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  <doc>
    <id>4692</id>
    <completedYear/>
    <publishedYear>2022</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber>10</pageNumber>
    <edition/>
    <issue/>
    <volume>12</volume>
    <type>article</type>
    <publisherName>Nature Portfolio</publisherName>
    <publisherPlace>London</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2022-07-04</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">An artificial intelligence algorithm is highly accurate for detecting endoscopic features of eosinophilic esophagitis</title>
    <abstract language="eng">The endoscopic features associated with eosinophilic esophagitis (EoE) may be missed during routine endoscopy. We aimed to develop and evaluate an Artificial Intelligence (AI) algorithm for detecting and quantifying the endoscopic features of EoE in white light images, supplemented by the EoE Endoscopic Reference Score (EREFS). An AI algorithm (AI-EoE) was constructed and trained to differentiate between EoE and normal esophagus using endoscopic white light images extracted from the database of the University Hospital Augsburg. In addition to binary classification, a second algorithm was trained with specific auxiliary branches for each EREFS feature (AI-EoE-EREFS). The AI algorithms were evaluated on an external data set from the University of North Carolina, Chapel Hill (UNC), and compared with the performance of human endoscopists with varying levels of experience. The overall sensitivity, specificity, and accuracy of AI-EoE were 0.93 for all measures, while the AUC was 0.986. With additional auxiliary branches for the EREFS categories, the AI algorithm (AI-EoEEREFS) performance improved to 0.96, 0.94, 0.95, and 0.992 for sensitivity, specificity, accuracy, and AUC, respectively. AI-EoE and AI-EoE-EREFS performed significantly better than endoscopy beginners and senior fellows on the same set of images. An AI algorithm can be trained to detect and quantify endoscopic features of EoE with excellent performance scores. The addition of the EREFS criteria improved the performance of the AI algorithm, which performed significantly better than endoscopists with a lower or medium experience level.</abstract>
    <parentTitle language="eng">Scientific Reports</parentTitle>
    <identifier type="urn">urn:nbn:de:bvb:898-opus4-46928</identifier>
    <identifier type="doi">10.1038/s41598-022-14605-z</identifier>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <licence>Creative Commons - CC BY - Namensnennung 4.0 International</licence>
    <author>Christoph Römmele</author>
    <author>Robert Mendel</author>
    <author>Caroline Barrett</author>
    <author>Hans Kiesl</author>
    <author>David Rauber</author>
    <author>Tobias Rückert</author>
    <author>Lisa Kraus</author>
    <author>Jakob Heinkele</author>
    <author>Christine Dhillon</author>
    <author>Bianca Grosser</author>
    <author>Friederike Prinz</author>
    <author>Julia Wanzl</author>
    <author>Carola Fleischmann</author>
    <author>Sandra Nagl</author>
    <author>Elisabeth Schnoy</author>
    <author>Jakob Schlottmann</author>
    <author>Evan S. Dellon</author>
    <author>Helmut Messmann</author>
    <author>Christoph Palm</author>
    <author>Alanna Ebigbo</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Artificial Intelligence</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Smart Endoscopy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>eosinophilic esophagitis</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCHST">Regensburg Center of Health Sciences and Technology - RCHST</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="oaweg" number="">Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
    <thesisPublisher>Ostbayerische Technische Hochschule Regensburg</thesisPublisher>
    <file>https://opus4.kobv.de/opus4-oth-regensburg/files/4692/s41598-022-14605-z.pdf</file>
  </doc>
  <doc>
    <id>7281</id>
    <completedYear/>
    <publishedYear>2024</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>641</pageFirst>
    <pageLast>649</pageLast>
    <pageNumber>9</pageNumber>
    <edition/>
    <issue/>
    <volume>56</volume>
    <type>article</type>
    <publisherName>Georg Thieme Verlag</publisherName>
