One-year outcomes in children with eosinophilic esophagitis

Kovačić, Matea; Unić, Josipa; Mišak, Zrinjka; Jadrešin, Oleg; Konjik, Vlatka; Kolaček, Sanja; Hojsak, Iva

doi:10.1007/s10388-018-0647-3

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…EoE is becoming increasingly important due to its rising incidence, but endoscopists may still have difficulty detecting and diagnosing EoE during routine EGD, leading to diagnostic delay 1 , 2 , 24 , 25 . The suspicion of EoE during routine EGD and based on the endoscopic image alone is challenging 7 , 8 , and the presence of EoE must be suspected either clinically or macroscopically to prompt taking esophageal biopsies.…”

Section: Discussionmentioning

confidence: 99%

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An artificial intelligence algorithm is highly accurate for detecting endoscopic features of eosinophilic esophagitis

Römmele

Mendel

Barrett

et al. 2022

Sci Rep

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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-EoE-EREFS) 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.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of eosinophilic esophagitis (EoE) has risen significantly in the past decade and has become a significant cause of dysphagia and food impaction 1 – 3 . EoE is diagnosed in the setting of symptoms of esophageal dysfunction and histopathological demonstration of marked esophageal eosinophilia 4 , 5 .…”

Section: Introductionmentioning

confidence: 99%

An artificial intelligence algorithm is highly accurate for detecting endoscopic features of eosinophilic esophagitis

Römmele

Mendel

Barrett

et al. 2022

Sci Rep

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“…. Dietician supervised elimination diets do not influence the nutritional state of the patient 18 …”

Section: Discussionmentioning

confidence: 99%

“…Dietician supervised elimination diets do not influence the nutritional state of the patient. 18 PPIs treatment is considered a first line treatment with clinical remission in 64.9% and histologic remission in 54.1% of cases 17 The efficacy of topical steroid treatment with budesonide or fluticasone propionate was shown in different studies and in comparison with placebo. 4,8 EoE is a relatively new entity, and this is probably the reason for so many unanswered questions about the aetiology, natural course and prognosis of these patients.…”

Section: Ta B L E 3 the Effect Of Treatment Interventions On Clinical Endoscopic And Histologic Improvementsmentioning

confidence: 99%

The management and course of eosinophilic oesophagitis in Israeli children

et al. 2021

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Aim Eosinophilic oesophagitis (EoE) is a chronic inflammatory oesophageal disease, which has become more recognised in the past decade. We wanted to characterise our patients and review their course of disease and response to treatment. Methods We retrospectively reviewed the medical records of EoE patients from January 2010 to May 2018 in our Gastroenterology Institute. A hundred and two children were included in this study. We investigated the characteristics of patients and the response to three treatment options: proton pump inhibitors, elimination diet and topical steroids. The response to treatment was analysed according to 3 aspects: clinical, endoscopic appearance and histological features. Results Clinical improvement was noted in 55%, 75% and 87.5% on PPIs, diet and budesonide, respectively. Endoscopic improvement was noted in 38.4%, 51.4% and 65.4% on PPIs, diet and budesonide, respectively. Histological improvement was noted in 43.7%, 62.2% and 88.5% on PPIs, diet and budesonide, respectively. Conclusion Our findings suggest that Israeli paediatric EoE patients have characteristics that resemble previous reports. Although there is a correlation between symptoms, endoscopic and histological appearance, we cannot rely on patients reports alone, and therefore, repeated endoscopy and biopsies are mandated. Topical steroids seem to be the most effective treatment option.

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