***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Goal Aim of this study is to assess the feasibility of substituting sodium phosphate ( NaP ) with polyethylene glycol (PEG)-boosters in the protocol preparation for PillCam Colon Capsule Endoscopy ( CCE ) . Background CCE represents a new diagnostic , endoscopic technology for colonic exploration . Bowel preparation for CCE is necessary not only to clean the colon , but also to promote capsule propulsion . For this reason , NaP boosters have been added to a 4 L PEG-preparation . NaP has been recently related with major side-effects . Study Forty patients were prospect ively r and omized to St and ard ( n=20 ) or Modified ( n=20 ) regimen . St and ard regimen included clear liquid diet , 4 L of PEG , and 1 or 2 NaP boosters . In the Modified regimen , NaP boosters were substituted by 1 or 2 PEG boosters ; 4 senna tablets and a low-residue diet were also included . Patients underwent CCE and conventional colonoscopy , carried out on the same day . CCE excretion rate , colon transit time , colon cleansing , and accuracy were evaluated . Results Hundred percent and 75 % of CCE were excreted with the St and ard and Modified regimen , respectively ( P=0.02 ) . Mean±SE colonic transit time of capsule was 2.17±1.43 hours in the St and ard group , and 5.32±2.53 hours in the Modified group ( P<0.001 ) . Adequate preparation was achieved in 42.5 % of the cases , without statistically significant difference between the 2 groups ( 35 % vs. 53 % ; P = NS ) . CCE sensitivity and specificity for ≥6 mm polyps were 63 % and 87 % , without difference between the 2 groups . Conclusions The exclusion of NaP booster from CCE preparation result ed into a clinical ly meaningful reduction of the capsule excretion rate that was only partially compensated by the PEG booster BACKGROUND AND STUDY AIMS Population -based screening for colorectal cancer is widely recommended , with conventional colonoscopy considered to be the preferred diagnostic modality . However , compliance with screening colonoscopy is low and manpower capacity is limited . Capsule endoscopy might therefore represent a desirable alternative strategy . PATIENTS AND METHODS The PillCam Colon capsule endoscope was prospect ively tested in a multicenter setting . The indications for endoscopy in the enrolled patients included colorectal cancer screening ( 43 % ) , postpolypectomy surveillance ( 26 % ) , and lower gastrointestinal signs and symptoms ( 31 % ) . Study subjects underwent colon preparation and then ingested the capsule on the morning of the examination , with conventional colonoscopy being performed the same day . The PillCam Colon capsule findings were review ed by three experts in capsule endoscopy who were blinded to the conventional colonoscopy findings . RESULTS A total of 91 subjects were enrolled in three Israeli centers ( 55 men , 36 women ; mean age 57 ) , and the results were evaluable in 84 cases . The capsule was excreted within 10 hours in 74 % of the patients and reached the rectosigmoid colon in the other 16 % . Of the 84 evaluable patients , 20 ( 24 % ) had significant findings , defined as at least one polyp of 6 mm or more in size or three or more polyps of any size : 14/20 ( 70 % ) were identified with the capsule and 16/20 ( 80 % ) were identified by conventional colonoscopy .  Polyps of any size were found in 45 patients , 34/45 ( 76 % ) found by the capsule and 36/45 ( 80 % ) by conventional colonoscopy . In comparison with conventional colonoscopy , false-positive findings on PillCam Colon capsule examination were recorded in 15/45 cases ( 33 % ) . There were no adverse events related to the capsule endoscopy . CONCLUSIONS PillCam Colon capsule endoscopy appears to be a promising new modality for colonic evaluation . Further improvements in the procedure will probably increase capsule examination completion and polyp detection rates . Additional studies are needed to evaluate the accuracy of PillCam Colon endoscopy in other patient population s with different prevalence levels of colonic disease BACKGROUND & AIMS The efficacy of screening