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- Leenhardt, R., et al.
(författare)
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Key research questions for implementation of artificial intelligence in capsule endoscopy
- 2022
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Ingår i: Therapeutic Advances in Gastroenterology. - : SAGE Publications. - 1756-283X .- 1756-2848. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artificial intelligence (AI) is rapidly infiltrating multiple areas in medicine, with gastrointestinal endoscopy paving the way in both research and clinical applications. Multiple challenges associated with the incorporation of AI in endoscopy are being addressed in recent consensus documents. Objectives: In the current paper, we aimed to map future challenges and areas of research for the incorporation of AI in capsule endoscopy (CE) practice. Design: Modified three-round Delphi consensus online survey. Methods: The study design was based on a modified three-round Delphi consensus online survey distributed to a group of CE and AI experts. Round one aimed to map out key research statements and challenges for the implementation of AI in CE. All queries addressing the same questions were merged into a single issue. The second round aimed to rank all generated questions during round one and to identify the top-ranked statements with the highest total score. Finally, the third round aimed to redistribute and rescore the top-ranked statements. Results: Twenty-one (16 gastroenterologists and 5 data scientists) experts participated in the survey. In the first round, 48 statements divided into seven themes were generated. After scoring all statements and rescoring the top 12, the question of AI use for identification and grading of small bowel pathologies was scored the highest (mean score 9.15), correlation of AI and human expert reading-second (9.05), and real-life feasibility-third (9.0). Conclusion: In summary, our current study points out a roadmap for future challenges and research areas on our way to fully incorporating AI in CE reading.
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| 3. |
- Huang, JJ, et al.
(författare)
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Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries
- 2021
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to examine the global burden, risk factors, and trends of esophageal cancer based on age, sex, and histological subtype. The data were retrieved from cancer registries database from 48 countries in the period 1980–2017. Temporal patterns of incidence and mortality were evaluated by average annual percent change (AAPC) using joinpoint regression. Associations with risk factors were examined by linear regression. The highest incidence of esophageal cancer was observed in Eastern Asia. The highest incidence of adenocarcinoma (AC) was found in the Netherlands, the United Kingdom, and Ireland. A higher AC/squamous cell carcinoma (SCC) incidence ratio was associated with a higher prevalence of obesity and elevated cholesterol. We observed an incidence increase (including AC and SCC) in some countries, with the Czech Republic (female: AAPC 4.66), Spain (female: 3.41), Norway (male: 3.10), Japan (female: 2.18), Thailand (male: 2.17), the Netherlands (male: 2.11; female: 1.88), and Canada (male: 1.51) showing the most significant increase. Countries with increasing mortality included Thailand (male: 5.24), Austria (female: 3.67), Latvia (male: 2.33), and Portugal (male: 1.12). Although the incidence of esophageal cancer showed an overall decreasing trend, an increasing trend was observed in some countries with high AC/SCC incidence ratios. More preventive measures are needed for these countries.
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- Koulaouzidis, George, et al.
(författare)
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Computed tomography coronary angiography as initial work-up for unstable angina pectoris : [Unstable anjina pektoris için başlangıç work-up olarak bilgisayarlı tomografi koroner anjiyografi]
- 2012
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Ingår i: European Journal of General Medicine. - : Modestum. - 1304-3889 .- 1304-3897 .- 2516-3507. ; 9:2, s. 111-117
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Tidskriftsartikel (refereegranskat)abstract
- Computed Tomography Coronary Angiography (CTCA) is a rapid, non-invasive diagnostic tool for coronary artery disease (CAD). Rapid Access Chest Pain Clinics (RACPC) were introduced in UK in 2000, in order to assess rapidly patients with chest pain. To evaluate the use of CTCA as initial work-up for unstable angina pectoris in a primary care-based RACPC. Eighty-eight (n=88) patients were examined by a consultant cardiologist and referred for CTCA if indicated. CTCA was performed with a 640 slices, 320-row CT scanner. Thirty-five (n=35) patients were discharged without further investigations; 50 (mean age 59.8 years; 24 male) were referred for CTCA and 3 were referred directly for an invasive angiography (IA). Following CTCA, 17 patients were discharged. Seventeen (n=17) patients with no history of CAD, but with positive CTCA findings and eleven (n=11) patients with known CAD but without new lesions on CTCA were discharged after optimisation of medical treatment. Five (n=5) of the 50 patients eventually underwent IA; 2 were referred for CABG; 3 continued with medical treatment. No major adverse cardiac events were recorded in a 6-months' follow up period. The cost for each patient who underwent CTCA was £1,087; 94% of patients rated their experience as good or excellent. The time interval from RACPC visit-to-definitive diagnosis was <3 weeks in 50% of patients, <6 weeks in 90%. Use of CTCA as initial investigation in Primary Care, is both clinically and cost-effective. CTCA should be considered in the initial diagnostic work-up of unstable angina pectoris patients, with or without prior history of CAD.
