{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:55:33Z","timestamp":1791042933222,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["55\/4\/11\/CARE\u2010ID\/2018\u2010NCD\u2010III"],"award-info":[{"award-number":["55\/4\/11\/CARE\u2010ID\/2018\u2010NCD\u2010III"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Differentiating Intestinal tuberculosis (ITB) from Crohn's disease is a major diagnostic challenge in endemic regions, often leading to inappropriate treatment. We aimed to develop and prospectively validate a machine learning\u2010based mobile application, \u201cCrohn's Aid\u201d, to provide an accurate, real\u2010time clinical decision support tool at the point of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of a prospectively maintained database of 1066 patients (CD\u2009=\u2009650; ITB\u2009=\u2009416) from a tertiary centre in India. Thirty clinical, endoscopic and radiological variables were used to train multiple machine learning models, including CatBoost, Random forest and logistic regression. The lead model (CatBoost) was integrated into a mobile application. Performance was evaluated using area under the receiver operating characteristic (AUROC) and prospectively validated on a cohort of patients. Explainable AI (SHAP) values were used to identify key diagnostic drivers. The model was then validated on a prospective validation cohort of 121 patients at the same centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Internal cross\u2010validation was repeated ten times, and the CatBoost model achieved a mean AUROC of 0.886 with a mean sensitivity of 76.0% and specificity of 84.1%. In the prospective validation cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009121), the model maintained high diagnostic accuracy\u2014AUROC 0.921(0.870\u20130.963) and outperformed the standard Bayesian reference standard (AUROC 0.750). At the optimum threshold, the model demonstrated a balanced sensitivity and specificity of 86.4% and 85.5%, respectively. Key predictors included symptom duration, transverse ulcers, granuloma, rectosigmoid involvement, and perianal disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Crohn's Aid represents a step forward in the application of digital health to solve a long\u2010standing clinical dilemma by combining the power of gradient\u2010boosted decision trees with the ubiquity of smartphone technology to reduce misdiagnosis between ITB and CD in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.70984","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:04:07Z","timestamp":1790049847000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and Prospective Validation of a Machine Learning\u2010Based Mobile Application (CROHN'S\n                    <scp>AID<\/scp>\n                    ) for Differentiating Crohn's Disease From Intestinal Tuberculosis in Tuberculosis\u2010Endemic Regions"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9208-2888","authenticated-orcid":false,"given":"Srikant","family":"Mohta","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintu","family":"Kutum","sequence":"additional","affiliation":[{"name":"Ashoka University  Sonipat Haryana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6487-016X","authenticated-orcid":false,"given":"Akshat","family":"Dhoundiyal","sequence":"additional","affiliation":[{"name":"Netaji Subhas University of Technology  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritvik","family":"Pendyala","sequence":"additional","affiliation":[{"name":"Indraprastha Institute of Information Technology  Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshal","family":"Dev","sequence":"additional","affiliation":[{"name":"Indraprastha Institute of Information Technology  Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5363-7273","authenticated-orcid":false,"given":"Bhaskar","family":"Kante","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences  New Delhi India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8281-3237","authenticated-orcid":false,"given":"Sudheer Kumar","family":"Vuyyuru","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences  New Delhi 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M.","year":"2021","journal-title":"Journal of Gastroenterology and Hepatology"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"11340","DOI":"10.1038\/s41598-022-15609-5","article-title":"Applying Logistic LASSO Regression for the Diagnosis of Atypical Crohn's Disease","volume":"12","author":"Li Y.","year":"2022","journal-title":"Scientific Reports"},{"key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1186\/s12876-021-01838-x","article-title":"Development and Validation of a New Algorithm Model for Differential Diagnosis Between Crohn's Disease and Intestinal Tuberculosis: A Combination of Laboratory, Imaging and Endoscopic Characteristics","volume":"21","author":"Lu Y.","year":"2021","journal-title":"BMC Gastroenterology"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.70984","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/apt.70984","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.70984","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:04:11Z","timestamp":1790049851000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.70984"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":20,"alternative-id":["10.1111\/apt.70984"],"URL":"https:\/\/doi.org\/10.1111\/apt.70984","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]},"assertion":[{"value":"2026-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"apt.70984"}}