    <publisherPlace>Stuttgart</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2024-05-05</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Influence of artificial intelligence on the diagnostic performance of endoscopists in the assessment of Barrett’s esophagus: a tandem randomized and video trial</title>
    <abstract language="eng">Background &#13;
This study evaluated the effect of an artificial intelligence (AI)-based clinical decision support system on the performance and diagnostic confidence of endoscopists in their assessment of Barrett’s esophagus (BE).&#13;
&#13;
Methods &#13;
96 standardized endoscopy videos were assessed by 22 endoscopists with varying degrees of BE experience from 12 centers. Assessment was randomized into two video sets: group A (review first without AI and second with AI) and group B (review first with AI and second without AI). Endoscopists were required to evaluate each video for the presence of Barrett’s esophagus-related neoplasia (BERN) and then decide on a spot for a targeted biopsy. After the second assessment, they were allowed to change their clinical decision and confidence level.&#13;
&#13;
Results &#13;
AI had a stand-alone sensitivity, specificity, and accuracy of 92.2%, 68.9%, and 81.3%, respectively. Without AI, BE experts had an overall sensitivity, specificity, and accuracy of 83.3%, 58.1%, and 71.5%, respectively. With AI, BE nonexperts showed a significant improvement in sensitivity and specificity when videos were assessed a second time with AI (sensitivity 69.8% [95%CI 65.2%–74.2%] to 78.0% [95%CI 74.0%–82.0%]; specificity 67.3% [95%CI 62.5%–72.2%] to 72.7% [95%CI 68.2%–77.3%]). In addition, the diagnostic confidence of BE nonexperts improved significantly with AI.&#13;
&#13;
Conclusion &#13;
BE nonexperts benefitted significantly from additional AI. BE experts and nonexperts remained significantly below the stand-alone performance of AI, suggesting that there may be other factors influencing endoscopists’ decisions to follow or discard AI advice.</abstract>
    <parentTitle language="eng">Endoscopy</parentTitle>
    <identifier type="doi">10.1055/a-2296-5696</identifier>
    <identifier type="urn">urn:nbn:de:bvb:898-opus4-72818</identifier>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <licence>Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International</licence>
    <author>Michael Meinikheim</author>
    <author>Robert Mendel</author>
    <author>Christoph Palm</author>
    <author>Andreas Probst</author>
    <author>Anna Muzalyova</author>
    <author>Markus W. Scheppach</author>
    <author>Sandra Nagl</author>
    <author>Elisabeth Schnoy</author>
    <author>Christoph Römmele</author>
    <author>Dominik Andreas Helmut Otto Schulz</author>
    <author>Jakob Schlottmann</author>
    <author>Friederike Prinz</author>
    <author>David Rauber</author>
    <author>Tobias Rückert</author>
    <author>Tomoaki Matsumura</author>
    <author>Glòria Fernández-Esparrach</author>
    <author>Nasim Parsa</author>
    <author>Michael F. Byrne</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Artificial Intelligence</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Endoscopy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Medical Image Computing</value>
    </subject>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmbarrett">Palm, Christoph (Prof. Dr.) - Projekt Barrett</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="oaweg" number="">Hybrid Open Access - OA-Veröffentlichung in einer Subskriptionszeitschrift/-medium</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
    <thesisPublisher>Ostbayerische Technische Hochschule Regensburg</thesisPublisher>
    <file>https://opus4.kobv.de/opus4-oth-regensburg/files/7281/Meinikheim_Mendel_Endoscopy_2024.pdf</file>
  </doc>
  <doc>
    <id>6039</id>
    <completedYear/>
    <publishedYear>2023</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber>S165</pageNumber>
    <edition/>
    <issue>S02</issue>
    <volume>55</volume>
    <type>conferencepresentation</type>
    <publisherName>Thieme</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2023-05-04</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Performance comparison of a deep learning algorithm with endoscopists in the detection of duodenal villous atrophy (VA)</title>
    <abstract language="eng">Aims &#13;
