Development of a Low-Cost Gastroscope Prototype (GP) for Potential Cost-Effective Gastric Cancer Screening in Prevalent Regions

James Xu; Mark E. Benson; Liam M. Granlund; Seth Gehrke; Dylan Stanfield; Jennifer Weiss; Patrick Pfau; Anurag Soni; Ben L. Cox; George Petry; Robert A. Swader; Mark Reichelderfer; Zhanhai Li; Tenzin Atrukstang; Nyah Banik; Kevin W. Eliceiri; Deepak V. Gopal

doi:10.1055/s-0043-1762574

Journal of Digestive Endoscopy, Table of Contents

CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(01): 022-029
DOI: 10.1055/s-0043-1762574

Research Article

Development of a Low-Cost Gastroscope Prototype (GP) for Potential Cost-Effective Gastric Cancer Screening in Prevalent Regions

Authors

James Xu

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States

²Department of Internal Medicine, Kaiser Permanente San Francisco Medical Center, University of California-San Francisco, and University of California-Berkeley, United States
Mark E. Benson

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Liam M. Granlund

³Morgridge Institute for Research, Madison, Wisconsin, United States
Seth Gehrke

³Morgridge Institute for Research, Madison, Wisconsin, United States
Dylan Stanfield

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Jennifer Weiss

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Patrick Pfau

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Anurag Soni

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Ben L. Cox

³Morgridge Institute for Research, Madison, Wisconsin, United States
George Petry

³Morgridge Institute for Research, Madison, Wisconsin, United States
Robert A. Swader

³Morgridge Institute for Research, Madison, Wisconsin, United States
Mark Reichelderfer

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Zhanhai Li

⁴Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Wisconsin, United States
Tenzin Atrukstang

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Nyah Banik

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States
Kevin W. Eliceiri

³Morgridge Institute for Research, Madison, Wisconsin, United States

⁵Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Wisconsin, United States
Deepak V. Gopal

¹Division of Gastroenterology & Hepatology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Wisconsin, United States

Abstract

Background Screening for gastric cancer is known to be associated with reduced mortality in populations with high prevalence. However, many countries with high prevalence do not screen, with high costs being a significant reason for this.

Aims To describe, develop, and assess the potential for a low-cost gastroscope for early cancer screening and patient risk stratification.

Methods Our interdisciplinary team used both off-the-shelf and fabricated components to create multiple gastroscope prototypes (GP) in iterative fashion based off clinician feedback. Clinician endoscopists were surveyed using Likert scales regarding device potential, video quality, and handling when testing on a GI training device. Video quality comparison to clinically standard high-definition white light endoscopy (HD-WLE) was done using the absolute categorical ratings (ACR) method.

Results A candidate cost-effective GP with clinical potential was developed. Although initial versions were scored as inferior via ACR on all views tested when compared to HD-WLE (p < 0.001), participants agreed the concept may be beneficial (M = 4.52/5, SD = 0.72). In testing improved versions, participants agreed the device had the ability to identify discrete (M = 4.62/5, SD = 0.51) and subtle lesions (M = 4/5, SD = 0.7) but most felt video quality, although improved, was still less than HD-WLE. Sufficiency of maneuverability of device to visualize gastric views was rated as equivocal (M = 2.69/5, SD = 1.25).

Conclusion The presented low-cost gastroscopic devices have potential for clinical application. With further device development and refinement including the possible addition of technologies in telemedicine and artificial intelligence, we hope the GP can help expand gastric cancer screening for populations in need.

Keywords

endoscopy - gastric cancer - screening

Full Text

References

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