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Journal of Clinical Medicine May 2023Recent years have seen the emergence and application of artificial intelligence (AI) in diagnostic decision support systems. There are approximately 80 etiologies that... (Review)
Review
Recent years have seen the emergence and application of artificial intelligence (AI) in diagnostic decision support systems. There are approximately 80 etiologies that can underly uveitis, some very rare, and AI may lend itself to their detection. This synthesis of the literature selected articles that focused on the use of AI in determining the diagnosis, classification, and underlying etiology of uveitis. The AI-based systems demonstrated relatively good performance, with a classification accuracy of 93-99% and a sensitivity of at least 80% for identifying the two most probable etiologies underlying uveitis. However, there were limitations to the evidence. Firstly, most data were collected retrospectively with missing data. Secondly, ophthalmic, demographic, clinical, and ancillary tests were not reliably integrated into the algorithms' dataset. Thirdly, patient numbers were small, which is problematic when aiming to discriminate rare and complex diagnoses. In conclusion, the data indicate that AI has potential as a diagnostic decision support system, but clinical applicability is not yet established. Future studies and technologies need to incorporate more comprehensive clinical data and larger patient populations. In time, these should improve AI-based diagnostic tools and help clinicians diagnose, classify, and manage patients with uveitis.
PubMed: 37297939
DOI: 10.3390/jcm12113746 -
International Journal of Clinical... 2022Distinguishing between benign and malignant thyroid nodules remains difficult. Ultrasound has been established as a non-invasive and relatively simple imaging technique... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Distinguishing between benign and malignant thyroid nodules remains difficult. Ultrasound has been established as a non-invasive and relatively simple imaging technique for thyroid nodules. This study aimed to assess the diagnostic accuracy of conventional ultrasound and ultrasound elastography for the differentiation between benign and malignant thyroid nodules by meta-analyzing published studies.
METHODS
Literature was retrieved from the PubMed and Embase databases from inception to May 31, 2022. The literature was screened using inclusion and exclusion criteria. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS2) scale was used to assess the quality of the included literature. Publication bias of the included studies was assessed by Deek's funnel plot. Heterogeneity tests were performed using Cochrane statistic and I statistic.
RESULTS
Finally, 9 articles were included. The meta-analysis showed that the combined sensitivity and specificity of ultrasound for the diagnosis of thyroid nodules were 0.88 [95% CI (0.83-0.91)] and 0.86 [95% CI (0.79-0.90)], respectively. The area under the curve (AUC) of the summary receiver operating characteristic curve (SROC) was 0.92 [95% CI (0.90-0.94)]. There was no significant publication bias in this study. . Existing evidence shows that ultrasound has a certain accuracy in diagnosing benign and malignant thyroid nodules, providing a scientific basis for thyroid assessment and diagnosis.
Topics: Diagnosis, Differential; Elasticity Imaging Techniques; Humans; ROC Curve; Sensitivity and Specificity; Thyroid Nodule
PubMed: 36160289
DOI: 10.1155/2022/5056082 -
Nutrients Dec 2022Interventions for stroke-related sarcopenia in patients with stroke are needed, but the details of the target population are unclear. This systematic review aimed to... (Review)
Review
Interventions for stroke-related sarcopenia in patients with stroke are needed, but the details of the target population are unclear. This systematic review aimed to identify trajectories of the prevalence of sarcopenia in the pre- and post-stroke periods and to determine the diagnostic criteria used in patients with stroke. We searched for literature in six databases: MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Ichushi-web (in Japanese). We included 1627 studies in the primary screening, and 35 studies were finally included. Of the 35 studies, 32 (91.4%) included Asian patients, and the criteria of the Asian Working Group for Sarcopenia was mainly used as the diagnostic criteria. Nineteen studies used muscle strength and muscle mass to diagnose sarcopenia, whereas a full assessment, including physical performance, was performed in five studies. The estimated prevalences of sarcopenia in pre-stroke, within 10 days of stroke, and from 10 days to 1 month after stroke were 15.8%, 29.5%, and 51.6%, respectively. Sarcopenia increased by approximately 15% from pre-stroke to 10 days, and increased by approximately 20% from 10 days to 1 month. Healthcare providers should note that the prevalence of sarcopenia increases during the acute phase in patients with stroke.
