{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T03:44:38Z","timestamp":1782704678962,"version":"3.54.5"},"reference-count":18,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T00:00:00Z","timestamp":1782518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Capsule endoscopy (CE) is a non-invasive tool for evaluating small bowel pathology, but prolonged reading times can lead to reader fatigue. Artificial intelligence-integrated reading software has shown promise to overcome this. This study assesses the diagnostic performance of TOP100 against standard human reading (SR) across different clinical indications. Methods: A retrospective single-centre cohort study was conducted at a tertiary referral centre, including patients who underwent PillCam\u2122SB3 CE between January 2023 to August 2025. Initial reading was performed by expert CE readers (&gt;1000 CE experience) considered as SR. Second blinded reading was performed with TOP100. CE findings from SR were compared with those from TOP100. Results: A total of 1382 CE were identified, of which 1374 had complete examinations and TOP100 data for analysis. The most common indications were inflammatory bowel disease (IBD) (51.5%) and iron-deficiency anaemia (IDA) (25.0%). Diagnostic yield was significantly higher with SR than TOP100 (36.0% vs. 27.5%, p &lt; 0.001). TOP100 demonstrated moderate sensitivity but high specificity; 64.0% and 99.0% for active bleeding, 58.2% and 97.5% for angiodysplasia. In overt bleeding and IDA, sensitivity, and specificity for P2 lesions were 61.0% and 94.3%, respectively. Overall sensitivity and specificity were 55.3% and 95.9% for ulcers, 43.1% and 89.0% for erosions. In IBD, ulcer detection was similar, while TOP100 sensitivity for erosions improved by 9.4%. Conclusions: SR remains the reference standard for reading and reporting capsule endoscopies. However, TOP100 may be a useful adjunct to support interpretation and case prioritisation, especially in high-volume centres.<\/jats:p>","DOI":"10.3390\/diagnostics16132005","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:16:44Z","timestamp":1782699404000},"page":"2005","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Performance of the TOP100 Tool in Detecting Key Small Bowel Findings at Capsule Endoscopy"],"prefix":"10.3390","volume":"16","author":[{"given":"Aishwarya","family":"Devanand","sequence":"first","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"},{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2RX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7376-0063","authenticated-orcid":false,"given":"Cristina","family":"Caranfil","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"},{"name":"Department of Surgery, Oncology and Gastroenterology, University of Padova, 35124 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Moore","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"},{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2RX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4450-2593","authenticated-orcid":false,"given":"Nicoletta","family":"Nandi","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4272-2007","authenticated-orcid":false,"given":"Foong Way David","family":"Tai","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Hale","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bentley","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Thurston","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailish","family":"Healy","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0985-3643","authenticated-orcid":false,"given":"Mark E.","family":"McAlindon","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0820-2400","authenticated-orcid":false,"given":"Reena","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK"},{"name":"Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2RX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1055\/s-0029-1214790","article-title":"Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: An international OMED-ECCO consensus","volume":"41","author":"Bourreille","year":"2009","journal-title":"Endoscopy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1055\/a-1973-3796","article-title":"Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline\u2014Update 2022","volume":"55","author":"Pennazio","year":"2023","journal-title":"Endoscopy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1053\/j.gastro.2025.02.031","article-title":"Capsule Endoscopy\u2013Guided Proactive Treat-to-Target Versus Continued Standard Care in Patients with Quiescent Crohn\u2019s Disease: A Randomized Controlled Trial","volume":"169","author":"Lahat","year":"2025","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Agache, A., Olesen, N.G., Skifte, A.S., Justsen, J.F.F., and Koulaouzidis, A. (2026). Conference Report: The FutuRE oF MinimalLy InvasivE GI and Capsule DiagnosTics (REFLECT), September 2025. Diagnostics, 16.","DOI":"10.3390\/diagnostics16091315"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/j.gie.2021.12.009","article-title":"Diagnostic and therapeutic yields of early capsule endoscopy and device-assisted enteroscopy in the setting of overt GI bleeding: A systematic review with meta-analysis","volume":"95","author":"Estevinho","year":"2022","journal-title":"Gastrointest. Endosc."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Su, C.C., Chou, C.K., Mukundan, A., Karmakar, R., Sanbatcha, B.F., Huang, C.W., Weng, W.C., and Wang, H.C. (2025). Capsule Endoscopy: Current Trends, Technological Advancements, and Future Perspectives in Gastrointestinal Diagnostics. Bioengineering, 12.","DOI":"10.3390\/bioengineering12060613"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1016\/j.dld.2021.04.024","article-title":"The impact of reader fatigue on the accuracy of capsule endoscopy interpretation","volume":"53","author":"Beg","year":"2021","journal-title":"Dig. Liver Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1053\/j.gastro.2019.06.025","article-title":"Gastroenterologist-Level Identification of Small-Bowel Diseases and Normal Variants by Capsule Endoscopy Using a Deep-Learning Model","volume":"157","author":"Ding","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/jgh.16931","article-title":"Artificial Intelligence-Assisted Capsule Endoscopy Versus Conventional Capsule Endoscopy for Detection of Small Bowel Lesions: A Systematic Review and Meta-Analysis","volume":"40","author":"Dhali","year":"2025","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1055\/a-2522-1995","article-title":"Performance measures for small-bowel endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative\u2014Update 2025","volume":"57","author":"Sidhu","year":"2025","journal-title":"Endoscopy"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/den.13896","article-title":"Artificial intelligence and deep learning for small bowel capsule endoscopy","volume":"33","author":"Trasolini","year":"2021","journal-title":"Dig. Endosc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E802","DOI":"10.1055\/a-1372-4051","article-title":"Scoring systems in clinical small-bowel capsule endoscopy: All you need to know!","volume":"9","author":"Rosa","year":"2021","journal-title":"Endosc. Int. Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"7658","DOI":"10.1007\/s00464-023-10273-w","article-title":"Diagnostic accuracy of artificial intelligence-aided capsule endoscopy (TOP100) in overt small bowel bleeding","volume":"37","author":"Giordano","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1080\/00365521.2020.1745880","article-title":"Simplify to improve in capsule endoscopy\u2014TOP 100 is a swift and reliable evaluation tool for the small bowel inflammatory activity in Crohn\u2019s disease","volume":"55","author":"Freitas","year":"2020","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1097\/MEG.0000000000002809","article-title":"TOP 100 and detection of colorectal lesions in colon capsule endoscopy: More than meets the eye","volume":"36","author":"Capela","year":"2024","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Mushtaq, K., Lim, Y.J., Spada, C., Mussetto, A., Koulaouzidis, A., Kaung, T., Borrow, D.-M., Casadei, C., Patel, P., and Rahman, I. (2026). AI-Assisted Double-Headed Capsule Endoscopy: Multicentre Prospective Diagnostic Accuracy Study Across Small Bowel Indications. Diagnostics, 16.","DOI":"10.3390\/diagnostics16020239"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e001906","DOI":"10.1136\/bmjgast-2025-001906","article-title":"Artificial intelligence-assisted versus conventional reading in pan-intestinal capsule endoscopy for suspected mid-lower gastrointestinal bleeding: A retrospective analysis of a prospective cohort","volume":"12","author":"Rosa","year":"2025","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e345","DOI":"10.1016\/S2589-7500(24)00048-7","article-title":"AI-assisted capsule endoscopy reading in suspected small bowel bleeding: A multicentre prospective study","volume":"6","author":"Spada","year":"2024","journal-title":"Lancet Digit. 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