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“MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost

In potential small bowel bleeding, video capsule endoscopy (VCE) is excellent to detect mucosal lesions, while mural-based lesions are better detected by computed tomography enterography (CTE). A predictive tool to identify mural-based lesions should guide selecting investigations. In this retrospec...

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Autores principales: Limsrivilai, Julajak, Chaemsupaphan, Thanaboon, Khamplod, Sipawath, Srisajjakul, Sitthipong, Kositamongkol, Chayanis, Phisalprapa, Pochamana, Maipang, Kochakon, Kaosombatwattana, Uayporn, Pausawasdi, Nonthalee, Charatcharoenwitthaya, Phunchai, Leelakusolvong, Somchai, Pongprasobchai, Supot
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726317/
https://www.ncbi.nlm.nih.gov/pubmed/36482571
http://dx.doi.org/10.1097/MD.0000000000031989
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author Limsrivilai, Julajak
Chaemsupaphan, Thanaboon
Khamplod, Sipawath
Srisajjakul, Sitthipong
Kositamongkol, Chayanis
Phisalprapa, Pochamana
Maipang, Kochakon
Kaosombatwattana, Uayporn
Pausawasdi, Nonthalee
Charatcharoenwitthaya, Phunchai
Leelakusolvong, Somchai
Pongprasobchai, Supot
author_facet Limsrivilai, Julajak
Chaemsupaphan, Thanaboon
Khamplod, Sipawath
Srisajjakul, Sitthipong
Kositamongkol, Chayanis
Phisalprapa, Pochamana
Maipang, Kochakon
Kaosombatwattana, Uayporn
Pausawasdi, Nonthalee
Charatcharoenwitthaya, Phunchai
Leelakusolvong, Somchai
Pongprasobchai, Supot
author_sort Limsrivilai, Julajak
collection PubMed
description In potential small bowel bleeding, video capsule endoscopy (VCE) is excellent to detect mucosal lesions, while mural-based lesions are better detected by computed tomography enterography (CTE). A predictive tool to identify mural-based lesions should guide selecting investigations. In this retrospective study, we developed and validated the “MURAL” model based on logistic regression to predicts bleeding from mural-based lesions. Cost-effectiveness analysis comparing diagnostic strategy among VCE, CTE, and MURAL model was performed. Of 296 patients, 196 and 100 patients were randomly included in the derivative and validation cohorts, respectively. The MURAL model comprises 5 parameters: age, presence of atherosclerosis, chronic kidney disease, antiplatelet use, and serum albumin level. The area under the receiver operating characteristic curve was 0.778 and 0.821 for the derivative and validation cohorts, respectively. At a cutoff value of 24.2%, the model identified mural-based lesions with 70% sensitivity and 83% specificity in the validation cohort. Cost-effectiveness analysis revealed that application of the MURAL model demonstrated a comparable missed lesion rate but had a lower missed tumor rate, and lower cost compared to VCE strategy. The model for predicting mural-based lesions provide some guidance in investigative decision-making, which may improve diagnostic efficiency and reduce costs.
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spelling pubmed-97263172022-12-09 “MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost Limsrivilai, Julajak Chaemsupaphan, Thanaboon Khamplod, Sipawath Srisajjakul, Sitthipong Kositamongkol, Chayanis Phisalprapa, Pochamana Maipang, Kochakon Kaosombatwattana, Uayporn Pausawasdi, Nonthalee Charatcharoenwitthaya, Phunchai Leelakusolvong, Somchai Pongprasobchai, Supot Medicine (Baltimore) 4500 In potential small bowel bleeding, video capsule endoscopy (VCE) is excellent to detect mucosal lesions, while mural-based lesions are better detected by computed tomography enterography (CTE). A predictive tool to identify mural-based lesions should guide selecting investigations. In this retrospective study, we developed and validated the “MURAL” model based on logistic regression to predicts bleeding from mural-based lesions. Cost-effectiveness analysis comparing diagnostic strategy among VCE, CTE, and MURAL model was performed. Of 296 patients, 196 and 100 patients were randomly included in the derivative and validation cohorts, respectively. The MURAL model comprises 5 parameters: age, presence of atherosclerosis, chronic kidney disease, antiplatelet use, and serum albumin level. The area under the receiver operating characteristic curve was 0.778 and 0.821 for the derivative and validation cohorts, respectively. At a cutoff value of 24.2%, the model identified mural-based lesions with 70% sensitivity and 83% specificity in the validation cohort. Cost-effectiveness analysis revealed that application of the MURAL model demonstrated a comparable missed lesion rate but had a lower missed tumor rate, and lower cost compared to VCE strategy. The model for predicting mural-based lesions provide some guidance in investigative decision-making, which may improve diagnostic efficiency and reduce costs. Lippincott Williams & Wilkins 2022-12-02 /pmc/articles/PMC9726317/ /pubmed/36482571 http://dx.doi.org/10.1097/MD.0000000000031989 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle 4500
Limsrivilai, Julajak
Chaemsupaphan, Thanaboon
Khamplod, Sipawath
Srisajjakul, Sitthipong
Kositamongkol, Chayanis
Phisalprapa, Pochamana
Maipang, Kochakon
Kaosombatwattana, Uayporn
Pausawasdi, Nonthalee
Charatcharoenwitthaya, Phunchai
Leelakusolvong, Somchai
Pongprasobchai, Supot
“MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
title “MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
title_full “MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
title_fullStr “MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
title_full_unstemmed “MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
title_short “MURAL” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
title_sort “mural” model to predict bleeding from mural-based lesions in potential small bowel bleeding may improve diagnostic capability and decrease cost
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9726317/
https://www.ncbi.nlm.nih.gov/pubmed/36482571
http://dx.doi.org/10.1097/MD.0000000000031989
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