Topics: Humans; Sarcopenia; Prevalence; Muscle Strength; Stroke
PubMed: 36615772
DOI: 10.3390/nu15010113 -
Journal of Medical Internet Research Aug 2021Most colorectal polyps are diminutive and benign, especially those in the rectosigmoid colon, and the resection of these polyps is not cost-effective. Advancements in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Most colorectal polyps are diminutive and benign, especially those in the rectosigmoid colon, and the resection of these polyps is not cost-effective. Advancements in image-enhanced endoscopy have improved the optical prediction of colorectal polyp histology. However, subjective interpretability and inter- and intraobserver variability prohibits widespread implementation. The number of studies on computer-aided diagnosis (CAD) is increasing; however, their small sample sizes limit statistical significance.
OBJECTIVE
This review aims to evaluate the diagnostic test accuracy of CAD models in predicting the histology of diminutive colorectal polyps by using endoscopic images.
METHODS
Core databases were searched for studies that were based on endoscopic imaging, used CAD models for the histologic diagnosis of diminutive colorectal polyps, and presented data on diagnostic performance. A systematic review and diagnostic test accuracy meta-analysis were performed.
RESULTS
Overall, 13 studies were included. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD models for the diagnosis of diminutive colorectal polyps (adenomatous or neoplastic vs nonadenomatous or nonneoplastic) were 0.96 (95% CI 0.93-0.97), 0.93 (95% CI 0.91-0.95), 0.87 (95% CI 0.76-0.93), and 87 (95% CI 38-201), respectively. The meta-regression analysis showed no heterogeneity, and no publication bias was detected. Subgroup analyses showed robust results. The negative predictive value of CAD models for the diagnosis of adenomatous polyps in the rectosigmoid colon was 0.96 (95% CI 0.95-0.97), and this value exceeded the threshold of the diagnosis and leave strategy.
CONCLUSIONS
CAD models show potential for the optical histological diagnosis of diminutive colorectal polyps via the use of endoscopic images.
TRIAL REGISTRATION
PROSPERO CRD42021232189; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=232189.
Topics: Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Computers; Diagnostic Tests, Routine; Humans; Narrow Band Imaging
PubMed: 34432643
DOI: 10.2196/29682 -
Eye (London, England) Jul 2023Cerebral Visual Impairment (CVI) is a common condition in the UK. Patients with conditions associated with CVI are frequently seen in paediatric ophthalmology clinics... (Review)
Review
Cerebral Visual Impairment (CVI) is a common condition in the UK. Patients with conditions associated with CVI are frequently seen in paediatric ophthalmology clinics offering eye care professionals an opportunity to identify children proactively. In most cases CVI occurs as part of a neurodevelopmental condition or as a feature of multiple and complex disabilities. However, CVI can also be seen in children with apparently typical development. In some cases, high contrast visual acuity is normal and in other cases severely impaired. As such, identification of CVI requires evaluation of aspects of visual performance beyond high contrast acuity and consideration that visual function of those with CVI may fluctuate. Few paediatric ophthalmologists have received formal training in CVI. The detection and diagnosis of CVI varies across the UK and patients report hugely different experiences. A diagnosis of CVI is made based on professional clinical judgement and it is recognised that individual perspectives and local practice in the specific methodologies of assessment will vary. A systematic review and survey of professionals is underway to attempt to reach agreement on diagnostic criteria. Nonetheless, established pathways and published protocols can offer guidance on how a paediatric ophthalmology service can approach assessment of the child with suspected CVI. The purpose of this paper is to present a summary of research and clinical practice methods for detecting and diagnosing CVI in a paediatric ophthalmology outpatient setting. It represents current understanding of the topic and acknowledges the evolving nature of both practice and the evidence-base. A rapid literature review was undertaken to identify articles relating to clinical investigation of children with CVI. A focus group of QTVI and subject matter experts from sight loss charities was undertaken to address areas which were not covered by the literature review.
Topics: Child; Humans; Consensus; Vision Disorders; Visual Acuity; Ophthalmology; Blindness
PubMed: 36258009
DOI: 10.1038/s41433-022-02261-6 -
Gastrointestinal Endoscopy May 2021Diagnosis of esophageal cancer or precursor lesions by endoscopic imaging depends on endoscopist expertise and is inevitably subject to interobserver variability.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
Diagnosis of esophageal cancer or precursor lesions by endoscopic imaging depends on endoscopist expertise and is inevitably subject to interobserver variability. Studies on computer-aided diagnosis (CAD) using deep learning or machine learning are on the increase. However, studies with small sample sizes are limited by inadequate statistical strength. Here, we used a meta-analysis to evaluate the diagnostic test accuracy (DTA) of CAD algorithms of esophageal cancers or neoplasms using endoscopic images.