VA is an endoscopic finding of celiac disease (CD), which can easily be missed if pretest probability is low. In this study, we aimed to develop an artificial intelligence (AI) algorithm for the detection of villous atrophy on endoscopic images.&#13;
&#13;
Methods&#13;
858 images from 182 patients with VA and 846 images from 323 patients with normal duodenal mucosa were used for training and internal validation of an AI algorithm (ResNet18). A separate dataset was used for external validation, as well as determination of detection performance of experts, trainees and trainees with AI support. According to the AI consultation distribution, images were stratified into “easy” and “difficult”.&#13;
&#13;
Results&#13;
Internal validation showed 82%, 85% and 84% for sensitivity, specificity and accuracy. External validation showed 90%, 76% and 84%. The algorithm was significantly more sensitive and accurate than trainees, trainees with AI support and experts in endoscopy. AI support in trainees was associated with significantly improved performance. While all endoscopists showed significantly lower detection for “difficult” images, AI performance remained stable.&#13;
&#13;
Conclusions&#13;
The algorithm outperformed trainees and experts in sensitivity and accuracy for VA detection. The significant improvement with AI support suggests a potential clinical benefit. Stable performance of the algorithm in “easy” and “difficult” test images may indicate an advantage in macroscopically challenging cases.</abstract>
    <parentTitle language="eng">Endoscopy</parentTitle>
    <identifier type="doi">10.1055/s-0043-1765421</identifier>
    <enrichment key="ConferenceStatement">ESGE Days 2023</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="opus.doi.autoCreate">false</enrichment>
    <enrichment key="opus.urn.autoCreate">true</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Markus W. Scheppach</author>
    <author>David Rauber</author>
    <author>Johannes Stallhofer</author>
    <author>Anna Muzalyova</author>
    <author>Vera Otten</author>
    <author>Carolin Manzeneder</author>
    <author>Tanja Schwamberger</author>
    <author>Julia Wanzl</author>
    <author>Jakob Schlottmann</author>
    <author>Vidan Tadic</author>
    <author>Andreas Probst</author>
    <author>Elisabeth Schnoy</author>
    <author>Christoph Römmele</author>
    <author>Carola Fleischmann</author>
    <author>Michael Meinikheim</author>
    <author>Silvia Miller</author>
    <author>Bruno Märkl</author>
    <author>Christoph Palm</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <collection role="ddc" number="61">Medizin und Gesundheit</collection>
    <collection role="ddc" number="004">Datenverarbeitung; Informatik</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCHST">Regensburg Center of Health Sciences and Technology - RCHST</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>7261</id>
    <completedYear/>
    <publishedYear>2024</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>79</pageFirst>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue>S 02</issue>
    <volume>56</volume>
    <type>conferencepresentation</type>
    <publisherName>Georg Thieme Verlag</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Human-Computer Interaction: Impact of Artificial Intelligence on the diagnostic confidence of endoscopists assessing videos of Barrett’s esophagus</title>
    <abstract language="eng">Aims &#13;
Human-computer interactions (HCI) may have a relevant impact on the performance of Artificial Intelligence (AI). Studies show that although endoscopists assessing Barrett’s esophagus (BE) with AI improve their performance significantly, they do not achieve the level of the stand-alone performance of AI. One aspect of HCI is the impact of AI on the degree of certainty and confidence displayed by the endoscopist. Indirectly, diagnostic confidence when using AI may be linked to trust and acceptance of AI. In a BE video study, we aimed to understand the impact of AI on the diagnostic confidence of endoscopists and the possible correlation with diagnostic performance.&#13;
&#13;
Methods &#13;
