@article{ChristenGordijnWeberetal., author = {Christen, Markus and Gordijn, Bert and Weber, Karsten and van de Poel, Ibo and Yaghmaei, Emad}, title = {A Review of Value-Conflicts in Cybersecurity}, series = {Orbit Journal - An Online Journal for Responsible Research and Innovation in ICT}, volume = {1}, journal = {Orbit Journal - An Online Journal for Responsible Research and Innovation in ICT}, number = {1}, doi = {10.29297/orbit.v1i1.28}, pages = {1 -- 19}, abstract = {Cybersecurity is of capital importance in a world where economic and social processes increasingly rely on digital technology. Although the primary ethical motivation of cybersecurity is prevention of informational or physical harm, its enforcement can also entail conflicts with other moral values. This contribution provides an outline of value conflicts in cybersecurity based on a quantitative literature analysis and qualitative case studies. The aim is to demonstrate that the security-privacy-dichotomy—that still seems to dominate the ethics discourse based on our bibliometric analysis—is insufficient when discussing the ethical challenges of cybersecurity. Furthermore, we want to sketch how the notion of contextual integrity could help to better understand and mitigate such value conflicts.}, language = {en} } @article{LoiChristenKleineetal., author = {Loi, Michele and Christen, Markus and Kleine, Nadine and Weber, Karsten}, title = {Cybersecurity in health}, series = {Journal of Information, Communication \& Ethics in Society}, volume = {17}, journal = {Journal of Information, Communication \& Ethics in Society}, number = {2}, doi = {10.1108/JICES-12-2018-0095}, pages = {229 -- 245}, abstract = {Purpose Cybersecurity in healthcare has become an urgent matter in recent years due to various malicious attacks on hospitals and other parts of the healthcare infrastructure. The purpose of this paper is to provide an outline of how core values of the health systems, such as the principles of biomedical ethics, are in a supportive or conflicting relation to cybersecurity. Design/methodology/approach This paper claims that it is possible to map the desiderata relevant to cybersecurity onto the four principles of medical ethics, i.e. beneficence, non-maleficence, autonomy and justice, and explore value conflicts in that way. Findings With respect to the question of how these principles should be balanced, there are reasons to think that the priority of autonomy relative to beneficence and non-maleficence in contemporary medical ethics could be extended to value conflicts in health-related cybersecurity. Research limitations/implications However, the tension between autonomy and justice, which relates to the desideratum of usability of information and communication technology systems, cannot be ignored even if one assumes that respect for autonomy should take priority over other moral concerns. Originality/value In terms of value conflicts, most discussions in healthcare deal with the conflict of balancing efficiency and privacy given the sensible nature of health information. In this paper, the authors provide a broader and more detailed outline.}, language = {en} } @article{WeberLoiChristenetal., author = {Weber, Karsten and Loi, Michele and Christen, Markus and Kleine, Nadine}, title = {Digital Medicine, Cybersecurity, and Ethics}, series = {American Journal of Bioethics}, volume = {18}, journal = {American Journal of Bioethics}, number = {9}, publisher = {Taylor\&Francis}, doi = {10.1080/15265161.2018.1498935}, pages = {52 -- 53}, language = {en} } @article{WeberChristenHerrmann, author = {Weber, Karsten and Christen, Markus and Herrmann, Dominik}, title = {Bedrohung, Verwundbarkeit, Werte und Schaden : Cyberattacken und Cybersicherheit