METHODS
Core databases were searched for studies based on endoscopic imaging using CAD algorithms for the diagnosis of esophageal cancer or neoplasms and presenting data on diagnostic performance, and a systematic review and DTA meta-analysis were performed.
RESULTS
Overall, 21 and 19 studies were included in the systematic review and DTA meta-analysis, respectively. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD algorithms for the diagnosis of esophageal cancer or neoplasms in the image-based analysis were 0.97 (95% confidence interval [CI], 0.95-0.99), 0.94 (95% CI, 0.89-0.96), 0.88 (95% CI, 0.76-0.94), and 108 (95% CI, 43-273), respectively. Meta-regression showed no heterogeneity, and no publication bias was detected. The pooled area under the curve, sensitivity, specificity, and diagnostic odds ratio of CAD algorithms for the diagnosis of esophageal cancer invasion depth were 0.96 (95% CI, 0.86-0.99), 0.90 (95% CI, 0.88-0.92), 0.88 (95% CI, 0.83-0.91), and 138 (95% CI, 12-1569), respectively.
CONCLUSIONS
CAD algorithms showed high accuracy for the automatic endoscopic diagnosis of esophageal cancer and neoplasms. The limitation of a lack in performance in external validation and clinical applications should be overcome.
Topics: Computers; Diagnosis, Computer-Assisted; Diagnostic Tests, Routine; Esophageal Neoplasms; Humans; Sensitivity and Specificity
PubMed: 33290771
DOI: 10.1016/j.gie.2020.11.025 -
Sensors (Basel, Switzerland) Mar 2021According to the Center for Disease Control and Prevention (CDC), the average human life expectancy is 78.8 years. Specifically, 3.2 million deaths are reported yearly... (Review)
Review
According to the Center for Disease Control and Prevention (CDC), the average human life expectancy is 78.8 years. Specifically, 3.2 million deaths are reported yearly due to heart disease, cancer, Alzheimer's disease, diabetes, and COVID-19. Diagnosing the disease is mandatory in the current way of living to avoid unfortunate deaths and maintain average life expectancy. CMOS image sensor (CIS) became a prominent technology in assisting the monitoring and clinical diagnosis devices to treat diseases in the medical domain. To address the significance of CMOS image 'sensors' usage in disease diagnosis systems, this paper focuses on the CIS incorporated disease diagnosis systems related to vital organs of the human body like the heart, lungs, brain, eyes, intestines, bones, skin, blood, and bacteria cells causing diseases. This literature survey's main objective is to evaluate the 'systems' capabilities and highlight the most potent ones with advantages, disadvantages, and accuracy, that are used in disease diagnosis. This systematic review used PRISMA workflow for study selection methodology, and the parameter-based evaluation is performed on disease diagnosis systems related to the human body's organs. The corresponding CIS models used in systems are mapped organ-wise, and the data collected over the last decade are tabulated.
Topics: Diagnostic Imaging; Human Body; Humans; Semiconductors
PubMed: 33802718
DOI: 10.3390/s21062098 -
Frontiers in Endocrinology 2023To evaluate and compare the value of conventional ultrasound-based superb microvascular imaging (SMI) and color Doppler flow imaging (CDFI) in the diagnosis of malignant... (Meta-Analysis)
Meta-Analysis
The value of conventional ultrasound combined with superb microvascular imaging and color Doppler flow imaging in the diagnosis of thyroid malignant nodules: a systematic review and meta-analysis.
PURPOSE
To evaluate and compare the value of conventional ultrasound-based superb microvascular imaging (SMI) and color Doppler flow imaging (CDFI) in the diagnosis of malignant thyroid nodule by meta-analysis.