22 endoscopists from 12 centers with varying levels of BE experience reviewed ninety-six standardized endoscopy videos. Endoscopists were categorized into experts and non-experts and randomly assigned to assess the videos with and without AI. Participants were randomized in two arms: Arm A assessed videos first without AI and then with AI, while Arm B assessed videos in the opposite order. Evaluators were tasked with identifying BE-related neoplasia and rating their confidence with and without AI on a scale from 0 to 9.&#13;
&#13;
Results &#13;
The utilization of AI in Arm A (without AI first, with AI second) significantly elevated confidence levels for experts and non-experts (7.1 to 8.0 and 6.1 to 6.6, respectively). Only non-experts benefitted from AI with a significant increase in accuracy (68.6% to 75.5%). Interestingly, while the confidence levels of experts without AI were higher than those of non-experts with AI, there was no significant difference in accuracy between these two groups (71.3% vs. 75.5%). In Arm B (with AI first, without AI second), experts and non-experts experienced a significant reduction in confidence (7.6 to 7.1 and 6.4 to 6.2, respectively), while maintaining consistent accuracy levels (71.8% to 71.8% and 67.5% to 67.1%, respectively).&#13;
&#13;
Conclusions &#13;
AI significantly enhanced confidence levels for both expert and non-expert endoscopists. Endoscopists felt significantly more uncertain in their assessments without AI. Furthermore, experts with or without AI consistently displayed higher confidence levels than non-experts with AI, irrespective of comparable outcomes. These findings underscore the possible role of AI in improving diagnostic confidence during endoscopic assessment.</abstract>
    <parentTitle language="eng">Endoscopy</parentTitle>
    <identifier type="issn">1438-8812</identifier>
    <identifier type="doi">10.1055/s-0044-1782859</identifier>
    <enrichment key="ConferenceStatement">ESGE Days 2024, Berlin, 25.–27.04.2024</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>David Roser</author>
    <author>Michael Meinikheim</author>
    <author>Robert Mendel</author>
    <author>Christoph Palm</author>
    <author>Andreas Probst</author>
    <author>Anna Muzalyova</author>
    <author>Markus W. Scheppach</author>
    <author>Sandra Nagl</author>
    <author>Elisabeth Schnoy</author>
    <author>Christoph Römmele</author>
    <author>Dominik Andreas Helmut Otto Schulz</author>
    <author>Jakob Schlottmann</author>
    <author>Friederike Prinz</author>
    <author>David Rauber</author>
    <author>Tobias Rückert</author>
    <author>Tomoaki Matsumura</author>
    <author>G. Fernandez-Esparrach</author>
    <author>Nasim Parsa</author>
    <author>Michael F. Byrne</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmbarrett">Palm, Christoph (Prof. Dr.) - Projekt Barrett</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>5777</id>
    <completedYear/>
    <publishedYear>2023</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume/>
    <type>article</type>
    <publisherName>Elsevier</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2023-02-02</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Detection of duodenal villous atrophy on endoscopic images using a deep learning algorithm</title>
    <abstract language="eng">Background and aims&#13;
Celiac disease with its endoscopic manifestation of villous atrophy is underdiagnosed worldwide. The application of artificial intelligence (AI) for the macroscopic detection of villous atrophy at routine esophagogastroduodenoscopy may improve diagnostic performance.&#13;
&#13;
Methods&#13;
A dataset of 858 endoscopic images of 182 patients with villous atrophy and 846 images from 323 patients with normal duodenal mucosa was collected and used to train a ResNet 18 deep learning model to detect villous atrophy. An external data set was used to test the algorithm, in addition to six fellows and four board certified gastroenterologists. Fellows could consult the AI algorithm’s result during the test. From their consultation distribution, a stratification of test images into “easy” and “difficult” was performed and used for classified performance measurement.&#13;
&#13;
Results&#13;
External validation of the AI algorithm yielded values of 90 %, 76 %, and 84 % for sensitivity, specificity, and accuracy, respectively. Fellows scored values of 63 %, 72 % and 67 %, while the corresponding values in experts were 72 %, 69 % and 71 %, respectively. AI consultation significantly improved all trainee performance statistics. While fellows and experts showed significantly lower performance for “difficult” images, the performance of the AI algorithm was stable.&#13;
