ABSTRACT
Crohn's disease is often initially misdiagnosed as irritable bowel syndrome. The goal of this research was to determine if computerized auscultation (fasting enterotachogram analysis) could have a role in distinguishing between these diagnoses. Patients with irritable bowel syndrome, Crohn's disease, and a control group were enrolled in the study. The fasting sound-to-sound interval, standard deviation of the interval, sounds per minute, and percentage time involved with bowel sounds was determined by computerized enterotachogram analysis. The mean sound-to-sound interval for the Crohn's group (1232 msecs) and the controls (1706 msecs) was significantly higher than the irritable bowel group (511 msecs, P < 0.0001). We conclude that Crohn's is not characterized by a shortened interval. The high negative predictive value of the fasting enterotachogram for irritable bowel syndrome suggests that an interval greater than 740 msecs should trigger a search for an alternative diagnosis to irritable bowel. Crohn's disease should be included in that differential.
Subject(s)
Auscultation , Colonic Diseases, Functional/diagnosis , Crohn Disease/diagnosis , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , ROC CurveABSTRACT
The purpose of this study was to investigate the potential of a computerized auscultation method for providing an objective, quantitative measure characteristic of irritable bowel syndrome. Bowel sounds from irritable bowel patients and normal controls were digitized using an electronic stethoscope. Computerized analysis indicated that the character of the bowel sounds did not differ significantly between groups. However, the fasting sound-to-sound interval was significantly different between groups (1931 +/- 365 msec for normals and 452 +/- 35 msec for the irritable bowel group; P = 0.0001). Using the sound-to-sound interval as a test for irritable bowel syndrome, the cutoff value of 640 msec resulted in a sensitivity of 89%, and a specificity of 100%. We conclude that computerized analysis of bowel sounds has the potential to be a noninvasive, quantitative, and objective test providing positive criteria in the diagnosis of irritable bowel syndrome.
Subject(s)
Auscultation , Colonic Diseases, Functional/diagnosis , Diagnosis, Computer-Assisted , Colonic Diseases, Functional/physiopathology , Fasting , Female , Humans , Intestines/physiopathology , Male , Sensitivity and Specificity , Sound , Time FactorsABSTRACT
The quantitative measurement of areas on the cervix is of interest to researchers studying the natural history of human papilloma viral lesions. Measurement of areas from images obtained through a colposcope are, however, inherently in error due to the image being a two-dimensional projection of a three-dimensional object. The ability to correct for these errors through use of digital imaging colposcopy and a practical application of a shape from shading algorithm was developed in this study. The shape from shading technique requires empirical measurement of the relationship between observed light intensity and the viewing angle (referred to as a reflection map). It was found that a population mean reflection map provided a correction that was about as accurate as using an individual's own reflection map (making it unnecessary to measure a map for each exam). Digital red filtering of the images increased accuracy and precision of measurement.
