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Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy

BACKGROUND AND STUDY AIMS:  An objective and reliable scoring system is needed to assess quality of visualization in small bowel (SB) capsule endoscopy (CE), for both clinical practice and research purposes. The aim of this study was to establish and to validate a SB-computed assessment of cleansing...

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Autores principales: Abou Ali, Einas, Histace, Aymeric, Camus, Marine, Gerometta, Rafaële, Becq, Aymeric, Pietri, Olivia, Nion-Larmurier, Isabelle, Li, Cynthia, Chaput, Ulriikka, Marteau, Philippe, Florent, Christian, Dray, Xavier
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979189/
https://www.ncbi.nlm.nih.gov/pubmed/29868628
http://dx.doi.org/10.1055/a-0581-8758
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author Abou Ali, Einas
Histace, Aymeric
Camus, Marine
Gerometta, Rafaële
Becq, Aymeric
Pietri, Olivia
Nion-Larmurier, Isabelle
Li, Cynthia
Chaput, Ulriikka
Marteau, Philippe
Florent, Christian
Dray, Xavier
author_facet Abou Ali, Einas
Histace, Aymeric
Camus, Marine
Gerometta, Rafaële
Becq, Aymeric
Pietri, Olivia
Nion-Larmurier, Isabelle
Li, Cynthia
Chaput, Ulriikka
Marteau, Philippe
Florent, Christian
Dray, Xavier
author_sort Abou Ali, Einas
collection PubMed
description BACKGROUND AND STUDY AIMS:  An objective and reliable scoring system is needed to assess quality of visualization in small bowel (SB) capsule endoscopy (CE), for both clinical practice and research purposes. The aim of this study was to establish and to validate a SB-computed assessment of cleansing (SB-CAC) score. PATIENTS AND METHODS:  Thirty-three SB-CE were selected. A CAC score, defined as the ratio of the red over green pixels (R/G ratio), was calculated for each frame. Intervals were then determined, ranging from the lowest to the highest ratio among the extracted frames. Twelve frames were randomly selected in each of these intervals. Two hundred eighty-eight frames were shuffled and analyzed twice in random order by two experienced CE readers who were blinded to the CAC scores. Once an “adequately cleansed” or “inadequately cleansed” qualification was allotted to every still frame, a receiver operating characteristic (ROC) curve was created. In case of discrepancy between the two readers, the still frames were excluded. A second dataset of 288 different SB still frames was generated and read twice in random order by two other experienced SB-CE readers, using the same methodology. RESULTS:  A SB-CAC score threshold of 1.6 best achieved discrimination of adequately from inadequately cleansed frames, with a sensitivity of 92.7 % (95 %CI [89.7 – 95.8]) and a specificity of 92.9 % (95 %CI [89.9 – 95.9]). This threshold was validated using the second dataset, yielding the following performances: sensitivity 91.3 % (95 %CI [87.9 – 94.6]), specificity 94.7 % (95 %CI [92.1 – 97.3]). CONCLUSION:  An SB-CAC score of 1.6 has the highest sensitivity and specificity to discriminate “adequately cleansed” from “inadequately cleansed” SB-CE still frames. This constitutes an objective, reproducible, reliable, and automated cleansing score for SB-CE.
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spelling pubmed-59791892018-06-04 Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy Abou Ali, Einas Histace, Aymeric Camus, Marine Gerometta, Rafaële Becq, Aymeric Pietri, Olivia Nion-Larmurier, Isabelle Li, Cynthia Chaput, Ulriikka Marteau, Philippe Florent, Christian Dray, Xavier Endosc Int Open BACKGROUND AND STUDY AIMS:  An objective and reliable scoring system is needed to assess quality of visualization in small bowel (SB) capsule endoscopy (CE), for both clinical practice and research purposes. The aim of this study was to establish and to validate a SB-computed assessment of cleansing (SB-CAC) score. PATIENTS AND METHODS:  Thirty-three SB-CE were selected. A CAC score, defined as the ratio of the red over green pixels (R/G ratio), was calculated for each frame. Intervals were then determined, ranging from the lowest to the highest ratio among the extracted frames. Twelve frames were randomly selected in each of these intervals. Two hundred eighty-eight frames were shuffled and analyzed twice in random order by two experienced CE readers who were blinded to the CAC scores. Once an “adequately cleansed” or “inadequately cleansed” qualification was allotted to every still frame, a receiver operating characteristic (ROC) curve was created. In case of discrepancy between the two readers, the still frames were excluded. A second dataset of 288 different SB still frames was generated and read twice in random order by two other experienced SB-CE readers, using the same methodology. RESULTS:  A SB-CAC score threshold of 1.6 best achieved discrimination of adequately from inadequately cleansed frames, with a sensitivity of 92.7 % (95 %CI [89.7 – 95.8]) and a specificity of 92.9 % (95 %CI [89.9 – 95.9]). This threshold was validated using the second dataset, yielding the following performances: sensitivity 91.3 % (95 %CI [87.9 – 94.6]), specificity 94.7 % (95 %CI [92.1 – 97.3]). CONCLUSION:  An SB-CAC score of 1.6 has the highest sensitivity and specificity to discriminate “adequately cleansed” from “inadequately cleansed” SB-CE still frames. This constitutes an objective, reproducible, reliable, and automated cleansing score for SB-CE. © Georg Thieme Verlag KG 2018-06 2018-05-25 /pmc/articles/PMC5979189/ /pubmed/29868628 http://dx.doi.org/10.1055/a-0581-8758 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Abou Ali, Einas
Histace, Aymeric
Camus, Marine
Gerometta, Rafaële
Becq, Aymeric
Pietri, Olivia
Nion-Larmurier, Isabelle
Li, Cynthia
Chaput, Ulriikka
Marteau, Philippe
Florent, Christian
Dray, Xavier
Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
title Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
title_full Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
title_fullStr Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
title_full_unstemmed Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
title_short Development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
title_sort development and validation of a computed assessment of cleansing score for evaluation of quality of small-bowel visualization in capsule endoscopy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979189/
https://www.ncbi.nlm.nih.gov/pubmed/29868628
http://dx.doi.org/10.1055/a-0581-8758
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