&#13;
Conclusion&#13;
In this study, an AI algorithm outperformed endoscopy fellows and experts in the detection of villous atrophy on endoscopic still images. AI decision support significantly improved the performance of non-expert endoscopists. The stable performance on “difficult” images suggests a further positive add-on effect in challenging cases.</abstract>
    <parentTitle language="eng">Gastrointestinal Endoscopy</parentTitle>
    <identifier type="doi">10.1016/j.gie.2023.01.006</identifier>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="Kostentraeger">2071855</enrichment>
    <licence>Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International</licence>
    <author>Markus W. Scheppach</author>
    <author>David Rauber</author>
    <author>Johannes Stallhofer</author>
    <author>Anna Muzalyova</author>
    <author>Vera Otten</author>
    <author>Carolin Manzeneder</author>
    <author>Tanja Schwamberger</author>
    <author>Julia Wanzl</author>
    <author>Jakob Schlottmann</author>
    <author>Vidan Tadic</author>
    <author>Andreas Probst</author>
    <author>Elisabeth Schnoy</author>
    <author>Christoph Römmele</author>
    <author>Carola Fleischmann</author>
    <author>Michael Meinikheim</author>
    <author>Silvia Miller</author>
    <author>Bruno Märkl</author>
    <author>Andreas Stallmach</author>
    <author>Christoph Palm</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>celiac disease</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>villous atrophy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>endoscopy detection</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>artificial intelligence</value>
    </subject>
    <collection role="ddc" number="00">Informatik, Wissen, Systeme</collection>
    <collection role="ddc" number="61">Medizin und Gesundheit</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCHST">Regensburg Center of Health Sciences and Technology - RCHST</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="oaweg" number="">Hybrid Open Access - OA-Veröffentlichung in einer Subskriptionszeitschrift/-medium</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>6040</id>
    <completedYear/>
    <publishedYear>2023</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber>S169</pageNumber>
    <edition/>
    <issue>S02</issue>
    <volume>55</volume>
    <type>conferencepresentation</type>
    <publisherName>Thieme</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2023-05-04</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">AI-assisted detection and characterization of early Barrett's neoplasia: Results of an Interim analysis</title>
    <abstract language="eng">Aims &#13;
Evaluation of the add-on effect an artificial intelligence (AI) based clinical decision support system has on the performance of endoscopists with different degrees of expertise in the field of Barrett's esophagus (BE) and Barrett's esophagus-related neoplasia (BERN).&#13;
&#13;
Methods &#13;
The support system is based on a multi-task deep learning model trained to solve a segmentation and several classification tasks. The training approach represents an extension of the ECMT semi-supervised learning algorithm. The complete system evaluates a decision tree between estimated motion, classification, segmentation, and temporal constraints, to decide when and how the prediction is highlighted to the observer. In our current study, ninety-six video cases of patients with BE and BERN were prospectively collected and assessed by Barrett's specialists and non-specialists. All video cases were evaluated twice – with and without AI assistance. The order of appearance, either with or without AI support, was assigned randomly. Participants were asked to detect and characterize regions of dysplasia or early neoplasia within the video sequences.&#13;
&#13;
Results &#13;
Standalone sensitivity, specificity, and accuracy of the AI system were 92.16%, 68.89%, and 81.25%, respectively. Mean sensitivity, specificity, and accuracy of expert endoscopists without AI support were 83,33%, 58,20%, and 71,48 %, respectively. Gastroenterologists without Barrett's expertise but with AI support had a comparable performance with a mean sensitivity, specificity, and accuracy of 76,63%, 65,35%, and 71,36%, respectively.&#13;
