Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 30, 2020
Date Accepted: Aug 3, 2020
Artificial intelligence for the prediction of Helicobacter pylori infection in endoscopic images: systematic review and meta-analysis of diagnostic test accuracy
ABSTRACT
Background:
Helicobacter pylori (H. pylori) plays a central role in the development of gastric cancer, and prediction of H. pylori infection by visual inspection of the gastric mucosa is an important function of endoscopy. However, there are currently no established methods of optical diagnosis of H. pylori infection using endoscopic images. Definitive diagnosis requires endoscopic biopsy. Artificial intelligence (AI) has been increasingly adopted in clinical practice, especially for image recognition and classification.
Objective:
This study aimed to evaluate the diagnostic test accuracy of AI for the prediction of H. pylori infection using endoscopic images.
Methods:
Two independent evaluators searched core databases. The inclusion criteria included the following: studies with endoscopic images of H. pylori infection and with application of AI for the prediction of H. pylori infection presenting diagnostic performance. Systematic review and diagnostic test accuracy meta-analysis were performed.
Results:
Ultimately, eight studies were identified. Pooled sensitivity, specificity, diagnostic odds ratio, and area under the curve of AI for the prediction of H. pylori infection were 0.87 (95% confidence interval: 0.72-0.94), 0.86 (0.77-0.92), 40 (15-112), and 0.92 (0.90-0.94), respectively. Meta-regression showed methodological quality and included the number of patients in each study for the purpose of heterogeneity. There was no evidence of publication bias. The accuracy of the AI algorithm reached 82% for discrimination between non-infected images and post-eradication images.
Conclusions:
AI algorithm is a reliable, non-invasive tool for endoscopic diagnosis of H. pylori infection. The limitations of lacking external validation performance and being conducted only in Asia should be overcome.
Citation
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Copyright
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