Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding

Background: Capsule endoscopy (CE) is the first-choice exploration in case of overt small bowel bleeding (SBB). An early CE is known to increase diagnostic yield, but long reading times may delay therapeutics. The study evaluates the diagnostic performance of the artificial intelligence tool TOP100...

Descripción completa

Detalles Bibliográficos
Autores: Giordano, Antonio, Escapa, Míriam, Urpí Ferreruela, Miquel, Casanova, Gherzon, Fernández Esparrach, Glòria, Ginès i Gibert, M. Àngels, Llach Vila, Josep, González Suárez, Begoña
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/217622
Acceso en línea:https://hdl.handle.net/2445/217622
Access Level:acceso abierto
Palabra clave:Càpsula endoscòpica
Intestí prim
Hemorràgia gastrointestinal
Intel·ligència artificial en medicina
Terapèutica
Capsule endoscopy
Small intestine
Gastrointestinal hemorrhage
Medical artificial intelligence
Therapeutics
id ES_b70eeea1aa2ed63a5418cb15ca490ea2
oai_identifier_str oai:diposit.ub.edu:2445/217622
network_acronym_str ES
network_name_str España
repository_id_str
spelling Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleedingGiordano, AntonioEscapa, MíriamUrpí Ferreruela, MiquelCasanova, GherzonFernández Esparrach, GlòriaGinès i Gibert, M. ÀngelsLlach Vila, JosepGonzález Suárez, BegoñaCàpsula endoscòpicaIntestí primHemorràgia gastrointestinalIntel·ligència artificial en medicinaTerapèuticaCapsule endoscopySmall intestineGastrointestinal hemorrhageMedical artificial intelligenceTherapeuticsBackground: Capsule endoscopy (CE) is the first-choice exploration in case of overt small bowel bleeding (SBB). An early CE is known to increase diagnostic yield, but long reading times may delay therapeutics. The study evaluates the diagnostic performance of the artificial intelligence tool TOP100 in patients with overt SBB undergoing early CE with Pillcam SB3. Methods: Patients who underwent early CE (up to 14 days from the bleeding episode) for suspected overt SBB were included. One experienced endoscopist prospectively performed standard reading (SR) and a second blind experienced endoscopist performed a TOP100-based reading (TR). The primary endpoint was TR diagnostic accuracy for lesions with high bleeding potential (P2). Results: A total of 111 patients were analyzed. The most common clinical presentation was melena (64%). CE showed angiodysplasias in 40.5% of patients (45/111). In per-patient analysis, TR showed a sensitivity of 90.48% (95% CI 82.09-95.80), specificity of 100% (95% CI 87.23-100) with a PPV of 100% (95% CI 94.01-100), NPV of 77.14% (95% CI 63.58-86.71) and diagnostic accuracy of 92.79 (86.29-96.84). At multivariate analysis, adequate intestinal cleansing was the only independent predictor of concordance between TR and SR (OR 2.909, p = 0.019). The median reading time for SR and TR was 23 min (18.0-26.8) and 1.9 min (range 1.7-2.1), respectively (p < 0.001). Conclusions: TOP100 provides a fast-reading mode for early CE in case of overt small bowel bleeding. It identifies most patients with active bleeding and angiodysplasias, aiding in the prioritization of therapeutic procedures. However, its accuracy in detecting ulcers, varices and P1 lesions seems insufficient.Springer Verlag2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/217622Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1007/s00464-023-10273-wSurgical Endoscopy, 2023, vol. 37, num.10, p. 7658-7666https://doi.org/10.1007/s00464-023-10273-wcc-by (c) Giordano, Antonio et al., 2023http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2176222026-05-27T06:46:51Z
dc.title.none.fl_str_mv Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
title Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
spellingShingle Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
Giordano, Antonio
Càpsula endoscòpica
Intestí prim
Hemorràgia gastrointestinal
Intel·ligència artificial en medicina
Terapèutica
Capsule endoscopy
Small intestine
Gastrointestinal hemorrhage
Medical artificial intelligence
Therapeutics
title_short Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
title_full Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
title_fullStr Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
title_full_unstemmed Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
title_sort Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding
dc.creator.none.fl_str_mv Giordano, Antonio
Escapa, Míriam
Urpí Ferreruela, Miquel
Casanova, Gherzon
Fernández Esparrach, Glòria
Ginès i Gibert, M. Àngels
Llach Vila, Josep
González Suárez, Begoña
author Giordano, Antonio
author_facet Giordano, Antonio
Escapa, Míriam
Urpí Ferreruela, Miquel
Casanova, Gherzon
Fernández Esparrach, Glòria
Ginès i Gibert, M. Àngels
Llach Vila, Josep
González Suárez, Begoña
author_role author
author2 Escapa, Míriam
Urpí Ferreruela, Miquel
Casanova, Gherzon
Fernández Esparrach, Glòria
Ginès i Gibert, M. Àngels
Llach Vila, Josep
González Suárez, Begoña
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Càpsula endoscòpica
Intestí prim
Hemorràgia gastrointestinal
Intel·ligència artificial en medicina
Terapèutica
Capsule endoscopy
Small intestine
Gastrointestinal hemorrhage
Medical artificial intelligence
Therapeutics
topic Càpsula endoscòpica
Intestí prim
Hemorràgia gastrointestinal
Intel·ligència artificial en medicina
Terapèutica
Capsule endoscopy
Small intestine
Gastrointestinal hemorrhage
Medical artificial intelligence
Therapeutics
description Background: Capsule endoscopy (CE) is the first-choice exploration in case of overt small bowel bleeding (SBB). An early CE is known to increase diagnostic yield, but long reading times may delay therapeutics. The study evaluates the diagnostic performance of the artificial intelligence tool TOP100 in patients with overt SBB undergoing early CE with Pillcam SB3. Methods: Patients who underwent early CE (up to 14 days from the bleeding episode) for suspected overt SBB were included. One experienced endoscopist prospectively performed standard reading (SR) and a second blind experienced endoscopist performed a TOP100-based reading (TR). The primary endpoint was TR diagnostic accuracy for lesions with high bleeding potential (P2). Results: A total of 111 patients were analyzed. The most common clinical presentation was melena (64%). CE showed angiodysplasias in 40.5% of patients (45/111). In per-patient analysis, TR showed a sensitivity of 90.48% (95% CI 82.09-95.80), specificity of 100% (95% CI 87.23-100) with a PPV of 100% (95% CI 94.01-100), NPV of 77.14% (95% CI 63.58-86.71) and diagnostic accuracy of 92.79 (86.29-96.84). At multivariate analysis, adequate intestinal cleansing was the only independent predictor of concordance between TR and SR (OR 2.909, p = 0.019). The median reading time for SR and TR was 23 min (18.0-26.8) and 1.9 min (range 1.7-2.1), respectively (p < 0.001). Conclusions: TOP100 provides a fast-reading mode for early CE in case of overt small bowel bleeding. It identifies most patients with active bleeding and angiodysplasias, aiding in the prioritization of therapeutic procedures. However, its accuracy in detecting ulcers, varices and P1 lesions seems insufficient.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/217622
url https://hdl.handle.net/2445/217622
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1007/s00464-023-10273-w
Surgical Endoscopy, 2023, vol. 37, num.10, p. 7658-7666
https://doi.org/10.1007/s00464-023-10273-w
dc.rights.none.fl_str_mv cc-by (c) Giordano, Antonio et al., 2023
http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) Giordano, Antonio et al., 2023
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer Verlag
publisher.none.fl_str_mv Springer Verlag
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869417497597313024
score 15.81155

Similares en LA Referencia