Validation of an Acoustic Gastrointestinal Surveillance Biosensor for Postoperative Ileus

Spiegel, Brennan; Kaneshiro, Marc; Russell, Marcia M.; Lin, Anne; Patel, Anish V.; Tashjian, Vartan C.; Zegarski, Vincent; Singh, Dalbir; Cohen, Sidney; Reid, Mark W.; Whitman, Cynthia B.; Talley, Jennifer; Martínez, Bibiana; Kaiser, William J.

doi:10.1007/s11605-014-2597-y

Cited by 36 publications

(35 citation statements)

References 19 publications

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“…Diagnosis of pyloric stenosis (based on ?). Spiegal et al 2014 [ 23 ] Post-operative ileus Case-control (3 gate): healthy controls (8), patients with post-operative ileus (25), post-operative patients tolerating feeding (7). Controls 62.5% male, patients 100% male.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies involved ROC analysis to determine test cut-off points and provided data on sensitivity and specificity. In three cases, this was derived from multi-gate data [ 13 , 14 , 23 ]. The fourth study had a prospective, blinded, cross-sectional (single-gate) design, undertaken at multiple centres, and we would expect that this gives a better indication of accuracy in the clinical setting in which the test will be applied [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…In all these, the bowel sound analysis was objective or, less frequently, was conducted blind [ 24 ] or prior [ 26 ]. However, in all cases, we determined that the index test could still have given rise to bias because the bowel sound feature or threshold was not pre-specified [ 13 – 16 , 18 , 19 , 21 , 23 , 24 ]. Tests of association or correlation between the target condition and a range of different features were made to find one of interest, or the cut-off threshold was determined as part of the study.…”

Section: Resultsmentioning

confidence: 99%

“…Ching and Tan’s [ 18 ] study on bowel obstruction was considered susceptible to a high level of bias because the reference standard was not objective and was made after the bowel sound analysis (diagnosis confirmed by clinical follow-up, by clinical evaluation, and by radiological and operative findings). There was an unclear risk of bias in the further three studies, where we could not determine if the diagnosis was made without knowledge of the bowel sound analysis or not [ 17 , 19 , 23 ]. This problem was rectified in the second study with the AGIS system [ 24 ] where there were different teams undertaking clinical assessment and bowel sound analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The statistics on heterogeneity across groups for the first component of the first paper on the AGIS system [ 23 ] were considered to add bias, since the small sample sizes meant that non-parametric tests would have been more appropriate. This was rectified in their second paper, which detailed a similar method of bowel sound analysis for post-operative ileus diagnosis [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

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The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review

et al. 2018

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BackgroundGastrointestinal (GI) conditions are highly prevalent, and their standard diagnostic tests are costly and carry risks. There is a need for new, cost-effective, non-invasive tests. Our main objective was to assess the potential for use of bowel sounds computerised analysis in the diagnosis of GI conditions.MethodsThe systematic review followed the PRISMA requirements. Searches were made of four databases (PubMed, MEDLINE, Embase, and IEEE Xplore) and the references of included papers. Studies of all types were included. The titles and abstracts were screened by one author. Full articles were reviewed and data collected by two authors independently. A third reviewer decided on inclusion in the event of disagreement. Bias and applicability were assessed via a QUADAS tool adapted to accommodate studies of multiple types.ResultsTwo thousand eight hundred eighty-four studies were retrieved; however, only 14 studies were included. Most of these simply assessed associations between a bowel sound feature and a condition. Four studies also included assessments of diagnostic accuracy. We found many significant associations between a bowel sound feature and a GI condition. Receiver operating characteristic curve analyses revealed high sensitivity and specificity for an irritable bowel syndrome test, and a high negative predictive value for a test for post-operative ileus. Assessment of methodological quality identified weaknesses in all studies. We particularly noted a high risk of bias in patient selection. Because of the limited number of trials included and the variety in conditions, technology, and statistics, we were unable to conduct pooled analyses.ConclusionsDue to concerns over quality and small sample sizes, we cannot yet recommend an existing BSCA diagnostic test without additional studies. However, the preliminary results found in the included studies and the technological advances described in excluded studies indicate excellent future potential. Research combining sophistical clinical and engineering skills is likely to be fruitful.Systematic review registrationThe review protocol (review ID number 42016054028) was developed by three authors (AI, KMW, and JM) and was published in the PROSPERO International prospective register of systematic reviews. It can be accessed from https://www.crd.york.ac.uk/PROSPERO/.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0789-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review

et al. 2018

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Are Classic Bedside Exam Findings Required to Initiate Enteral Nutrition in Critically Ill Patients: Emphasis on Bowel Sounds and Abdominal Distension

et al. 2020

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The general physical examination of a patient is an axiom of critical care medicine, but evidence to support this practice remains sparse. Given the lack of evidence for a comprehensive physical examination of the entire patient on admission to the intensive care unit, which most clinicians consider an essential part of care, should clinicians continue the practice of a specialized gastrointestinal system physical examination when commencing enteral nutrition in critically ill patients? In this review of literature related to gastrointestinal system examination in critically ill patients, the focus is on gastrointestinal sounds and abdominal distension. There is a summary of what these physical features represent, an evaluation of the evidence regarding use of these physical features in patients after abdominal surgery, exploration of the rationale for and against using the physical findings in routine practice, and detail regarding what is known about each feature in critically ill patients. Based on the available evidence, it is recommended that an isolated symptom, sign, or bedside test does not provide meaningful information. However, it is submitted that a comprehensive physical assessment of the gastrointestinal system still has a role when initiating or administering enteral nutrition: specifically, when multiple features are present, clinicians should consider further investigation or intervention.

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Bowel sound recognition using SVM classification in a wearable health monitoring system

Yin

Jiang

Feng

et al. 2018

Sci. China Inf. Sci.

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Validation of an Acoustic Gastrointestinal Surveillance Biosensor for Postoperative Ileus

Abstract: Non-invasive, abdominal acoustic monitoring distinguishes POI from non-POI subjects. Future research will test whether AGIS can identify patients at risk for development of POI and assist with postoperative feeding decisions.

Cited by 36 publications

References 19 publications

The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review

The potential of computerised analysis of bowel sounds for diagnosis of gastrointestinal conditions: a systematic review

Are Classic Bedside Exam Findings Required to Initiate Enteral Nutrition in Critically Ill Patients: Emphasis on Bowel Sounds and Abdominal Distension

Bowel sound recognition using SVM classification in a wearable health monitoring system

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