Amir Klein1, Moshe Gizbar1, Michael J Bourke1,2, Golo Ahlenstiel1,3. 1. Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia. 2. The University of Sydney, Sydney, Australia. 3. The Westmead Millennium Institute for Medical Research, Sydney, Australia.
Abstract
BACKGROUND AND AIM: Diagnostic yield of video capsule endoscopy may be hampered by intestinal content or air bubbles. A major limitation in video capsule-related study is the lack of a validated objective score for bowel preparation quality. We aimed to design and validate a computed small bowel preparation score for research and clinical use. METHODS: Two experienced physicians reached a consensus regarding bowel preparation quality based on known criteria used in previous studies and their confidence of an accurate medical interpretation of the procedure. A computed algorithm based on the pixels in the color bar was created and validated. Concordance between the gastroenterologists' agreement (gold standard) and the computed analysis was assessed. RESULTS: Of 85 videos studied, 44 (52%), 13 (15%) and 28 (33%) had adequate, borderline and inadequate bowel preparation, respectively, according to the gastroenterologists' agreement. Computer analysis restricted to adequate and inadequate cases yielded accurate classification of bowel preparation in 65/72 cases (90% agreement, sensitivity 95%, specificity 82%, total accuracy 90%, Kappa 0.79). When adding the borderline definition, the computer analysis correctly classified 71/85 of the cases, yielding an overall agreement of 84% (Kappa 0.72). Minute-by-minute analysis of 10 cases also yielded an agreement of 91.4%. CONCLUSION: The present study introduces a user-friendly computer analysis-based small bowel preparation score, which demonstrated excellent concordance with the physician's assessment. This score holds promise as a standardization tool in research and clinical practice of video capsule endoscopy. Further validation is warranted.
BACKGROUND AND AIM: Diagnostic yield of video capsule endoscopy may be hampered by intestinal content or air bubbles. A major limitation in video capsule-related study is the lack of a validated objective score for bowel preparation quality. We aimed to design and validate a computed small bowel preparation score for research and clinical use. METHODS: Two experienced physicians reached a consensus regarding bowel preparation quality based on known criteria used in previous studies and their confidence of an accurate medical interpretation of the procedure. A computed algorithm based on the pixels in the color bar was created and validated. Concordance between the gastroenterologists' agreement (gold standard) and the computed analysis was assessed. RESULTS: Of 85 videos studied, 44 (52%), 13 (15%) and 28 (33%) had adequate, borderline and inadequate bowel preparation, respectively, according to the gastroenterologists' agreement. Computer analysis restricted to adequate and inadequate cases yielded accurate classification of bowel preparation in 65/72 cases (90% agreement, sensitivity 95%, specificity 82%, total accuracy 90%, Kappa 0.79). When adding the borderline definition, the computer analysis correctly classified 71/85 of the cases, yielding an overall agreement of 84% (Kappa 0.72). Minute-by-minute analysis of 10 cases also yielded an agreement of 91.4%. CONCLUSION: The present study introduces a user-friendly computer analysis-based small bowel preparation score, which demonstrated excellent concordance with the physician's assessment. This score holds promise as a standardization tool in research and clinical practice of video capsule endoscopy. Further validation is warranted.
Authors: Cristiano Spada; Deirdre McNamara; Edward J Despott; Samuel Adler; Brooks D Cash; Ignacio Fernández-Urién; Hrvoje Ivekovic; Martin Keuchel; Mark McAlindon; Jean-Christophe Saurin; Simon Panter; Cristina Bellisario; Silvia Minozzi; Carlo Senore; Cathy Bennett; Michael Bretthauer; Mario Dinis-Ribeiro; Dirk Domagk; Cesare Hassan; Michal F Kaminski; Colin J Rees; Roland Valori; Raf Bisschops; Matthew D Rutter Journal: United European Gastroenterol J Date: 2019-05-15 Impact factor: 4.623
Authors: Bruno Rosa; Reuma Margalit-Yehuda; Kelly Gatt; Martina Sciberras; Carlo Girelli; Jean-Christophe Saurin; Pablo Cortegoso Valdivia; Jose Cotter; Rami Eliakim; Flavio Caprioli; Gunnar Baatrup; Martin Keuchel; Pierre Ellul; Ervin Toth; Anastasios Koulaouzidis Journal: Endosc Int Open Date: 2021-05-27