&#13;
Conclusions &#13;
Non-Barrett's experts with AI support had a similar performance as experts in a video-based study.</abstract>
    <parentTitle language="eng">Endoscopy</parentTitle>
    <identifier type="doi">10.1055/s-0043-1765437</identifier>
    <enrichment key="ConferenceStatement">ESGE Days 2023</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="opus.doi.autoCreate">false</enrichment>
    <enrichment key="opus.urn.autoCreate">true</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Michael Meinikheim</author>
    <author>Robert Mendel</author>
    <author>Andreas Probst</author>
    <author>Markus W. Scheppach</author>
    <author>Elisabeth Schnoy</author>
    <author>Sandra Nagl</author>
    <author>Christoph Römmele</author>
    <author>Friederike Prinz</author>
    <author>Jakob Schlottmann</author>
    <author>Daniela Golger</author>
    <author>Christoph Palm</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <collection role="ddc" number="61">Medizin und Gesundheit</collection>
    <collection role="ddc" number="000">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCHST">Regensburg Center of Health Sciences and Technology - RCHST</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>3507</id>
    <completedYear/>
    <publishedYear>2022</publishedYear>
    <thesisYearAccepted/>
    <language>deu</language>
    <pageFirst>251</pageFirst>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue>4</issue>
    <volume>60</volume>
    <type>conferencepresentation</type>
    <publisherName>Thieme</publisherName>
    <publisherPlace>Stuttgart</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2022-04-10</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="deu">Einsatz von künstlicher Intelligenz (KI) als Entscheidungsunterstützungssystem für nicht-Experten bei der Beurteilung von Barrett-Ösophagus assoziierten Neoplasien (BERN)</title>
    <abstract language="deu">Einleitung&#13;
Die sichere Detektion und Charakterisierung von Barrett-Ösophagus assoziierten Neoplasien (BERN) stellt selbst für erfahrene Endoskopiker eine Herausforderung dar.&#13;
&#13;
Ziel&#13;
Ziel dieser Studie ist es, den Add-on Effekt eines künstlichen Intelligenz (KI) Systems (Barrett-Ampel) als Entscheidungsunterstüzungssystem für Endoskopiker ohne Expertise bei der Untersuchung von BERN zu evaluieren.&#13;
&#13;
Material und Methodik&#13;
Zwölf Videos in „Weißlicht“ (WL), „narrow-band imaging“ (NBI) und „texture and color enhanced imaging“ (TXI) von histologisch bestätigten Barrett-Metaplasien oder BERN wurden von Experten und Untersuchern ohne Barrett-Expertise evaluiert. Die Probanden wurden dazu aufgefordert in den Videos auftauchende BERN zu identifizieren und gegebenenfalls die optimale Biopsiestelle zu markieren. Unser KI-System wurde demselben Test unterzogen, wobei dieses BERN in Echtzeit segmentierte und farblich von umliegendem Epithel differenzierte. Anschließend wurden den Probanden die Videos mit zusätzlicher KI-Unterstützung gezeigt. Basierend auf dieser neuen Information, wurden die Probanden zu einer Reevaluation ihrer initialen Beurteilung aufgefordert.&#13;
&#13;
Ergebnisse&#13;
Die „Barrett-Ampel“ identifizierte unabhängig von den verwendeten Darstellungsmodi (WL, NBI, TXI) alle BERN. Zwei entzündlich veränderte Läsionen wurden fehlinterpretiert (Genauigkeit=75%). Während Experten vergleichbare Ergebnisse erzielten (Genauigkeit=70,8%), hatten Endoskopiker ohne Expertise bei der Beurteilung von Barrett-Metaplasien eine Genauigkeit von lediglich 58,3%. Wurden die nicht-Experten allerdings von unserem KI-System unterstützt, erreichten diese eine Genauigkeit von 75%.&#13;
&#13;
Zusammenfassung&#13;
Unser KI-System hat das Potential als Entscheidungsunterstützungssystem bei der Differenzierung zwischen Barrett-Metaplasie und BERN zu fungieren und so Endoskopiker ohne entsprechende Expertise zu assistieren. Eine Limitation dieser Studie ist die niedrige Anzahl an eingeschlossenen Videos. Um die Ergebnisse dieser Studie zu bestätigen, müssen randomisierte kontrollierte klinische Studien durchgeführt werden.</abstract>
    <parentTitle language="deu">Zeitschrift für Gastroenterologie</parentTitle>
    <identifier type="doi">10.1055/s-0042-1745653</identifier>
