Clinical application and diagnostic accuracy of artificial intelligence in colonoscopy for inflammatory bowel disease: systematic review

Linda S Yang; Evelyn Perry; Leonard Shan; Helen Wilding; William Connell; Alexander J Thompson; Andrew C F Taylor; Paul V Desmond; Bronte A Holt

doi:10.1055/a-1846-0642

Clinical application and diagnostic accuracy of artificial intelligence in colonoscopy for inflammatory bowel disease: systematic review

Endosc Int Open. 2022 Jul 15;10(7):E1004-E1013. doi: 10.1055/a-1846-0642. eCollection 2022 Jul.

Authors

Linda S Yang¹, Evelyn Perry¹, Leonard Shan², Helen Wilding³, William Connell¹, Alexander J Thompson¹, Andrew C F Taylor¹, Paul V Desmond¹, Bronte A Holt¹

Affiliations

¹ Department of Gastroenterology, St. Vincent's Hospital and the University of Melbourne, Fitzroy, Victoria, Australia.
² Department of Surgery, Faculty of Medicine, Dentistry and Health Sciences, the University of Melbourne, Fitzroy, Victoria, Australia.
³ Library Service, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.

Abstract

Background and aims Artificial intelligence (AI) technology is being evaluated for its potential to improve colonoscopic assessment of inflammatory bowel disease (IBD), particularly with computer-aided image classifiers. This review evaluates the clinical application and diagnostic test accuracy (DTA) of AI algorithms in colonoscopy for IBD. Methods A systematic review was performed on studies evaluating AI in colonoscopy of adult patients with IBD. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Cochrane Library and Clinicaltrials.gov databases were searched on 28 ^th April 2021 for English language articles published between January 1, 2000 and April 28, 2021. Risk of bias and applicability were assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Diagnostic accuracy was presented as median (interquartile range). Results Of 1029 records screened, nine studies with 7813 patients were included for review. AI was used to predict endoscopic and histologic disease activity in ulcerative colitis, and differentiation of Crohn's disease from Behcet's disease and intestinal tuberculosis. DTA of AI algorithms ranged between 52-91 %. The sensitivity and specificity for AI algorithms predicting endoscopic severity of disease were 78 % (range 72-83, interquartile range 5.5) and 91 % (range 86-96, interquartile range 5), respectively. Conclusions AI has been primarily used to assess disease activity in ulcerative colitis. The diagnostic performance is promising and suggests potential for other clinical application of AI in IBD colonoscopy such as dysplasia detection. However, current evidence is limited by retrospective data and models trained on still images only. Future prospective multicenter studies with full-motion videos are needed to replicate the real-world clinical setting.

The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Publication types

Review