Artificial Intelligence Evaluation of Stool Quality Guides Management of Hepatic Encephalopathy Using a Smartphone App

Abstract

Lactulose-based hepatic encephalopathy (HE) treatment requires bowel movements/day(BMs) titration, which is improves with Bristol stool scale (BSS) incorporation. Dieta-App evaluates AI-based BSS(AI-BSS) with stool images. Initially, controls(N=13) and cirrhosis patients on lactulose/not(n=33) were trained on the App. They entered self-reported-BSS(self-BSS) with AI-BSS communicated. Lactulose dose changes were tracked. A subset (n=12) was retested with AI communication blocked. Most subjects were comfortable with the App. Self/AI-BSS and lactulose dose/AI-BSS correlation increased with App use. AI-BSS communications improved insight into self-BSS over time. Dieta-App to gauge stool AI characteristics was acceptable and increased insight into lactulose dose and BSS in cirrhosis.

Emerging digital technologies to help patients with cirrhosis

“…To assist patients in stool assessments and lactulose adjustments, an artificial intelligence-based smartphone application used patient-obtained stool photos to provide feedback based on stool features. [2,3] Patients using the application experienced improved self-efficacy in lactulose titration and subjective control of HE symptoms. In a more comprehensive smartphone application with a focus on HE, Ganapathy et al enrolled patients to use the Patient Buddy smartphone application.…”

“…In HE, symptom control depends on the careful titration of lactulose therapy to achieve bowel movement goals. To assist patients in stool assessments and lactulose adjustments, an artificial intelligence-based smartphone application used patient-obtained stool photos to provide feedback based on stool features 2,3 . Patients using the application experienced improved self-efficacy in lactulose titration and subjective control of HE symptoms.…”