Currently submitted to: JMIR Medical Informatics
Date Submitted: Jan 31, 2026
Open Peer Review Period: Feb 20, 2026 - Apr 17, 2026
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Automated Lewis Score Calculation in Crohn’s Disease: A Multi-Task Artificial Intelligence Framework：Retrospective Study
ABSTRACT
Background:
Inflammatory Bowel Disease (IBD) is a chronic nonspecific intestinal inflammatory condition; accurate severity assessment is critical for clinical treatment decisions and prognosis. Current IBD evaluation relies primarily on endoscopic examinations and physician expertise, which are subjective and inconsistent.
Objective:
This study aimed to develop an automated deep learning-based scoring algorithm for objective quantitative assessment of IBD lesion severity to address the clinical challenge of subjective evaluation.
Methods:
A multi-stage deep learning architecture was employed for automatic IBD scoring: (1) an improved YOLO-V11 segmentation network (enhanced by attention mechanisms and multi-scale feature fusion) precisely identified edema and ulcer regions in intestinal endoscopic images; (2) a classification module based on YOLO-V11-derived lesion features recognized stenosis; (3) an LSTM lightweight normalization network integrated spatial and temporal lesion features to generate comprehensive IBD scores. Validation used endoscopic video data from 814 patients at a large medical center: 725 cases (4,400 annotated images) for edema/ulcer/stenosis recognition, and 89 cases for comprehensive scoring.
Results:
The model’s automatic scoring results showed a mean squared error (MSE) of 14.693 and a coefficient of determination (R²) of 0.82 compared with expert scoring. Key innovations included: (1) first combination of lesion recognition algorithms with image distribution frequency features for a multi-dimensional evaluation system; (2) development of a lightweight lesion recognition network suitable for clinical settings; (3) establishment of a large-scale annotated dataset encompassing various IBD subtypes.
Conclusions:
This automated scoring system improves the objectivity and repeatability of IBD severity assessment, providing a reliable tool for telemedicine and clinical trials. Future research will optimize the model’s performance in pediatric IBD and small bowel lesions.
Citation
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