    <enrichment key="ConferenceStatement">49. Jahrestagung der Gesellschaft für Gastroenterologie in Bayern e.V., Freising</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Michael Meinikheim</author>
    <author>Robert Mendel</author>
    <author>Markus W. Scheppach</author>
    <author>Andreas Probst</author>
    <author>Friederike Prinz</author>
    <author>Tanja Schwamberger</author>
    <author>Jakob Schlottmann</author>
    <author>Stefan Karl Gölder</author>
    <author>Benjamin Walter</author>
    <author>Ingo Steinbrück</author>
    <author>Christoph Palm</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Barrett-Ösophagus</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Künstliche Intelligenz</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>psyndex</type>
      <value>Speiseröhrenkrankheit</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmbarrett">Palm, Christoph (Prof. Dr.) - Projekt Barrett</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>3540</id>
    <completedYear/>
    <publishedYear>2022</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>S39</pageFirst>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue>S 01</issue>
    <volume>54</volume>
    <type>conferencepresentation</type>
    <publisherName>Thieme</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2022-04-19</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">INFLUENCE OF AN ARTIFICIAL INTELLIGENCE (AI) BASED DECISION SUPPORT SYSTEM (DSS) ON THE DIAGNOSTIC PERFORMANCE OF NON-EXPERTS IN BARRETT´S ESOPHAGUS RELATED NEOPLASIA (BERN)</title>
    <abstract language="eng">Aims&#13;
Barrett´s esophagus related neoplasia (BERN) is difficult to detect and characterize during endoscopy, even for expert endoscopists. We aimed to assess the add-on effect of an Artificial Intelligence (AI) algorithm (Barrett-Ampel) as a decision support system (DSS) for non-expert endoscopists in the evaluation of Barrett’s esophagus (BE) and BERN.&#13;
&#13;
Methods&#13;
Twelve videos with multimodal imaging white light (WL), narrow-band imaging (NBI), texture and color enhanced imaging (TXI) of histologically confirmed BE and BERN were assessed by expert and non-expert endoscopists. For each video, endoscopists were asked to identify the area of BERN and decide on the biopsy spot. Videos were assessed by the AI algorithm and regions of BERN were highlighted in real-time by a transparent overlay. Finally, endoscopists were shown the AI videos and asked to either confirm or change their initial decision based on the AI support.&#13;
&#13;
Results&#13;
Barrett-Ampel correctly identified all areas of BERN, irrespective of the imaging modality (WL, NBI, TXI), but misinterpreted two inflammatory lesions (Accuracy=75%). Expert endoscopists had a similar performance (Accuracy=70,8%), while non-experts had an accuracy of 58.3%. When AI was implemented as a DSS, non-expert endoscopists improved their diagnostic accuracy to 75%.&#13;
&#13;
Conclusions&#13;
AI may have the potential to support non-expert endoscopists in the assessment of videos of BE and BERN. Limitations of this study include the low number of videos used. Randomized clinical trials in a real-life setting should be performed to confirm these results.</abstract>
    <parentTitle language="eng">Endoscopy</parentTitle>
    <identifier type="doi">10.1055/s-00000012</identifier>
    <enrichment key="ConferenceStatement">ESGE Days 2022</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Michael Meinikheim</author>
    <author>Robert Mendel</author>
    <author>Markus W. Scheppach</author>
    <author>Andreas Probst</author>
    <author>Friederike Prinz</author>
    <author>Tanja Schwamberger</author>
    <author>Jakob Schlottmann</author>
    <author>Stefan Karl Gölder</author>
    <author>Benjamin Walter</author>
    <author>Ingo Steinbrück</author>
    <author>Christoph Palm</author>
    <author>Helmut Messmann</author>
    <author>Alanna Ebigbo</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Artificial Intelligence</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Barrett's Esophagus</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Speiseröhrenkrankheit</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Künstliche Intelligenz</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Diagnose</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>6476</id>
