Implementation of a digital tool to assist physicians during breath tests for SIBO: Impact on diagnostic accuracy,...

We aimed to evaluate the implementation of a digital tool that assists physicians during breath tests (BTs) for small intestinal bacterial overgrowth (SIBO), measuring its impact on diagnostic accuracy, report quality, and physician workload. Tool usability was also assessed.

We conducted a retrospective evaluation of all BTs done at our institution from January 2024 to September 2024. All BTs were performed using the same equipment and interpreted by the same four board-certified gastroenterologists. In May 2024, a digital tool (i.e. Smart Breath) was adopted to help performing and reporting all BTs. Accuracy and report quality were compared before and after implementation of such digital tool. Three blinded SIBO experts used current international guidelines to adjudicate diagnoses and assess report completeness based on 12 quality criteria. Usability of the digital tool and workload were evaluated with the System Usability Scale (SUS) and NASA Task Load Index (NASA-TLX).

A total of 637 BTs were analyzed: 324 standard BT (before the implementation of Smart Breath) and 313 assisted by Smart Breath. Accuracy significantly improved after the implementation of Smart Breath (100% vs. 89.2% for SIBO; 100% vs. 90.1% for IMO; p<0.0001). Report completeness increased from a median of 6-12 quality elements (p<0.0001). The digital tool achieved a mean SUS score of 92.5 and workload scores decreased significantly across all NASA-TLX dimensions.

The implementation of a digital assistant for SIBO breath testing significantly improved diagnostic accuracy and report quality while reducing physician workload. Evidence-based digital tools may enhance the performance of complex diagnostic procedures in clinical practice.