als Thema der Technikfolgenabsch{\"a}tzung}, series = {TATuP - Journal for Technology Assessment in Theory and Practice}, volume = {29}, journal = {TATuP - Journal for Technology Assessment in Theory and Practice}, number = {1}, publisher = {oekom-verlag}, issn = {2567-8833}, doi = {10.14512/tatup.29.1.10}, pages = {10 -- 43}, abstract = {The annual monetary costs incurred worldwide by cyberattacks are growing steadily and are on a scale comparable to the budgets of entire countries. Cyberattacks affect individuals, businesses, public institutions, authorities, and governments; they affect an infrastructure without which modern societies can hardly function. But ensuring cybersecurity can lead to conflicts of interest. Technologies used to ensure the security and resilience of this infrastructure should therefore be a subject of technology assessment.}, language = {de} } @misc{AuerReinkerSuessetal., author = {Auer, Simon and Reinker, Lukas and S{\"u}ß, Franz and Kubowitsch, Simone and Krutsch, Werner and Weber, Markus and Renkawitz, Tobias and Dendorfer, Sebastian}, title = {Webcast: Effect of mental demand on leg loading in highly dynamic motion}, abstract = {Football players have a high risk of leg muscle injuries, especially when exposed to mental stress. Injuries to muscles of the thigh are common in amateur and professional football, representing almost a third of all injuries. These injuries occur primarily in non-contact situations and from overuse. They can lead to a range of costs, including financial costs associated with treatment as well as those associated with long-term recovery, and absence from training and/or competition. Further, there is a high risk of injury recurrence and subsequent injury.}, language = {en} } @incollection{DuttgeEngelZolletal., author = {Duttge, Gunnar and Engel, Wolfgang and Zoll, Barbara and Schulze, Thomas and Poser, Wolfgang and Lenk, Christian and Weber, Alexandra K. and Flatau, Laura and Frommeld, Debora and Houri, Leila and Reitt, Markus and Smogavec, Mateja and Tukuser, Xenia}, title = {Empfehlungen zum anwendungspraktischen Umgang mit dem »Recht auf Nichtwissen« : Ergebnisse einer rechtsethischen Grundlagenanalyse auf erfahrungswissenschaftlicher Basis in den Anwendungsfeldern von Humangenetik und Psychiatrie}, series = {Das sogenannte Recht auf Nichtwissen : Normatives Fundament und anwendungspraktische Geltungskraft}, booktitle = {Das sogenannte Recht auf Nichtwissen : Normatives Fundament und anwendungspraktische Geltungskraft}, editor = {Duttge, Gunnar and Lenk, Christian}, publisher = {mentis Verlag GmbH}, address = {Paderborn}, isbn = {9783957437792}, doi = {10.30965/9783957437792_018}, pages = {253 -- 269}, abstract = {BMBF-Projektgruppe »Recht auf Nichtwissen": Projektleitung: Prof. Dr. iur. Gunnar Duttge; Co-Projektbeteiligte: Prof. Dr. med. Dr. h. c. Wolf-gang Engel und Prof. Dr. Barbara Zoll (Humangenetik); Prof. Dr. med. Thomas Schulze (Psych-iatrische Genetik); Prof. Dr. med. Wolfgang Poser (Psychiatrie); Prof. Dr. phil. Christian Lenk(Medizinethik); Koordinatorin: Dipl.-Jur. Alexandra K. Weber, MLE. Projektmitarbeiter: LauraFlatau, M.Sc, Debora Frommeld, M.A., Dipl.-Jur. Laila Houri, Dr. rer. nat. Dipl.-Psych. MarkusReitt, Mateja Smogavec, Dipl.