    <completedYear/>
    <publishedYear>2023</publishedYear>
    <thesisYearAccepted/>
    <language>deu</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue>8</issue>
    <volume>61</volume>
    <type>conferencepresentation</type>
    <publisherName>Thieme</publisherName>
    <publisherPlace>Stuttgart</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2023-09-09</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="deu">Einfluss von Künstlicher Intelligenz auf die Performance von niedergelassenen Gastroenterolog:innen bei der Beurteilung von Barrett-Ösophagus</title>
    <abstract language="deu">Einleitung &#13;
Die Differenzierung zwischen nicht dysplastischem Barrett-Ösophagus (NDBE) und mit Barrett-Ösophagus assoziierten Neoplasien (BERN) während der endoskopischen Inspektion erfordert viel Expertise. Die frühe Diagnosestellung ist wichtig für die weitere Prognose des Barrett-Karzinoms. In Deutschland werden Patient:innen mit einem Barrett-Ösophagus (BE) in der Regel im niedergelassenen Sektor überwacht.&#13;
&#13;
Ziele &#13;
Ziel ist es, den Einfluss von einem auf Künstlicher Intelligenz (KI) basierenden klinischen Entscheidungsunterstützungssystems (CDSS) auf die Performance von niedergelassenen Gastroenterolog:innen (NG) bei der Evaluation von Barrett-Ösophagus (BE) zu untersuchen.&#13;
&#13;
Methodik &#13;
Es erfolgte die prospektive Sammlung von 96 unveränderten hochauflösenden Videos mit Fällen von Patient:innen mit histologisch bestätigtem NDBE und BERN. Alle eingeschlossenen Fälle enthielten mindestens zwei der folgenden Darstellungsmethoden: HD-Weißlichtendoskopie, Narrow Band Imaging oder Texture and Color Enhancement Imaging. Sechs NG von sechs unterschiedlichen Praxen wurden als Proband:innen eingeschlossen. Es erfolgte eine permutierte Block-Randomisierung der Videofälle in entweder Gruppe A oder Gruppe B. Gruppe A implizierte eine Evaluation des Falls durch Proband:innen zunächst ohne KI und anschließend mit KI als CDSS. In Gruppe B erfolgte die Evaluation in umgekehrter Reihenfolge. Anschließend erfolgte eine zufällige Wiedergabe der so entstandenen Subgruppen im Rahmen des Tests.&#13;
&#13;
Ergebnis &#13;
In diesem Test konnte ein von uns entwickeltes KI-System (Barrett-Ampel) eine Sensitivität von 92,2%, eine Spezifität von 68,9% und eine Accuracy von 81,3% erreichen. Mit der Hilfe von KI verbesserte sich die Sensitivität der NG von 64,1% auf 71,2% (p&lt;0,001) und die Accuracy von 66,3% auf 70,8% (p=0,006) signifikant. Eine signifikante Verbesserung dieser Parameter zeigte sich ebenfalls, wenn die Proband:innen die Fälle zunächst ohne KI evaluierten (Gruppe A). Wurde der Fall jedoch als Erstes mit der Hilfe von KI evaluiert (Gruppe B), blieb die Performance nahezu konstant.&#13;
&#13;
Schlussfolgerung &#13;
Es konnte ein performantes KI-System zur Evaluation von BE entwickelt werden. NG verbessern sich bei der Evaluation von BE durch den Einsatz von KI.</abstract>
    <parentTitle language="deu">Zeitschrift für Gastroenterologie</parentTitle>
    <identifier type="doi">10.1055/s-0043-1771711</identifier>
    <identifier type="url">https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0043-1771711</identifier>
    <enrichment key="ConferenceStatement">Viszeralmedizin 2023 77. Jahrestagung der DGVS mit Sektion Endoskopie Herbsttagung der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie mit den Arbeitsgemeinschaften der DGAV und Jahrestagung der CACP</enrichment>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Michael Meinikheim</author>
    <author>Robert Mendel</author>
    <author>Andreas Probst</author>
    <author>Markus W. Scheppach</author>
    <author>Sandra Nagl</author>
    <author>Elisabeth Schnoy</author>
    <author>Christoph Römmele</author>
    <author>Friederike Prinz</author>
    <author>Jakob Schlottmann</author>
    <author>Helmut Messmann</author>
    <author>Christoph Palm</author>
    <author>Alanna Ebigbo</author>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Barrett-Ösophagus</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Künstliche Intelligenz</value>
    </subject>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmbarrett">Palm, Christoph (Prof. Dr.) - Projekt Barrett</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
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