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[人工智能:子宫颈癌前病变诊断的准确性]

[Artificial Intelligence: accuracy for the diagnosis of precancerous lesions of the cervix].

作者信息

Medina Ruiz Luis, Chahla Rossana E, Vega Italia M, Ortega Eugenia S, Barrenechea Guillermo G, Ferre Contreras Miguel

机构信息

Ministerio de Salud Pública de Tucumán, Sistema Provincial de Salud SI.PRO.SA, Tucumán, Argentina.

Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina.

出版信息

Medicina (B Aires). 2024;84(3):459-467.

Abstract

INTRODUCTION

To compare the diagnostic sensitivity of artificial intelligence (AI) assisted videocolposcopy with standard videocolposcopy performed by specialist colposcopists.

METHODS

A descriptive retrospective cross-sectional study, 782 anonymized medical records from the Computerized System for Screening (SITAM) of women who underwent videocolposcopy with AI and colposcopy with common videocolposcopy performed by specialists, with their corresponding biopsies (gold standard) were analyzed. The relationship between the results of IA videocolposcopy and regular videocolposcopy and the results of biopsies was evaluated. The overall accuracy of each diagnostic procedure was calculated. The sensitivity and concordance of the results of AI videocolposcopy with the gold standard (biopsy) were determined.

RESULTS

A total of 395 patient records of patients with IA videocolposcopy and 387 with regular videocolposcopy were analyzed. The accuracy of results was 80% (IC 95%: 75-83%) in IA videocolposcopy and 65% (IC 95%: 60-69%) in regular videocolposcopy (p<0.001). Videocolposcopy results with IA and common colposcopy were significantly correlated with biopsy results, rs=0.75 vs. rs=0.57 respectively (p<0.001). The sensitivity of videocolposcopy with AI was 96% (95% CI: 94-98%), and 93% (95% CI: 89-95%) for regular colposcopy. The overall agreement of colposcopic impressions classified by videocolposcopy with AI and disease was higher than that of colposcopic interpretation by colposcopists (90% vs. 83%, Kappa 0.59 vs. 0.47, p<0.001).

CONCLUSION

The high diagnostic accuracy of AI videocolposcopy allows obtaining highly sensitive studies that help in the early detection of precursor lesions of cervical neoplasia.

摘要

引言

比较人工智能(AI)辅助阴道镜检查与专科阴道镜医师进行的标准阴道镜检查的诊断敏感性。

方法

一项描述性回顾性横断面研究,分析了来自计算机筛查系统(SITAM)的782份匿名医疗记录,这些记录来自接受AI阴道镜检查以及专科医师进行的普通阴道镜检查的女性,并伴有相应的活检(金标准)。评估了AI阴道镜检查结果与常规阴道镜检查结果以及活检结果之间的关系。计算了每种诊断程序的总体准确性。确定了AI阴道镜检查结果与金标准(活检)的敏感性和一致性。

结果

共分析了395例接受AI阴道镜检查患者的记录和387例接受常规阴道镜检查患者的记录。AI阴道镜检查结果的准确性为80%(95%置信区间:75-83%),常规阴道镜检查为65%(95%置信区间:60-69%)(p<0.001)。AI阴道镜检查和普通阴道镜检查的结果与活检结果显著相关,rs分别为0.75和0.57(p<0.001)。AI阴道镜检查的敏感性为96%(95%置信区间:94-98%),常规阴道镜检查为93%(95%置信区间:89-95%)。AI阴道镜检查分类的阴道镜印象与疾病的总体一致性高于阴道镜医师的阴道镜解释(90%对83%,Kappa值0.59对0.47,p<0.001)。

结论

AI阴道镜检查的高诊断准确性有助于获得高敏感性的研究,有助于早期发现宫颈肿瘤的前驱病变。

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