-Jur. Xenia Tukuser. Projekthomepage: http://www . recht - auf -nichtwissen.uni-goettingen.de/}, language = {de} } @article{LenkDuttgeFlatauetal., author = {Lenk, Christian and Duttge, Gunnar and Flatau, Laura and Frommeld, Debora and Poser, Wolfgang and Reitt, Markus and Schulze, Thomas and Weber, Alexandra and Zoll, Barbara}, title = {A look into the future? Patients' and health care staff's perception and evaluation of genetic information and the right not to know}, series = {American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics}, volume = {180}, journal = {American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics}, number = {8}, publisher = {Wiley}, doi = {10.1002/ajmg.b.32751}, pages = {576 -- 588}, abstract = {The progress of medical genetics leads to a significant increase in genetic knowledge and a vast expansion of genetic diagnostics. However, it is still unknown how these changes will be integrated into medical practice and how they will change patients' and healthy persons' perception and evaluation of genetic diagnoses and genetic knowledge. Therefore, we carried out a comprehensive questionnaire survey with more than 500 patients, clients seeking genetic counseling, health care staff, and healthy persons (N = 523). The questionnaire survey covered detailed questions on the value of genetic diagnoses for the different groups of study participants, the right to know or not to know genetic diagnoses, possible differences between genetic and other medical diagnoses, and the practical use and implications of genetic knowledge with a special focus on hereditary neuropsychiatric diseases. A huge majority of the participants (90.7\%) stated to have a right to learn every aspect of her or his genetic make-up. Similarly, study participants showed high interest (81.8\%) in incidental health care findings-independent of whether the diseases are treatable or not. One can derive from the data outcome that study participants did not follow the implications of a "genetic exceptionalism" and often considered genetic findings as equivalent in relation to other medical diagnoses.}, language = {en} } @misc{BeimlerLeisslEbneretal., author = {Beimler, Josef and Leißl, Caroline and Ebner, Lena and Elsner, Michael and M{\"u}hlbauer, Gerhard and Kohlert, Dieter and Schubert, Martin J. W. and Weiß, Andreas P. and Sterner, Michael and Raith, Thomas and Afranseder, Martin and Krapf, Tobias and Mottok, J{\"u}rgen and Siemers, Christian and Großmann, Benjamin and H{\"o}cherl, Johannes and Schlegl, Thomas and Schneider, Ralph and Milaev, Johannes and Rampelt, Christina and Roduner, Christian and Glowa, Christoph and Bachl, Christoph and Schliekmann, Claus and Gnan, Alfons and Grill, Martin and Ruhland, Karl and Piehler, Thomas and Friers, Daniel and Wels, Harald and Pflug, Kenny and Kucera, Markus and Waas, Thomas and Schlachetzki, Felix and Boy, Sandra and Pemmerl, Josef and Leis, Alexander and Welsch, Andreas F.X. and Graf, Franz and Zenger, Gerhard and Volbert, Klaus and Waas, Thomas and Scherzinger, Stefanie and Klettke, Meike and St{\"o}rl, Uta and Heyl, C. and Boldenko, A. and Monkman, Gareth J. and Kujat, Richard and Briem, Ulrich and Hierl, Stefan and Talbot, Sebastian and Schmailzl, Anton and Ławrowski, Robert Damian and Prommesberger, Christian and Langer, Christoph and Dams, Florian and Schreiner, Rupert and Valentino, Piergiorgio and Romano, Marco and Ehrlich, Ingo and Furgiuele, Franco and Gebbeken, Norbert and Eisenried, Michael and Jungbauer, Bastian and Hutterer, Albert and Bauhuber, Michael and Mikrievskij, Andreas and Argauer, Monika and Hummel, Helmut and Lechner, Alfred and Liebetruth, Thomas and Schumm, Michael and Joseph, Saskia and Reschke, Michael and Soska, Alexander and Schroll-Decker, Irmgard and Putzer, Michael and Rasmussen, John and Dendorfer, Sebastian and Weber, Tim and Al-Munajjed, Amir Andreas and Verkerke, Gijsbertus Jacob and Renkawitz, Tobias and Haug, Sonja and Rudolph, Clarissa and Zeitler, Annika and Schaubeck, Simon and Steffens, Oliver and Rechenauer, Christian and Schulz-Brize, Thekla and Fleischmann, Florian and Kusterle, Wolfgang and Beer, Anne and Wagner, Bernd and Neidhart, Thomas}, title = {Forschungsbericht 2013}, editor = {Baier, Wolfgang}, address = {Regensburg}, organization = {Ostbayerische Technische Hochschule Regensburg}, doi = {10.35096/othr/pub-799}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-7990}, pages = {80}, language = {de} } @misc{LautenschlaegerLeisDendorferetal., author = {Lautenschl{\"a}ger, Toni and Leis, Alexander and Dendorfer, Sebastian and Palm, Christoph and Schreiner, Rupert and Langer, Christoph and Prommesberger, Christian and Ławrowski, Robert Damian and Dams, Florian and Bornmann, Benjamin and Navitski, Aliaksandr and Serbun, Pavel and M{\"u}ller, G{\"u}nter and Liebetruth, Thomas and Kohlert, Dieter and Pernsteiner, Jochen and Schreier, Franz and Heerklotz, Sabrina and Heerklotz, Allwin and Boos, Alexander and Herwald, Dominik and Monkman, Gareth J. and Treiber, Daniel and Mayer, Matthias and H{\"o}rner, Eva and Bentz, Alexander and Shamonin (Chamonine), Mikhail and Johansen, S{\o}ren Peter and Reichel, Marco and Stoll, Andrea and Briem, Ulrich and Dullien, Silvia and Renkawitz, Tobias and Weber, Tim and Dendorfer, Sebastian and Grifka, Joachim and Penzkofer, Rainer and Barnsteiner, K. and Jovanovik, M. and Wernecke, P. and V{\"o}gele, A. and Bachmann, T. and Pl{\"o}tz, Martin and Schliekmann, Claus and Wels, Harald and Helmberger, Paul and Kaspar, Marcel and H{\"o}nicka, M. and Schrammel, Siegfried and Enser, Markus and Schmidmeier, Monika and Schroll-Decker, Irmgard and Haug, Sonja and Gelfert, Verena and Vernim, Matthias}, title = {Forschungsbericht 2012}, editor = {Baier, Wolfgang}, address = {Regensburg}, organization = {Ostbayerische Technische Hochschule Regensburg}, doi = {10.35096/othr/pub-783}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-7834}, pages = {64}, language = {de} } @misc{WeberDendorferSuessetal., author = {Weber, Karsten and Dendorfer, Sebastian and S{\"u}ß, Franz and Kubowitsch, Simone and Schratzenstaller, Thomas and Haug, Sonja and Mohr, Christa and Kiesl, Hans and Drechsler, J{\"o}rg and Westner, Markus and Kobus, J{\"o}rn and Schubert, Martin J. W. and Zenger, Stefan and Pietsch, Alexander and Weiß, Josef and Hinterseer, Sebastian and Schieck, Roland and Scherzinger, Stefanie and Klettke, Meike and Ringlstetter, Andreas and St{\"o}rl, Uta and Bissyand{\´e}, Tegawend{\´e} F. and Seeburger, Achim and Schindler, Timo and Ramsauer, Ralf and Kiszka, Jan and K{\"o}lbl, Andreas and Lohmann, Daniel and Mauerer, Wolfgang and Maier, Johannes and Scorna, Ulrike and Palm, Christoph and Soska, Alexander and Mottok, J{\"u}rgen and Ellermeier, Andreas and V{\"o}gele, Daniel and Hierl, Stefan and Briem, Ulrich and Buschmann, Knut and Ehrlich, Ingo and Pongratz, Christian and Pielmeier, Benjamin and Tyroller, Quirin and Monkman, Gareth J. and Gut, Franz and Roth, Carina and Hausler, Peter and Bierl, Rudolf and Prommesberger, Christian and Ławrowski, Robert Damian and Langer, Christoph and Schreiner, Rupert and Huang, Yifeng and She, Juncong and Ottl, Andreas and Rieger, Walter and Kraml, Agnes and Poxleitner, Thomas and Hofer, Simon and Heisterkamp, Benjamin and Lerch, Maximilian and Sammer, Nike and Golde, Olivia and Wellnitz, Felix and Schmid, Sandra and Muntschick, Claudia and Kusterle, Wolfgang and Paric, Ivan and Br{\"u}ckl, Oliver and Haslbeck, Matthias and Schmidt, Ottfried and Schwanzer, Peter and Rabl, Hans-Peter and Sterner, Michael and Bauer, Franz and Steinmann, Sven and Eckert, Fabian and Hofrichter, Andreas}, title = {Forschungsbericht 2017}, editor = {Baier, Wolfgang}, address = {Regensburg}, organization = {Ostbayerische Technische Hochschule Regensburg}, isbn = {978-3-9818209-3-5}, doi = {10.35096/othr/pub-1383}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-13835}, subject = {Forschung}, language = {de} } @incollection{ChristenGordijnWeberetal., author = {Christen, Markus