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| 6. |
- Leenhardt, R., et al.
(författare)
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A guide for assessing the clinical relevance of findings in small bowel capsule endoscopy : analysis of 8064 answers of international experts to an illustrated script questionnaire
- 2021
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Ingår i: Clinics and Research in Hepatology and Gastroenterology. - : Elsevier BV. - 2210-7401. ; 45:6
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Although recommended, the P-score used for assessing the pertinence / relevance of findings seen in small bowel (SB) capsule endoscopy (CE) is based on a low level of knowledge. The aim of this study was to evaluate the clinical relevance of the most frequent SBCE findings through an illustrated script questionnaire. Materials and Methods: Sixteen types of SBCE findings were illustrated four times each in three different settings (occult and overt obscure gastrointestinal bleeding and suspected Crohn's disease), and with a variable number (n = 1/n = 2–5/n ≥ 6), thus providing a questionnaire with 192 scenarios and 576 illustrated questions. Fifteen international experts were asked to rate the finding's relevance for each question as very unlikely (−2) / unlikely (−1) / doubtful (0) / likely (+1) / very likely (+2). The median score (≤−0.75, between -0.75 and 0.75, or ≥0.75) obtained for each scenario determined a low (P0), intermediate (P1) or high (P2) relevance, respectively. Results: 8064 answers were analyzed. Participation and completion rates were 93% and 100%, respectively. In overt or occult OGIB, resultant P2 findings were 'typical angiectasia', 'deep ulceration', 'stenosis', and'blood', whatever their numbers, and 'superficial ulcerations' when multiple. While in suspected CD, consensus P2 lesions were 'deep ulceration' and 'stenosis' whatever their numbers, and 'aphthoid erosions' and 'superficial ulcerations' when multiple. Conclusion: This study establishes a guide for the evaluation of relevance of SBCE findings. It represents a step forward for SB-CE interpretation and is intended to be used as a tool for teaching and academic research.
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- Yung, Diana E., et al.
(författare)
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Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy
- 2017
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Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 5:7, s. 974-981
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recent data imply young patients (age ≤50 years) undergoing small-bowel (SB) capsule endoscopy (CE) for iron deficiency anaemia (IDA) show higher diagnostic yield (DY) for sinister pathology. We aimed to investigate DY of CE in a large cohort of young IDA patients, and evaluate factors predicting significant SB pathology. Materials and methods: This was a retrospective, multicentre study (2010–2015) in consecutive, young patients (≤50 years) from 18 centres/12 countries, with negative bidirectional gastrointestinal (GI) endoscopy undergoing SBCE for IDA. Exclusion criteria: previous/ongoing obscure-overt GI bleeding; age <19 or >50 years; comorbidities associated with IDA. Data retrieved: SBCE indications; prior investigations; medications; SBCE findings; final diagnosis. Clinical and laboratory data were analysed by multivariate logistic regression. Results: Data on 389 young IDA patients were retrieved. In total, 169 (43.4%) were excluded due to incomplete clinical data; data from 220 (122F/98M; mean age 40.5 ± 8.6 years) patients were analysed. Some 71 patients had at least one clinically significant SBCE finding (DY: 32.3%). They were divided into two groups: neoplastic pathology (10/220; 4.5%), and non-neoplastic but clinically significant pathology (61/220; 27.7%). The most common significant but non-neoplastic pathologies were angioectasias (22/61) and Crohn’s disease (15/61). On multivariate analysis, weight loss and lower mean corpuscular volume(MCV) were associated with significant SB pathology (OR: 3.87; 95%CI: 1.3–11.3; p = 0.01; and OR: 0.96; 95%CI: 0.92–0.99; p = 0.03; respectively). Our model also demonstrates association between use of antiplatelets and significant SB pathology, although due to the small number of patients, definitive conclusions cannot be drawn. Conclusion: In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our cohort was diagnosed with SB neoplasia; lower MCV or weight loss were associated with higher DY for SB pathology.
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