Endoflip vs high-definition manometry in the assessment of fecal incontinence: A data-driven unsupervised comparison

Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society
Ali ZifanRavinder K Mittal

Abstract

How much anal sphincter dysfunction contributes to fecal incontinence (FI) is not clear. High-definition anorectal manometry (HDAM) and functional luminal imaging probe (Endoflip) are two new techniques to study anal sphincter function. The goal was to compare the diagnostic utility of HDAM and Endoflip using optimal feature(s) in each modality for FI diagnosis. Blinded classification was carried out on 70 female subjects (32 FI & 38 controls), using 3 prominent machine-learning clustering techniques, with 3 distance metrics. For HDAM, descriptive statistics, shape, and textural features characterizing the spatial relationship of pixels in the HDAM high-pressure zone, and for Endoflip, permutations of pressure and CSA combinations (ie, multiplication, division, or individually) at rest and squeeze were tested. Intramodality: (a) Endoflip: Best clustering was obtained using the combination of the ratio of CSA over pressure at 40 and 50 mL at rest, which had significantly better specificity (P < 0.001) than using only pressure at 50 mL, no difference in sensitivity (P = 0.68). (b) HDAM: clustering using textural information at rest had significantly higher specificity compared to using only the maximal pressure at rest (P < 0.001...Continue Reading

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Citations

May 8, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Herbert Mason HedbergMichael B Ujiki
Aug 29, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Charlotte DesprezGuillaume Gourcerol
Jul 17, 2020·Digestive Diseases and Sciences·Y Claire DorseyAmit Patel
Aug 21, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Mayank SharmaAdil E Bharucha
Jul 29, 2020·Gastroenterology Clinics of North America·Alice C JiangSatish S C Rao
Apr 27, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Pia Møller FaaborgKlaus Krogh

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