Standalone performance of artificial intelligence for upper GI neoplasia: a meta-analysis

作者：Julia Arribas, Giulio Antonelli, Leonardo Frazzoni, Lorenzo Fuccio, Alanna Ebigbo, Fons van der Sommen, Noha Ghatwary, Christoph Palm, Miguel Coimbra, Francesco Renna, Jacques Bergman, Prateek Sharma, Helmut Messmann, Cesare Hassan, Mário Dinis‐Ribeiro · 发表于：Gut · 年份：2020 · DOI：10.1136/gutjnl-2020-321922 · 被引用次数：79 · 研究领域：Esophageal Cancer Research and Treatment、Radiomics and Machine Learning in Medical Imaging、Gastric Cancer Management and Outcomes

OBJECTIVE: Artificial intelligence (AI) may reduce underdiagnosed or overlooked upper GI (UGI) neoplastic and preneoplastic conditions, due to subtle appearance and low disease prevalence. Only disease-specific AI performances have been reported, generating uncertainty on its clinical value. DESIGN: We searched PubMed, Embase and Scopus until July 2020, for studies on the diagnostic performance of AI in detection and characterisation of UGI lesions. Primary outcomes were pooled diagnostic accuracy, sensitivity and specificity of AI. Secondary outcomes were pooled positive (PPV) and negative (NPV) predictive values. We calculated pooled proportion rates (%), designed summary receiving operating characteristic curves with respective area under the curves (AUCs) and performed metaregression and sensitivity analysis. RESULTS: Overall, 19 studies on detection of oesophageal squamous cell neoplasia (ESCN) or Barrett's esophagus-related neoplasia (BERN) or gastric adenocarcinoma (GCA) were included with 218, 445, 453 patients and 7976, 2340, 13 562 images, respectively. AI-sensitivity/specificity/PPV/NPV/positive likelihood ratio/negative likelihood ratio for UGI neoplasia detection were 90% (CI 85% to 94%)/89% (CI 85% to 92%)/87% (CI 83% to 91%)/91% (CI 87% to 94%)/8.2 (CI 5.7 to 11.7)/0.111 (CI 0.071 to 0.175), respectively, with an overall AUC of 0.95 (CI 0.93 to 0.97). No difference in AI performance across ESCN, BERN and GCA was found, AUC being 0.94 (CI 0.52 to 0.99), 0.96 (CI...