring in 15 to 20 percent of the U.S. population. Multiple professional societies define constipation (with slight variation) as fewer than two bowel movements per week or a decrease in a person's normal frequency of stools accompanied by straining, difficulty passing stool, or passage of hard solid stools. Physicians must assess patients with symptoms of constipation via their medical history and a physical examination to exclude malignant or organic causes of constipation. Clinicians should ask about warning signs such as new onset of symptoms, obstructive symptoms, rectal bleeding, unintentional weight loss, or family history of early colon cancer. A rectal examination can help to delineate rectal function and tone and exclude a low rectal cancer. Clinicians should perform a colonoscopy on all patients over 50 who have never received a screening colonoscopy, and those who have fecal occult blood, iron deficiency anemia, or any other warning signs. However, the yield of colonoscopy in patients with constipation with warning signs is low. Once a physician has eliminated all organic causes for constipation, a diagnosis of functional constipation is appropriate. Our objective was to summarize the evidence on how useful current testing modalities for gastric and colonic motility are for diagnosing disease. Key Questions addressed include: KQ 1. In the evaluation of gastric dysmotility, how does the WMC alone compare with gastric scintigraphy, antroduodenal manometry, and endoscopy, in terms of diagnostic accuracy of gastric emptying delay, accuracy of motility assessment, effect on treatment decisions, effect on patient-centered outcomes, harms, and effect on resource utilization? KQ 2. When gastric scintigraphy, antroduodenal manometry, or endoscopy is used in the evaluation of gastric dysmotility, what is the incremental value of also using WMC, in terms of diagnostic accuracy of gastric emptying delay, accuracy of motility assessment, effect on treatment decisions, effect on patient-centered outcomes, harms, and effect on resource utilization? KQ 3. In the evaluation of colonic dysmotility, how does WMC alone compare with ROM and scintigraphy in terms of diagnostic accuracy of slow-transit constipation, accuracy of motility assessment, effect on treatment decisions, effect on patient-centered outcomes, harms, and effect on resource utilization? KQ 4. When an ROM or scintigraphy is used in the evaluation of colonic dysmotility, what is the incremental value of also using WMC, in terms of diagnostic accuracy of slow-transit constipation, accuracy of motility assessment, effect pm treatment decisions, effect on patient centered outcomes, harms, and effect on resource utilization?Description
Condition Guidelines
Books - New and Used
The following guidelines apply to books:
- New: A brand-new copy with cover and original protective wrapping intact. Books with markings of any kind on the cover or pages, books marked as "Bargain" or "Remainder," or with any other labels attached, may not be listed as New condition.
- Used - Good: All pages and cover are intact (including the dust cover, if applicable). Spine may show signs of wear. Pages may include limited notes and highlighting. May include "From the library of" labels. Shrink wrap, dust covers, or boxed set case may be missing. Item may be missing bundled media.
- Used - Acceptable: All pages and the cover are intact, but shrink wrap, dust covers, or boxed set case may be missing. Pages may include limited notes, highlighting, or minor water damage but the text is readable. Item may but the dust cover may be missing. Pages may include limited notes and highlighting, but the text cannot be obscured or unreadable.
Note: Some electronic material access codes are valid only for one user. For this reason, used books, including books listed in the Used – Like New condition, may not come with functional electronic material access codes.
Shipping & Delivery
Shipping Fees
- Stevens Books offers FREE SHIPPING everywhere in the United States for ALL non-book orders, and $3.99 for each book.
- Packages are shipped from Monday to Friday.
- No additional fees and charges.
Delivery Times
The usual time for processing an order is 24 hours (1 business day), but may vary depending on the availability of products ordered. This period excludes delivery times, which depend on your geographic location.
Estimated delivery times:
- Standard Shipping: 5-8 business days
- Expedited Shipping: 3-5 business days
Shipping method varies depending on what is being shipped.
Tracking
All orders are shipped with a tracking number. Once your order has left our warehouse, a confirmation e-mail with a tracking number will be sent to you. You will be able to track your package at all times.
Damaged Parcel
If your package has been delivered in a PO Box, please note that we are not responsible for any damage that may result (consequences of extreme temperatures, theft, etc.).
If you have any questions regarding shipping or want to know about the status of an order, please contact us or email to support@stevensbooks.com.
Returns & Refunds
You may return most items within 30 days of delivery for a full refund.
To be eligible for a return, your item must be unused and in the same condition that you received it. It must also be in the original packaging.
Several types of goods are exempt from being returned. Perishable goods such as food, flowers, newspapers or magazines cannot be returned. We also do not accept products that are intimate or sanitary goods, hazardous materials, or flammable liquids or gases.
Additional non-returnable items:
- Gift cards
- Downloadable software products
- Some health and personal care items
To complete your return, we require a tracking number, which shows the items which you already returned to us.
There are certain situations where only partial refunds are granted (if applicable)
- Book with obvious signs of use
- CD, DVD, VHS tape, software, video game, cassette tape, or vinyl record that has been opened
- Any item not in its original condition, is damaged or missing parts for reasons not due to our error
- Any item that is returned more than 30 days after delivery
Items returned to us as a result of our error will receive a full refund,some returns may be subject to a restocking fee of 7% of the total item price, please contact a customer care team member to see if your return is subject. Returns that arrived on time and were as described are subject to a restocking fee.
Items returned to us that were not the result of our error, including items returned to us due to an invalid or incomplete address, will be refunded the original item price less our standard restocking fees.
If the item is returned to us for any of the following reasons, a 15% restocking fee will be applied to your refund total and you will be asked to pay for return shipping:
- Item(s) no longer needed or wanted.
- Item(s) returned to us due to an invalid or incomplete address.
- Item(s) returned to us that were not a result of our error.
You should expect to receive your refund within four weeks of giving your package to the return shipper, however, in many cases you will receive a refund more quickly. This time period includes the transit time for us to receive your return from the shipper (5 to 10 business days), the time it takes us to process your return once we receive it (3 to 5 business days), and the time it takes your bank to process our refund request (5 to 10 business days).
If you need to return an item, please Contact Us with your order number and details about the product you would like to return. We will respond quickly with instructions for how to return items from your order.
Shipping Cost
We'll pay the return shipping costs if the return is a result of our error (you received an incorrect or defective item, etc.). In other cases, you will be responsible for paying for your own shipping costs for returning your item. Shipping costs are non-refundable. If you receive a refund, the cost of return shipping will be deducted from your refund.
Depending on where you live, the time it may take for your exchanged product to reach you, may vary.
If you are shipping an item over $75, you should consider using a trackable shipping service or purchasing shipping insurance. We don’t guarantee that we will receive your returned item.
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