and Gordijn, Bert and Weber, Karsten and van de Poel, Ibo and Yaghmaei, Emad}, title = {A review of value-conflicts in cybersecurity}, series = {Bezpieczeństwo informacyjne w wymiarze systemowym}, booktitle = {Bezpieczeństwo informacyjne w wymiarze systemowym}, editor = {Oleksiewicz, Izabela}, publisher = {Rambler Press}, address = {Warszawa}, pages = {67 -- 92}, abstract = {The growing complexity of the digital ecosystem in combination with increasing global risks has created the following dilemma. Overemphasizing cybersecurity may violate fundamental values like equality, fairness, freedom, or privacy but neglecting cybersecurity could undermine citizens' trust and confidence in the digital infrastructure as well as in policy makers and state authorities. In order to increase our understanding of this dilemma, this contribution aims to provide an overview on value conflicts in cybersecurity based on a systematic review on the ethical, legal and technological literature on cybersecurity. It shall be emphasized that a focus on the opposition of cybersecurity vs. privacy is insufficient for understanding the ethical complexity of cybersecurity.}, subject = {Computersicherheit}, language = {en} } @misc{ScheppachNunesArizietal., author = {Scheppach, Markus W. and Nunes, Danilo Weber and Arizi, X. and Rauber, David and Probst, Andreas and Nagl, Sandra and R{\"o}mmele, Christoph and Palm, Christoph and Messmann, Helmut and Ebigbo, Alanna}, title = {Intraoperative Phasenerkennung bei endoskopischer Submukosadissektion mit Hilfe von k{\"u}nstlicher Intelligenz}, series = {Zeitschrift f{\"u}r Gastroenterologie}, volume = {62}, journal = {Zeitschrift f{\"u}r Gastroenterologie}, number = {09}, publisher = {Georg Thieme Verlag KG}, doi = {10.1055/s-0044-1790084}, pages = {e828}, abstract = {Einleitung: K{\"u}nstliche Intelligenz (KI) wird in der Endoskopie des Gastrointestinaltraktes zur Erkennung und Charakterisierung von Kolonpolypen eingesetzt. Die Rolle von KI bei therapeutischen Maßnahmen wurde noch nicht eingehend untersucht. Eine intraprozedurale Phasenerkennung bei endoskopischer Submukoasdissektion (ESD) k{\"o}nnte die Erhebung von Qualit{\"a}tsindikatoren erm{\"o}glichen. Weiterhin k{\"o}nnte diese Technologie zu einem tieferen Verst{\"a}ndnis {\"u}ber die Eigenschaften der Prozedur f{\"u}hren und weiterf{\"u}hrende Applikationen zur automatischen Dokumentation oder standardisiertem Training vorbereiten. Ziele: Ziel dieser Studie war die Entwicklung eines KI Algorithmus zur intraprozeduralen Phasenerkennung bei endoskopischer Submukosadissektion. Methodik: 2071546 Einzelbilder aus 27 ESD Videos in voller L{\"a}nge wurden f{\"u}r die {\"u}bergeordneten Klassen Diagnostik, Markierung, Nadelinjektion, Dissektion und Blutung, sowie die untergeordneten Klassen Endoskop-Manipulation, Injektion und Applikation von elektrischem Strom annotiert. Mit einem Trainingsdatensatz (898440 Einzelbilder, 17 ESDs) wurde ein Video Swin Transformer mit uniformer Stichprobenentnahme trainiert und intern validiert (769523 Einzelbilder, 6 ESDs). Neben der internen Validierung wurde der Algorithmus anhand von einem separaten Testdatensatz (403583 Einzelbilder, 4 ESDs) evaluiert. Ergebnis: Der F1 Score des Algorithmus f{\"u}r alle Klassen lag in der internen Validierung bei 83\%, in dem separaten Test bei 90\%. Anhand des separaten Tests wurden true positive (TP)-Raten f{\"u}r Diagnostik, Markierung, Nadelinjektion, Dissektion und Blutung von 100\%, 100\%, 96\%, 97\% und 93\% ermittelt. F{\"u}r Endoskopmanipulation, Injektion und Applikation von Elektrizit{\"a}t lagen die TP-Raten bei 92\%, 98\% und 91\%. Schlussfolgerung: Der entwickelte Algorithmus klassifizierte ESD Videos in voller L{\"a}nge und anhand jedes einzelnen Bildes mit hoher Genauigkeit. Zuk{\"u}nftige Forschungsvorhaben k{\"o}nnten intraoperative Qualit{\"a}tsindikatioren auf Basis dieser Informationen entwickeln und eine automatisierte Dokumentation erm{\"o}glichen.