“ Smart Toilet ” scans stool for blood, consistency

May 25, 2021 – Developing ‘smart toilet’ uses artificial intelligence to analyze stool for consistency and presence of blood – and early evidence suggests more accurate than patient self-report .

Remote, automated, real-time analysis and reporting increases the likelihood that doctors will detect gastrointestinal problems sooner, investigators say.

In a proof of concept study, smart toilets were 85% accurate in classifying stool consistency as loose, normal, or constipated. The results were presented at the 2021 Digestive Disease Week virtual meeting.

“This study highlights a very innovative and practical tool that could have major implications for patients and clinicians,” Andrea Shin, MD, who was not affiliated with the research, told Medscape.

“The shape or consistency of the stool and the signs of bleeding are some of the most important pieces of clinical history when it comes to gastrointestinal or intestinal symptoms,” added Shin, assistant professor of medicine in the department. of Gastroenterology and Hepatology from Indiana University School of Medicine at Indianapolis.

Image analysis

The researchers tested their AI algorithm on 3,328 images. They looked at photos from the Internet and some were submitted anonymously by study participants.

Two gastroenterologists also evaluated a set of 552 images. The doctors showed “satisfactory agreement” on the results of the AI, meaning that at least two of them agreed with his assessment.

The smart toilets were also 76% accurate in detecting blood.

“It’s objective and more specific,” said study author Sonia Grego, PhD. Unlike asking patients to keep a stool diary or remember the frequency and consistency of their stools over time, “the system does it for you.” she added.

“Our technology – by automating image acquisition – saves you having to follow your model for weeks or months,” added Grego, founding director of the Duke Smart Toilet Lab at Duke University in Durham, in North Carolina.

The information provided by patients “can have a big impact on decision-making,” Shin said. “For example, if I talk to someone who has Irritable Bowel Syndrome (IBS), I often ask them how loose, watery, and hard or shaped their stools are because this information gives me clues about the problems under. -jacents that can lead to their symptoms. “

Shin agreed that it can be difficult for people to know what is important to report to their doctor. “This tool has the potential to ease patient burden and facilitate communication between patient and clinician. It is a great example of how technology can be leveraged to improve care.”

Working behind the scenes

Gastroenterologist Deborah Anne Fisher, MD, associate professor of medicine at Duke, Grego and his colleagues designed a prototype that positions the image analyzer in the pipes behind the toilet. The analysis is therefore carried out after rinsing.

“We are toilet and toilet technology experts,” said Grego. “We’ve learned that people really don’t like to see anything weird around the toilet bowl.”

The smart toilet system is designed for multiple users in a residential or commercial setting. The technology could be used in hospitals or long-term care facilities, for example. A fingerprint reader on the flushing mechanism tracks each individual user.

Mixed reactions

Grego elicits a whole range of reactions when she tells people she is developing smart toilet technology.

“Friends and family don’t care about the concept of a smart toilet,” she said. “So all the possible jokes that have been made about poo, we know that.”

In fact, researchers collect the jokes they hear. “We are very systematic.”

However, gastroenterologists who learn about the developing technology are more enthusiastic, Grego said. “There is such a need to eliminate the uncertainty of patient recall about the frequency and appearance of bowel movements.

“We are looking to grow through collaboration with additional GI physicians. We want to develop a more advanced prototype and do further validation studies,” said Grego.

Digital health tool

There is an aversion in patients to manipulate the stool “or even talk about it,” Grego said. Colleagues tell him that people are more willing to provide a blood sample, which requires a needle, than a stool sample.

“But there is a lot of health data [in the stool]”, She added.” We believe that this will allow for a lot of research as well as the collection of data on consumers. “

Grego envisions pharmaceutical companies using the technology to detect or monitor any changes in stool or bowel health based on a treatment being developed in clinical trials.

Additionally, the technology could allow health-conscious consumers to track their own gut health. “This technology will be a whole new entry in the digital health toolbox,” said Grego.

While not included in the research presented at this year’s conference, the developers plan to add sampling capability. Biochemical analysis of stool samples could provide “metabolically relevant information,” including stool biomarkers and microbiome composition.

“We have demonstrated that in the lab. It will be part of the technology when it is developed into a product,” said Grego.

This proof of concept study “is the first step on a path that we are aggressively pursuing,” said Grego. She estimated that it would take around 12 to 18 months to develop a prototype for use with patients. “We hope to switch to a product soon after.”

“I can’t wait to see future iterations of this tool,” Shin said. “It could have a role in monitoring major gastrointestinal illnesses and disorders, including IBS and inflammatory bowel disease, or even in detecting ‘alarm symptoms’ that should not be ignored.

“I might even see it playing a role in preventive health in the future,” Shin added.

The technology was licensed to spin-off company Coprata to further develop the product.

“We hope to have an impact on people’s health very soon,” said Grego.

Medscape Medical News

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