METHODS
The literature included in the Cochrane Library, PubMed, and Embase were searched by using " superb microvascular imaging (SMI), color Doppler flow imaging (CDFI), ultrasound, thyroid nodules" as the keywords from inception through February 1, 2023. According to the inclusion and exclusion criteria, the clinical studies using SMI and CDFI to diagnose thyroid nodules were selected, and histopathology of thyroid nodules was used as reference standard. The diagnostic accuracy research quality assessment tool (QUADAS-2) was used to evaluate the quality of included literature, and the Review Manager 5.4 was used to make the quality evaluation chart. The heterogeneity test was performed on the literature that met the requirements, the combined sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were pooled, and a comprehensive ROC curve analysis was performed. Meta-DiSc version 1.4, StataSE 12, and Review Manager 5.4 software were used.
RESULTS
Finally, 13 studies were included in this meta-analysis. A total of 815 thyroid malignant nodules were assessed. All thyroid nodules were histologically confirmed after SMI or CDFI. The combined sensitivity, specificity, PLR, NLR, DOR, and area under the SROC curve of SMI for the diagnosis of malignant thyroid nodules were 0.80(95%CI: 0.77-0.83), 0.79(95%CI: 0.77-0.82), 4.37(95%CI: 3.0-6.36), 0.23(95%CI: 0.15-0.35), 22.29(95%CI: 12.18-40.78), and 0.8944, respectively; the corresponding values of CDFI were 0.62(95%CI: 0.57-0.67), 0.81(95%CI: 0.78-0.85), 3.33(95%CI: 2.18-5.07), 0.41(95%CI: 0.27-0.64), 8.93(95%CI: 3.96-20.16), and 0.8498. Deek funnel pattern showed no significant publication bias.
CONCLUSION
The diagnostic efficiency of SMI for malignant thyroid nodules is better than CDFI, and SMI technology can provide significantly more information on vascularity, make up for the deficiency of CDFI, and has better clinical application value.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023402064.
Topics: Humans; Thyroid Nodule; Sensitivity and Specificity; Diagnosis, Differential; Microvessels
PubMed: 37415660
DOI: 10.3389/fendo.2023.1182259 -
Integrative Cancer Therapies 2022Remote medical scent detection of cancer and infectious diseases with dogs and rats has been an increasing field of research these last 20 years. If validated, the... (Review)
Review
BACKGROUND
Remote medical scent detection of cancer and infectious diseases with dogs and rats has been an increasing field of research these last 20 years. If validated, the possibility of implementing such a technique in the clinic raises many hopes. This systematic review was performed to determine the evidence and performance of such methods and assess their potential relevance in the clinic.
METHODS
Pubmed and Web of Science databases were independently searched based on PRISMA standards between 01/01/2000 and 01/05/2021. We included studies aiming at detecting cancers and infectious diseases affecting humans with dogs or rats. We excluded studies using other animals, studies aiming to detect agricultural diseases, diseases affecting animals, and others such as diabetes and neurodegenerative diseases. Only original articles were included. Data about patients' selection, samples, animal characteristics, animal training, testing configurations, and performances were recorded.
RESULTS
A total of 62 studies were included. Sensitivity and specificity varied a lot among studies: While some publications report low sensitivities of 0.17 and specificities around 0.29, others achieve rates of 1 sensitivity and specificity. Only 6 studies were evaluated in a double-blind screening-like situation. In general, the risk of performance bias was high in most evaluated studies, and the quality of the evidence found was low.
CONCLUSIONS
Medical detection using animals' sense of smell lacks evidence and performances so far to be applied in the clinic. What odors the animals detect is not well understood. Further research should be conducted, focusing on patient selection, samples (choice of materials, standardization), and testing conditions. Interpolations of such results to free running detection (direct contact with humans) should be taken with extreme caution. Considering this synthesis, we discuss the challenges and highlight the excellent odor detection threshold exhibited by animals which represents a potential opportunity to develop an accessible and non-invasive method for disease detection.
Topics: Humans; Dogs; Animals; Rats; Odorants; Neoplasms; Smell; Communicable Diseases; Randomized Controlled Trials as Topic
PubMed: 36541180
DOI: 10.1177/15347354221140516 -
The Journal of Evidence-based Dental... Sep 2023The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis?
METHODS
This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot.
RESULTS
A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I = 0%, P < .01.
DISCUSSION
None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.
Topics: Adult; Humans; Halitosis; Sensation; Sulfides
PubMed: 37689445
DOI: 10.1016/j.jebdp.2023.101862