colonoscopy in first-degree relatives ( FDRs ) of patients with colorectal cancer ( CRC ) is limited by suboptimal uptake . We compared screening uptake of colon capsule endoscopy ( CCE ) vs colonoscopy in this population . METHODS We performed a prospect i ve study of 329 asymptomatic FDRs of patients with CRC who were r and omly assigned to groups examined by CCE ( PillCam , second generation ; n = 165 ) or colonoscopy ( n = 164 ) at a tertiary hospital in Spain from July 2012 through December 2013 . Crossover was permitted for patients who did not wish to undergo the assigned procedure . Subjects assigned to CCE who had a significant lesion ( polyp ≥ 10 mm , > 2 polyps of any size , or CRC ) were invited to undergo colonoscopy . RESULTS One hundred twenty subjects in the CCE group and 113 in the colonoscopy group were eligible for inclusion . In the intention-to-screen analysis , uptake was similar between groups ( 55.8 % CCE vs 52.2 % colonoscopy ; odds ratio [ OR ] , 0.86 ; 95 % confidence interval [ CI ] , 0.51 - 1.44 ; P = .57 ) ; 57.4 % of subjects crossed over from the CCE group , and 30.2 % crossed over from the colonoscopy group ( OR , 3.11 ; 95 % CI , 1.51 - 6.41 ; P = .002 ) . Unwillingness to repeat bowel preparation in the case of a positive result was the main reason that subjects assigned to the CCE group crossed over ; fear of colonoscopy was the reason that most patients in this group crossed over . A significant lesion was detected in 14 subjects ( 11.7 % ) in the CCE group and 13 subjects ( 11.5 % ) in the colonoscopy group ( OR , 1.02 ; 95 % CI , 0.45 - 2.26 ; P = .96 ) . CONCLUSIONS In a prospect i ve study , similar numbers of FDRs of patients with CRC assigned to undergo CCE or colonoscopy agreed to participate , but most preferred to  undergo colonoscopy . CCE was as effective as colonoscopy  in detecting significant lesions ; it could be a valid rescue strategy for subjects who reject screening colonoscopy . Clinical Trials.gov number : NCT01557101 Background Colonoscopy ( CSPY ) for colorectal cancer screening has several limitations . Colon Capsule Endoscopy ( PillCam Colon , CCE ) was compared to CSPY under routine screening conditions . Methods We performed a prospect i ve , single-center pilot study at a University Hospital . Data were obtained from November 2007 until May 2008 . Patients underwent CCE on Day 1 and CSPY on Day 2 . Outcomes were evaluated regarding sensitivity and specificity of polyp detection rate , with a significance level set at > 5 mm . Results 59 individuals were included in this study , the results were evaluable in 56 patients ( males 34 , females 22 ; median age 59 ) . CCE was complete in 36 subjects . Polyp detection rate for significant polyps was 11 % on CSPY and 27 % on CCE.6/56 ( 11 % ) patients had polyps on CSPY not detected on CCE ( miss rate).Overall sensitivity was 79 % ( 95 % confidence interval [ CI ] , 61 to 90 ) , specificity was 54 % ( 95 % CI , 35 to 70 ) , positive predictive value ( PPV ) was 63 % and negative predictive value ( NPV ) was 71 % . Adjusted to significance of findings , sensitivity was 50 % ( 95 % CI , 19 to 81 ) , specificity was 76 % ( 95 % CI , 63 to 86 ) , PPV was 20 % and NPV was 93 % . Conclusion In comparison to the gold st and ard , the sensitivity of CCE for detection of relevant polyps is low , however , the high NPV supports its role as a possible screening tool . Trial Registration NCT00991003 BACKGROUND Colon capsule endoscopy ( CCE ) is a new procedure for colon imaging . Limited information is available regarding visualization of flat colon lesions and patient acceptability in Japan . OBJECTIVE The aims of this study were to evaluate the sensitivity of CCE in detecting polyps and other lesions compared with optical colonoscopy ( OC ) and to evaluate its safety and acceptability in a cohort of Japanese patients . DESIGN A prospect i ve , open-label , clinical study in Japan . SETTING Multicenter . PATIENTS Patients referred for OC because of personal history of polyps ≥6 mm or any other colon lesion that required endoscopic or surgical treatment . INTERVENTIONS CCE