Artificial intelligence as a transforming factor in motility disorders-automatic detection of motility patterns in high-resolution anorectal manometry.

Journal: Scientific reports
PMID:

Abstract

High-resolution anorectal manometry (HR-ARM) is the gold standard for anorectal functional disorders' evaluation, despite being limited by its accessibility and complex data analysis. The London Protocol and Classification were developed to standardize anorectal motility patterns classification. This proof-of-concept study aims to develop and validate an artificial intelligence model for identification and differentiation of disorders of anal tone and contractility in HR-ARM. A dataset of 701 HR-ARM exams from a tertiary center, classified according to London Classification, was used to develop and test multiple machine learning (ML) algorithms. The exams were divided in a training and testing dataset with a 80/20% ratio. The testing dataset was used for models' evaluation through its accuracy, sensitivity, specificity, positive and negative predictive values and area under the receiving-operating characteristic curve. LGBM Classifier had the best performance, with an accuracy of 87.0% for identifying disorders of anal tone and contractility. Different ML models excelled in distinguishing specific disorders of anal tone and contractility, with accuracy over 90.0%. This is the first worldwide study proving the accuracy of a ML model for differentiation of motility patterns in HR-ARM, demonstrating the value of artificial intelligence models in optimizing HR-ARM availability while reducing interobserver variability and increasing accuracy.

Authors

  • Miguel Mascarenhas
    Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal.
  • Francisco Mendes
    Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal.
  • Joana Mota
    Department of Gastroenterology, Precision Medicine Unit, Centro Hospitalar Universitário São João, Alameda Professor Hernâni Monteiro, 4200-427, Porto, Portugal.
  • Tiago Ribeiro
    Department of Gastroenterology, São João University Hospital, Porto, Portugal.
  • Pedro Cardoso
    Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal.
  • Miguel Martins
    Precision Medicine Unit, Department of Gastroenterology, São João University Hospital, Alameda Professor Hernâni Monteiro, 4200-427 Porto, Portugal.
  • Maria João Almeida
    Department of Gastroenterology, Precision Medicine Unit, São João University Hospital, Porto, Portugal.
  • João Rala Cordeiro
    Department of Information Science and Technology, University Institute of Lisbon, Lisbon, Portugal.
  • João Ferreira
    Department of Mechanical Engineering, Faculty of Engineering of the University of Porto, Porto, Portugal.
  • Guilherme Macedo
    Department of Gastroenterology, São João University Hospital, Porto, Portugal.
  • Cecilio Santander
    Hospital Universitario La Princesa, Madrid, Spain.