Abstract

Widespread use of endomysial autoantibody (EmA) test in diagnostics of celiac disease is limited due to its subjectivity and its requirement of an expert evaluator. The study aimed to determine whether machine learning can be applied to create a new observer-independent method of automatic assessment and classification of the EmA test for celiac disease. The study material comprised of 2597 high-quality IgA-class EmA images collected in 2017–2018. According to standard procedure, highly-experienced professional classified samples into the following four classes: I - positive, II - negative, III - IgA deficient, and IV - equivocal. Machine learning was deployed to create a classification model. The sensitivity and specificity of the model were 82.84% and 99.40%, respectively. The accuracy was 96.80%. The classification error was 3.20%. The area under the curve was 99.67%, 99.61%, 100%, and 99.89%, for I, II, III, and IV class, respectively. The mean assessment time per image was 16.11 seconds. This is the first study deploying machine learning for the automatic classification of IgA-class EmA test for celiac disease. The results indicate that using machine learning enables quick and precise EmA test analysis that can be further developed to simplify EmA analysis.

Highlights

  • Celiac disease is an immune-mediated enteropathy driven by ingestion of gluten-containing cereals

  • Machine learning was deployed to create a new method of automatic assessment and classification of the IgA-class endomysial autoantibody (EmA) test for celiac disease

  • The classification was based in AdaBoost with support vector machine model (SVM), and the sample features obtained through multi-scale, rotational invariant, co-occurrence among adjacent local binary patterns

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Summary

Introduction

Celiac disease is an immune-mediated enteropathy driven by ingestion of gluten-containing cereals. Presence of celiac disease-specific IgA-class autoantibodies, determined by endomysial (EmA) and transglutaminase 2 autoantibody (TG2-Ab) assays, supports the diagnosis and serves as a valuable tool in selecting patients for endoscopy[3,4]. The value of celiac disease-specific autoantibody tests in the diagnostics is systematically acknowledged due to several limitations of the biopsy-based diagnosis, for instance, patchiness of small bowel mucosal lesions, difficulties regarding sampling, processing, and pathomorphological interpretation[5,6,7,8,9,10,11,12,13,14,15]. IV Equivocal measurements, positive EmA test, and celiac-type human leukocyte antigen haplotypes[6,16] Such diagnostic approach has been shown to be applicable in adults[17]. The aim of this research was to determine whether supervised machine learning can be applied to create an automated method with expert comparable precision for the assessment and classification of the IgA-class EmA test for celiac disease

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