The electronic nose technology in clinical diagnosis: A systematic review
Mariana Valente Farraia, MSca,∗, João Cavaleiro Rufo, PhDb , Inês Paciência, MSca,b,c,
Francisca Mendes, MSca , Luís Delgado, PhDd,e, André Moreira, PhDa,b,f
Abstract
Background:Volatile organic compounds (VOC) are end products of human metabolism (normal and disease-associated) that can be mainly excreted in breath, urine, and feces. Therefore, VOC can be very useful as markers of diseases and helpful for clinicians since its sampling is noninvasive, inexpensive, and painless. Electronic noses, or eNoses, provide an easy and inexpensive way to analyze gas samples. Thus, this device may be used for diagnosis, monitoring or phenotyping diseases according to specific breathprints (breath profile).
Objective:In this review, we summarize data showing the ability of eNose to be used as a noninvasive tool to improve diagnosis in clinical settings.
Methods:A PRISMA-oriented search was performed in PubMed and Cochrane Library. Only studies performed in humans and published since 2000 were included. Results:A total of 48 original articles, 21 reviews, and 7 other documents were eligible and fully analyzed. The quality assessment of the selected studies was conducted according to the Standards for Reporting of Diagnostic Accuracy. Airway obstructive diseases were the most studied and Cyranose 320 was the most used eNose.
Conclusions:Several case–control studies were performed to test this technology in diverse fields. More than a half of the selected studies showed good accuracy. However, there are some limitations regarding sampling methodology, analysis, reproducibility, and external validation that need to be standardized. Additionally, it is urgent to test this technology in intend-to-treat populations. Thus, it is possible to think in the contribution of VOC analysis by eNoses in a clinical setting.
Keywords: breathomics, diagnosis, electronic nose, volatile organic compounds
背景：揮發性有機化合物(VOC)是人體代謝(正常和疾病相關)的終產物，主要通過呼吸、尿液和糞便排出。因此，VOC作為疾病的標志物非常有用，對臨床醫生也很有幫助，因為它的取樣無創，廉價，無痛。電子鼻(enose)為分析氣體樣品提供了一種簡單而廉價的方法。因此，該裝置可根據特定的呼吸圖譜(呼吸剖面)用于診斷、監測或表型疾病。
目的：總結e-nose作為一種無創性工具在臨床診斷中的應用價值。
方法：在PubMed和Cochrane圖書館中進行面向PRISMA的檢索。僅包括2000年以來發表的人類研究。結果：共有48篇原始文章、21篇綜述和7篇其他文獻符合要求并進行了全面分析。所選研究的質量評估是根據診斷準確性報告標準進行的。研究多的是氣道阻塞性疾病，使用多的是Cyranose 320。
結論：我們進行了多個病例對照研究，以在不同領域測試這項技術。超過一半的研究顯示了良好的準確性。然而，在取樣方法、分析、再現性和外部驗證方面存在一些需要標準化的限制。此外，迫切需要在打算治療人群中測試這項技術。因此，在臨床環境中考慮enose對VOC分析的貢獻是可能的。
關鍵詞：呼吸經濟學、診斷學、電子鼻、揮發性有機化合物
