Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Department of Engineering, Design and Mathematics, University of the West of England, Bristol, UK.
Aliment Pharmacol Ther. 2017 Jan;45(1):82-90. doi: 10.1111/apt.13822. Epub 2016 Nov 10.
Inflammatory bowel disease and irritable bowel syndrome may present in a similar manner. Measuring faecal calprotectin concentration is often recommended to rule out inflammatory bowel disease, however, there are no tests to positively diagnose irritable bowel syndrome and invasive tests are still used to rule out other pathologies.
To investigate a platform technology for diagnosing inflammatory bowel disease and irritable bowel syndrome based on faecal gas.
The platform technology is composed of a gas chromatography column coupled to a metal oxide gas sensor (OdoReader) and a computer algorithm. The OdoReader separates the volatile compounds from faecal gas and the computer algorithm identifies resistance patterns associated with specific medical conditions and builds classification models. This platform was applied to faecal samples from 152 patients: 33 patients with active inflammatory bowel disease; 50 patients with inactive inflammatory bowel disease; 28 patients with irritable bowel syndrome and 41 healthy donors (Control).
The platform classified samples with accuracies from 75% to 100% using rigorous validation schemes: namely leave-one-out cross-validation, 10-fold cross-validation, double cross-validation and their Monte Carlo variations. The most clinically important findings, after double cross-validation, were the accuracy of active Crohn's disease vs. irritable bowel syndrome (87%; CI 84-89%) and irritable bowel syndrome vs. controls (78%; CI 76-80%). These schemes provide an estimate of out-of-sample predictive accuracy for similar populations.
This is the first description of an investigation for the positive diagnosis of irritable bowel syndrome, and for diagnosing inflammatory bowel disease.
炎症性肠病和肠易激综合征的表现可能相似。常建议测定粪便钙卫蛋白浓度以排除炎症性肠病，但目前尚无确诊肠易激综合征的检查方法，仍采用侵入性检查来排除其他病理。
研究基于粪便气体的炎症性肠病和肠易激综合征诊断平台技术。
该平台技术由气相色谱柱与金属氧化物气体传感器（OdoReader）和计算机算法组成。OdoReader 从粪便气体中分离挥发性化合物，计算机算法识别与特定医疗状况相关的电阻模式，并建立分类模型。该平台应用于 152 例患者的粪便样本：33 例活动期炎症性肠病患者；50 例缓解期炎症性肠病患者；28 例肠易激综合征患者和 41 例健康供者（对照组）。
该平台采用严格的验证方案，包括留一法交叉验证、10 折交叉验证、双交叉验证及其蒙特卡罗变异，分类准确率为 75%至 100%。双交叉验证后最具临床意义的发现是活动期克罗恩病与肠易激综合征（87%；CI 84-89%）以及肠易激综合征与对照组（78%；CI 76-80%）的准确率。这些方案可估计类似人群的样本外预测准确性。
这是首次描述用于肠易激综合征阳性诊断和炎症性肠病诊断的研究。