followed by therapeutic colonoscopy . MAIN OUTCOME MEASUREMENTS The primary endpoint was per-patient sensitivity of CCE in detecting significant colon lesion . The secondary endpoints were CCE safety and patient acceptability . RESULTS Sixty-six of the 72 patients enrolled in the study were evaluated for efficacy . The per-patient sensitivity was 94 % ( 95 % confidence interval [ CI ] , 88.2%-99.7 % ) . The per-polyp sensitivity was 86.6 % ( 95 % CI , 81.3%-91.9 % ) when pathology-confirmed polyps were considered true positives . There were no adverse events related to CCE , and the acceptability of CCE was high . LIMITATIONS All patients had previously confirmed colon lesions , which may have falsely elevated the sensitivity of CCE . CONCLUSION CCE had a high sensitivity for detecting significant colon lesions . CCE was safe and had a high level of patient acceptability . ( CLINICAL TRIAL REGISTRATION NUMBER University Hospital Medical Information Network , UMIN000007258 . ) BACKGROUND & AIMS Capsule colonoscopy is a minimally invasive imaging method . We measured the accuracy of this technology in detecting polyps 6 mm or larger in an average-risk screening population . METHODS In a prospect i ve study , asymptomatic subjects ( n = 884 ) underwent capsule colonoscopy followed by conventional colonoscopy  ( the reference ) several weeks later , with an endoscopist blinded to capsule results , at 10 centers in the United States and 6 centers in Israel from June 2011 through April 2012 . An unblinded colonoscopy was performed on subjects found to have lesions 6 mm or larger by capsule but not conventional colonoscopy . RESULTS Among the 884 subjects enrolled , 695 ( 79 % ) were included in the analysis of capsule performance for all polyps . There were 77 exclusions ( 9 % ) for inadequate cleansing and whole-colon capsule transit time fewer than 40 minutes , 45 exclusions ( 5 % ) before capsule ingestion , 15 exclusions ( 2 % ) after ingestion and before colonoscopy , and 15 exclusions ( 2 % ) for site termination . Capsule colonoscopy identified subjects with 1 or more polyps 6 mm or larger with 81 % sensitivity ( 95 % confidence interval [ CI ] , 77%-84 % ) and 93 % specificity ( 95 % CI , 91%-95 % ) , and polyps 10 mm or larger with 80 % sensitivity ( 95 % CI , 74%-86 % ) and 97 % specificity ( 95 % CI , 96%-98 % ) . Capsule colonoscopy identified subjects with 1 or more conventional adenomas 6 mm or larger with 88 % sensitivity ( 95 % CI , 82%-93 ) and 82 % specificity ( 95 % CI , 80%-83 % ) , and 10 mm or larger with 92 % sensitivity ( 95 % CI , 82%-97 % ) and 95 % specificity ( 95 % CI , 94%-95 % ) . Sessile serrated polyps and hyperplastic polyps accounted for 26 % and 37 % , respectively , of false-negative findings from capsule analyses . CONCLUSIONS In an average-risk screening population , technically adequate capsule colonoscopy identified individuals with 1 or more conventional adenomas 6 mm or larger with 88 % sensitivity and 82 % specificity . Capsule performance seems adequate for patients who can not undergo colonoscopy or who had incomplete colonoscopies . Additional studies are needed to improve capsule detection of serrated lesions . Clinical trials.gov number : NCT01372878 Objective In case of incomplete colonoscopy , several radiologic methods have traditionally been used , but more recently , capsule endoscopy was also shown to be accurate . Aim of this study was to compare  colon capsule endoscopy ( CCE ) and CT colonography ( CTC ) in a prospect i ve cohort of patients with incomplete colonoscopy . Design Consecutive patients with a previous incomplete colonoscopy underwent CCE and CTC followed by colonoscopy in case of positive findings on either test ( polyps/mass lesions ≥6 mm ) . Clinical follow-up was performed in the other cases to rule 
    Output:
    
The sensitivity in detection of polyps > 6 mm and > 10 mm increased substantially between development of first-generation and second-generation colon capsules .
High specificity values for detection of polyps by CCE-2 seem to be achievable with a 10-mm cutoff and in a screening setting