1.Development and validation of an intelligent surveillance system for upper gastrointestinal high-risk patients
Mei DENG ; Guoen LYU ; Conghui SHI ; Jia LI ; Lianlian WU ; Jun LIU ; Honggang YU
Chinese Journal of Digestive Endoscopy 2025;42(3):190-196
Objective:To develop an intelligent surveillance system for identifying upper gastrointestinal high-risk patients and assigning surveillance intervals, and to verify its efficacy.Methods:The endoscopic and pathological reports of 23 035 patients undergoing endoscopy at Renmin Hospital of Wuhan University from January to October 2021 were collected retrospectively. A training set of 17 934 patients (January to August) and a test set of 5 101 patients (September to October) were established. Keywords in the endoscopic and pathological reports were extracted by the intelligent surveillance system, and high-risk patients were automatically identified and classified into 7 risk levels. Then the standardized surveillance intervals were assigned based on the guideline. Guideline-based surveillance intervals assigned by expert endoscopists based on endoscopic and pathological reports were used as the golden standard. The accuracy of the intelligent surveillance system was calculated. Of the patients within the test set, 189 were hospitalized and the surveillance intervals given by physicians could be obtained from the electronic health records. The accuracy of the intelligent surveillance system with that of physicians from different departments was compared. Then 67 patients were randomly selected from 189 patients by simple random sampling to evaluate the adjunctive effect of the system in assigning surveillance intervals among 3 endoscopists.Results:The overall accuracy of the intelligent surveillance system in identifying upper gastrointestinal high-risk patients was 99.94% (5 098/5 101), and that of assigning surveillance intervals to correctly included patients was 100.00% (534/534). The intelligent surveillance system achieved significantly higher accuracy compared with all physicians from different departments [98.94% (187/189) VS 35.45% (67/189), χ2=118.01, P<0.001] as well as physicians from department of gastroenterology [100.00% (117/117) VS 24.79% (29/117), χ2=86.01, P<0.001]. With the assistance of the intelligent surveillance system, the endoscopists' accuracy of assigning surveillance intervals to 67 patients was significantly improved [55.22% (111/201) VS 22.39% (45/201), χ2=58.68, P<0.001]. Conclusion:The intelligent surveillance system can accurately identify upper gastrointestinal high-risk patients and assign surveillance intervals according to risk levels, which can alleviate the workload of doctors and improve the follow-up rate of patients.
2.Development and validation of an intelligent surveillance system for upper gastrointestinal high-risk patients
Mei DENG ; Guoen LYU ; Conghui SHI ; Jia LI ; Lianlian WU ; Jun LIU ; Honggang YU
Chinese Journal of Digestive Endoscopy 2025;42(3):190-196
Objective:To develop an intelligent surveillance system for identifying upper gastrointestinal high-risk patients and assigning surveillance intervals, and to verify its efficacy.Methods:The endoscopic and pathological reports of 23 035 patients undergoing endoscopy at Renmin Hospital of Wuhan University from January to October 2021 were collected retrospectively. A training set of 17 934 patients (January to August) and a test set of 5 101 patients (September to October) were established. Keywords in the endoscopic and pathological reports were extracted by the intelligent surveillance system, and high-risk patients were automatically identified and classified into 7 risk levels. Then the standardized surveillance intervals were assigned based on the guideline. Guideline-based surveillance intervals assigned by expert endoscopists based on endoscopic and pathological reports were used as the golden standard. The accuracy of the intelligent surveillance system was calculated. Of the patients within the test set, 189 were hospitalized and the surveillance intervals given by physicians could be obtained from the electronic health records. The accuracy of the intelligent surveillance system with that of physicians from different departments was compared. Then 67 patients were randomly selected from 189 patients by simple random sampling to evaluate the adjunctive effect of the system in assigning surveillance intervals among 3 endoscopists.Results:The overall accuracy of the intelligent surveillance system in identifying upper gastrointestinal high-risk patients was 99.94% (5 098/5 101), and that of assigning surveillance intervals to correctly included patients was 100.00% (534/534). The intelligent surveillance system achieved significantly higher accuracy compared with all physicians from different departments [98.94% (187/189) VS 35.45% (67/189), χ2=118.01, P<0.001] as well as physicians from department of gastroenterology [100.00% (117/117) VS 24.79% (29/117), χ2=86.01, P<0.001]. With the assistance of the intelligent surveillance system, the endoscopists' accuracy of assigning surveillance intervals to 67 patients was significantly improved [55.22% (111/201) VS 22.39% (45/201), χ2=58.68, P<0.001]. Conclusion:The intelligent surveillance system can accurately identify upper gastrointestinal high-risk patients and assign surveillance intervals according to risk levels, which can alleviate the workload of doctors and improve the follow-up rate of patients.
3.Evaluation on sensitivity and specificity of CA242/CA72-4 ratio in diagnosing early colorectal carcinoma
Zhongshun LIN ; Guoen LYU ; Junting LYU
International Journal of Laboratory Medicine 2016;37(16):2250-2251,2254
Objective To evaluate the sensitivity and specificity of CA242/CA72‐4 ratio in diagnosing early colorectal carcino‐ma .Methods Totally 87 blood specimens of colorectal carcinoma(CRC) were collected .The Chemiluminescence method was adopt‐ed to detect the levels of CA242 and CA72‐4 .Then the receiver‐operating characteristic (ROC) curve was used to analyze the sensi‐tivity and specificity of CA242/CA72 4 ratio in the diagnosis of CRC .Results Among 87 cases of suspected CRC ,56 cases (64 .37% )were eventually diagnosed as CRC ,31 cases (35 .63% ) were excluded from CRC ;the CA242 and CA72‐4 levels and CA242/CA72‐4 ratios in the CRC group were higher than those in the non‐CRC group ,the differences were statistically significant (P<0 .05) ,moreover the CA242/CA72‐4 ratio was more significant(P=0 .013) .The areas under curve (AUC) of CA242 ,CA72‐4 and CA242/CA72‐4 ratio were 0 .754 ,0 .621 and 0 .775 respectively ,in which CA72‐4 had no significant correlation with the early CRC ,while CA242 and CA242/CA72‐4 ratio had significant correlation with the CRC diagnosis(P=0 .013 ,0 .006) and their 95%confidence intervals (CI) were 0 .576-0 .851 and 0 .612 -0 .887;when the CA242/CA72 4 cutoff value was 2 .6(CA242=28 .6 , CA72‐4=11) ,the sensitivity for early diagnosis of CRC was 91 .32% and the specificity was 94 .57% .Conclusion The sensitivity and specificity of CA242/CA72‐4 ratio in the early diagnosis of CRC are higher than those of CA242 or CA72‐4 single index ,espe‐cially w hen the ratio is close to 2 .6 ,high attention should be paid to the possibility of CRC .

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