}, language = {de} } @misc{ScheppachNunesArizietal., author = {Scheppach, Markus W. and Nunes, Danilo Weber and Arizi, X. and Rauber, David and Probst, Andreas and Nagl, Sandra and R{\"o}mmele, Christoph and Meinikheim, Michael and Palm, Christoph and Messmann, Helmut and Ebigbo, Alanna}, title = {Procedural phase recognition in endoscopic submucosal dissection (ESD) using artificial intelligence (AI)}, series = {Endoscopy}, volume = {56}, journal = {Endoscopy}, number = {S 02}, publisher = {Thieme}, address = {Stuttgart}, doi = {10.1055/s-0044-1783804}, pages = {S439}, abstract = {Aims Recent evidence suggests the possibility of intraprocedural phase recognition in surgical operations as well as endoscopic interventions such as peroral endoscopic myotomy and endoscopic submucosal dissection (ESD) by AI-algorithms. The intricate measurement of intraprocedural phase distribution may deepen the understanding of the procedure. Furthermore, real-time quality assessment as well as automation of reporting may become possible. Therefore, we aimed to develop an AI-algorithm for intraprocedural phase recognition during ESD. Methods A training dataset of 364385 single images from 9 full-length ESD videos was compiled. Each frame was classified into one procedural phase. Phases included scope manipulation, marking, injection, application of electrical current and bleeding. Allocation of each frame was only possible to one category. This training dataset was used to train a Video Swin transformer to recognize the phases. Temporal information was included via logarithmic frame sampling. Validation was performed using two separate ESD videos with 29801 single frames. Results The validation yielded sensitivities of 97.81\%, 97.83\%, 95.53\%, 85.01\% and 87.55\% for scope manipulation, marking, injection, electric application and bleeding, respectively. Specificities of 77.78\%, 90.91\%, 95.91\%, 93.65\% and 84.76\% were measured for the same parameters. Conclusions The developed algorithm was able to classify full-length ESD videos on a frame-by-frame basis into the predefined classes with high sensitivities and specificities. Future research will aim at the development of quality metrics based on single-operator phase distribution.}, language = {en} } @misc{ScheppachWeberNunesArizietal., author = {Scheppach, Markus W. and Weber Nunes, Danilo and Arizi, X. and Rauber, David and Probst, Andreas and Nagl, Sandra and R{\"o}mmele, Christoph and Palm, Christoph and Messmann, Helmut and Ebigbo, Alanna}, title = {Single frame workflow recognition during endoscopic submucosal dissection (ESD) using artificial intelligence (AI)}, series = {Endoscopy}, volume = {57}, journal = {Endoscopy}, number = {S 02}, publisher = {Thieme}, address = {Stuttgart}, doi = {10.1055/s-0045-1806324}, pages = {S511}, abstract = {Aims Precise surgical phase recognition and evaluation may improve our understanding of complex endoscopic procedures. Furthermore, quality control measurements and endoscopy training could benefit from objective descriptions of surgical phase distributions. Therefore, we aimed to develop an artificial intelligence algorithm for frame-by-frame operational phase recognition during endoscopic submucosal dissection (ESD). Methods Full length ESD-videos from 31 patients comprising 6.297.782 single images were collected retrospectively. Videos were annotated on a frame-by-frame basis for the operational macro-phases diagnostics, marking, injection, dissection and bleeding. Further subphases were the application of electrical current, visible injection of fluid into the submucosal space and scope manipulation, leading to 11 phases in total. 