Towards the Probabilistic Analysis of Small Bowel Capsule Endoscopy Features to Predict Severity of Duodenal Histology i
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MOBILE & WIRELESS HEALTH
Towards the Probabilistic Analysis of Small Bowel Capsule Endoscopy Features to Predict Severity of Duodenal Histology in Patients with Villous Atrophy Stefania Chetcuti Zammit 1,2 & Lawrence A Bull 3 & David S Sanders 1 & Jessica Galvin 4 & Nikolaos Dervilis 3 & Reena Sidhu 1 & Keith Worden 3 Received: 24 December 2019 / Accepted: 16 September 2020 / Published online: 2 October 2020 # The Author(s) 2020
Abstract Small bowel capsule endoscopy (SBCE) can be complementary to histological assessment of celiac disease (CD) and serology negative villous atrophy (SNVA). Determining the severity of disease on SBCE using statistical machine learning methods can be useful in the follow up of patients. SBCE can play an additional role in differentiating between CD and SNVA. De-identified SBCEs of patients with CD and SNVA were included. Probabilistic analysis of features on SBCE were used to predict severity of duodenal histology and to distinguish between CD and SNVA. Patients with higher Marsh scores were more likely to have a positive SBCE and a continuous distribution of macroscopic features of disease than those with lower Marsh scores. The same pattern was also true for patients with CD when compared to patients with SNVA. The validation accuracy when predicting the severity of Marsh scores and when distinguishing between CD and SNVA was 69.1% in both cases. When the proportions of each SBCE class group within the dataset were included in the classification model, to distinguish between the two pathologies, the validation accuracy increased to 75.3%. The findings of this work suggest that by using features of CD and SNVA on SBCE, predictions can be made of the type of pathology and the severity of disease. Keywords Celiac disease . Seronegative villous atrophy . Probabilistic analysis . Small bowel capsule endoscopy . Duodenal histology
Introduction This is not a clinical trial. However, it has been registered with the Yorkshire and the Humber Research Ethics committee under the registration number STH 19998. This article is part of the Topical Collection on Mobile & Wireless Health Reena Sidhu and Keith Worden are Senior authors * Stefania Chetcuti Zammit [email protected] 1
Academic Unit, Department of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
2
Gastroenterology Department, Royal Hallamshire Hospital, Glossop Road, Sheffield S102JF, UK
3
Dynamics Research Group, Department of Mechanical Engineering, University of Sheffield, Sheffield, UK
4
Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Currently, the gold standard for the diagnosis of celiac disease (CD) and seronegative villous atrophy (SNVA) is based on duodenal histology [1]. Apart from the invasive nature of a gastroduodenoscopy, histological diagnosis can be flawed with errors. Unless an appropriate number of biopsies are taken and the samples are properly oriented [2] (at least four biopsies, including a biopsy from the duodenal bulb [1, 2]) a false n
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