Computer-aided detection for esophageal achalasia (with video).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Shiwaku Hironari, Misawa Masashi, Inoue Haruhiro, Jiang Kai, Oda Masahiro, Familiari Pietro, Costamagna Guido, Shimamura Yuto, Ikebuchi Yuichiro, Iwaya Yugo, Ominami Masaki, Hayee Bu'Hussain, Ho Khek-Yu, So Jimmy B Y, Htet Hein Myat Thu, Bhandari Pradeep, Grimes Kevin, Messmann Helmut, Colosso Bianca Maria Quarta, Maselli Roberta, Hassan Cesare, Repici Alessandro, Stavropoulos Stavros N, Fukami Norio, Bechara Robert, Kahaleh Michel, Sethi Amrita, Beyna Torsten, Neuhaus Horst, Chiu Philip W Y, Santi Esperanza Grace, Sharma Prateek, Eleftheriadis Nikolas, Minami Hitomi, Haber Gregory, Draganov Peter V, Seewald Stefan, Shiwaku Akio, Shiwaku Yoshiyuki, Mori Kensaku, Kudo Shin-Ei, Hasegawa Suguru
Аннотация
METHODS: Between February and August 2023, 83 endoscopists from 27 centers assessed 50 randomized endoscopic videos (25 achalasia, 25 nonachalasia) without and with CAD. Endoscopists assessed videos without CAD, then with CAD after 2 months. The primary end-point was improvement in sensitivity for nonexperienced endoscopists (no endoscopic experience of achalasia). Sensitivity, specificity, and accuracy with and without CAD were compared using the McNemar test.
RESULTS: Sensitivity for diagnosing achalasia increased significantly with CAD, rising from 74.2% (95% confidence interval [CI] 72.2-76.0%) to 91.2% (95% CI 89.9-92.4%) for all readers, showing a difference of 17.1% (95% CI 15.1-19.0%). Specifically, sensitivity improved from 66.9% (95% CI 63.6-70.0%) to 91.9% (95% CI 89.9-93.6%) among nonexperienced endoscopists, resulting in a difference of 25.0% (95% CI 21.7-28.4%), and from 79.5% (95% CI 77.1-81.8%) to 90.8% (95% CI 89.0-92.3%) among experienced endoscopists (endoscopic experience of at least one achalasia case), with a difference of 11.3% (95% CI 8.9-13.6%). Accuracy and specificity improved significantly with CAD assistance, regardless of reader's experience.
CONCLUSION: CAD improves achalasia detection by 17%, confirming preclinical results. The benefit was higher for nonexperienced endoscopists. CAD assistance may lead to prompt and effective treatment, minimizing the risk of false-negative diagnosis in clinical practice.
TRIAL REGISTRATION: This study was registered in the University Hospital Medical Information Network Clinical Trial Registry (https://www.umin.ac.jp/ctr/) number: UMIN000053047.