4.975.699 frames (21 patients) were used for training of a video swin transformer using uniform frame sampling for temporal information. Hyperparameter tuning was performed with 897.325 further frames (6 patients), while 424.758 frames (4 patients) were used for validation. Results The overall F1 scores on the test dataset for the macro-phases and all 11 phases were 0.96 and 0.90, respectively. The recall values for diagnostics, marking, injection, dissection and bleeding were 1.00, 1.00, 0.95, 0.96 and 0.93, respectively. Conclusions The algorithm classified operational phases during ESD with high accuracy. A precise evaluation of phase distribution may allow for the development of objective quality metrics for quality control and training.}, language = {en} } @misc{ScheppachRauberZingleretal., author = {Scheppach, Markus W. and Rauber, David and Zingler, C. and Weber Nunes, Danilo and Probst, Andreas and R{\"o}mmele, Christoph and Nagl, Sandra and Ebigbo, Alanna and Palm, Christoph and Messmann, Helmut}, title = {Instrumentenerkennung w{\"a}hrend der endoskopischen Submukosadissektion mittels k{\"u}nstlicher Intelligenz}, series = {Zeitschrift f{\"u}r Gastroenterologie}, volume = {63}, journal = {Zeitschrift f{\"u}r Gastroenterologie}, number = {8}, publisher = {Thieme}, doi = {10.1055/s-0045-1811092}, abstract = {Einleitung: Die endoskopische Submukosadissektion (ESD) ist eine komplexe Technik zur Resektion gastrointestinaler Fr{\"u}hneoplasien. Dabei werden f{\"u}r die verschiedenen Schritte der Intervention spezifische endoskopische Instrumente verwendet. Die pr{\"a}zise und automatische Erkennung und Abgrenzung der verwendeten Instrumente (Injektionsnadeln, elektrochirurgische Messer mit unterschiedlichen Konfigurationen, h{\"a}mostatische Zangen) k{\"o}nnte wertvolle Informationen {\"u}ber den Fortschritt und die Verfahrensmerkmale der ESD liefern und eine automatische standardisierte Berichterstattung erm{\"o}glichen. Ziele: Ziel dieser Studie war die Entwicklung eines KI-Algorithmus zur Erkennung und Delineation von endoskopischen Instrumenten bei der ESD. Methodik: 17 ESD-Videos (9×rektal, 5×{\"o}sophageal, 3×gastrisch) wurden retrospektiv zusammengestellt. Auf 8530 Einzelbilder dieser Videos wurden durch 2 Studienmitarbeiter die folgenden Klassen eingezeichnet: Hakenmesser - Spitze, Hakenmesser - Katheter, Nadelmesser - Spitze und - Katheter, Injektionsnadel -Spitze und - Katheter sowie h{\"a}mostatische Zange - Spitze und - Katheter. Der annotierte Datensatz wurde zum Training eines DeepLabV3+-Deep-Learning-Algorithmus mit ConvNeXt-Backbone zur Erkennung und Abgrenzung der genannten Klassen verwendet. Die Evaluation erfolgte durch 5-fache interne Kreuzvalidierung. Ergebnis: Die Validierung auf Einzelpixelbasis ergab insgesamt einen F1-Score von 0,80, eine Sensitivit{\"a}t von 0,81 und eine Spezifit{\"a}t von 1,00. Es wurden F1-Scores von 1,00, 0,97, 0,80, 0,98, 0,85, 0,97, 0,80, 0,51 bzw. 0,85 f{\"u}r die Klassen Hakenmesser - Katheter und - Spitze, Nadelmesser - Katheter und - Spitze, Injektionsnadel - Katheter und - Spitze, h{\"a}mostatische Zange - Katheter und - Spitze gemessen. Schlussfolgerung: In dieser Studie wurden die wichtigsten endoskopischen Instrumente, die w{\"a}hrend der ESD verwendet werden, mit hoher Genauigkeit erkannt. Die geringere Leistung bei der h{\"a}mostatische Zange - Katheter kann auf die Unterrepr{\"a}sentation dieser Klassen in den Trainingsdaten zur{\"u}ckgef{\"u}hrt werden. Zuk{\"u}nftige Studien werden sich auf die Erweiterung der Instrumentenklassen sowie auf die Ausbalancierung der Trainingsdaten konzentrieren.}, language = {de} }