An AI-assisted Clinical Decision Support System for Green Classification of Cystocele on Dynamic Transperineal Ultrasound.

Green classification of cystocele on dynamic transperineal ultrasound (TPUS) remains operator-dependent because it requires manual frame selection and landmark-based assessment of the Valsalva maneuver. We developed a workflow-oriented AI-assisted clinical decision support system for automated ureth...

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Publicado en:Journal of Medical Systems Vol. 50; no. 1; pp. 1 - 16
Autores principales: Zhu, Hongjie, Geng, Xin, Zhou, Huayuan, Guo, Wei, Dai, Yin, Zhang, Hao, Dong, Meng, Li, Hong, Wang, Xinlu
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Springer Nature 9/1/2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 9/1/2026
      vid: 50
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10916-026-02453-7
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        atl: An AI-assisted Clinical Decision Support System for Green Classification of Cystocele on Dynamic Transperineal Ultrasound.
      aug:
        au:
          Zhu, Hongjie
          Geng, Xin
          Zhou, Huayuan
          Guo, Wei
          Dai, Yin
          Zhang, Hao
          Dong, Meng
          Li, Hong
          Wang, Xinlu
        affil: https://ror.org/03awzbc87 College of Medicine and Biological Information Engineering, Northeastern University, 110167, Shenyang, China
      sug:
        subj:
          Artificial Intelligence
          Decision Support Systems, Clinical
          Cystocele Classification
          Pelvic Floor Muscles Ultrasonography
          Image Processing, Computer Assisted
          Human
          Retrospective Design
          Prediction Models
          Descriptive Statistics
          Data Analysis Software
          Confidence Intervals
          Wilcoxon Signed Rank Test
          Kruskal-Wallis Test
          Fisher's Exact Test
      ab: Green classification of cystocele on dynamic transperineal ultrasound (TPUS) remains operator-dependent because it requires manual frame selection and landmark-based assessment of the Valsalva maneuver. We developed a workflow-oriented AI-assisted clinical decision support system for automated urethrovesical junction localization and dynamic Green classification and prospectively evaluated its standalone and reader-support performance. This diagnostic accuracy and reader study included 881 patients from a tertiary referral hospital, comprising a retrospective development cohort (n = 688) and an independent prospective test cohort (n = 193). A nested subset of 67 prospective patients was used for a reader study involving two junior and two intermediate radiologists under unaided and AI-assisted conditions. In the complete prospective test cohort, Green-AttGRU achieved a macro-averaged AUC of 0.939 (95% CI, 0.897–0.971) and an overall accuracy of 0.902 (95% CI, 0.860–0.943). In the reader study, overall accuracy increased from 0.761 to 0.821 without AI to 0.851–0.881 with AI, while macro-F1 increased from 0.660 to 0.777 to 0.820–0.860. Overall inter-reader agreement increased from a Fleiss' κ of 0.453 to 0.786, and pooled median interpretation time decreased from 26.7 s to 9.9 s. These findings support the preliminary feasibility of the system as a workflow-oriented decision-support tool for dynamic TPUS interpretation.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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