Research Appraisaldiagnostic

From Flow to Feature Using a Proof-of-Concept Spectral-Driven Machine Learning Approach Using Smart Urinary and Drainage Catheter Systems: Algorithm Development and Validation

JMIR medical informaticsPoggi, Leonardo, Meckler, Anastasia, Künert, Sebastian et al.14 May 2026DOI

Clinical Snapshot

45CEBM
Evidence: Weakdiagnostic

PICO Framework

P — PopulationSurgical patients with urinary catheters (168 patients, 401 samples) and drainage systems (181 patients, 454 samples)
I — InterventionSmart catheter systems with mini-spectrometer sensors using machine learning analysis of spectral data
C — ComparatorTraditional visual inspection and manual sampling methods
O — OutcomesDiagnostic accuracy for differentiating pathological from healthy fluids using Matthews correlation coefficient, sensitivity, and specificity

Bottom Line

This proof-of-concept study demonstrates potential for spectral machine learning analysis of catheter fluids to detect pathological changes in real-time. While the Matthews correlation coefficients (0.81-0.83) suggest promising discrimination between healthy and pathological samples, the study lacks essential diagnostic accuracy measures including sensitivity, specificity, and confidence intervals. The methodology is insufficiently detailed for reproducibility, and clinical applicability remains uncertain. Before clinical implementation, this technology requires comprehensive validation studies with proper diagnostic accuracy reporting, clear patient selection criteria, and demonstration of clinical utility. Australian clinicians should view this as early-stage research requiring substantial further development rather than ready-for-practice technology.

Evidence: Weak

Key Findings

  • P Value: Not reported

  • Effect Size: CNN model achieved MCC 0.83 for hemoglobin detection, 0.81 for bilirubin detection

  • Primary Outcome: Matthews correlation coefficient for pathological versus healthy fluid differentiation

  • Nnt Or Sensitivity: Sensitivity and specificity not reported - only correlation coefficients available

  • Confidence Interval: Not reported

Clinical Application

Currently proof-of-concept stage requiring significant technical development and validation before clinical implementation Would require TGA approval as medical device. Potential integration with existing catheter systems in Australian hospitals. Cost-effectiveness analysis needed for PBS consideration if diagnostic claims made. Surgical patients requiring urinary catheterisation or drainage systems, particularly those at risk of complications requiring biomarker monitoring

Abstract

BACKGROUND: Current urinary and drainage catheter systems collect fluids for visual inspection or manual sampling, offering limited diagnostic value while being labor-intensive and prone to error. Machine learning (ML) has the potential to automate the analysis of these fluids. However, existing methods rely on complex preprocessing steps, which hinder real-time analysis. OBJECTIVE: We aim to develop and evaluate a fully automated, real-time diagnostic approach for smart urinary and drainage catheter systems by leveraging spectral data and ML to differentiate pathological from healthy excreted fluids without the need for manual preprocessing. METHODS: This study proposes a novel, fully automated approach for smart urinary and drainage catheter systems that uses spectra and ML to extract features from excreted fluids, enabling real-time analysis directly. A total of 454 surgical drainage fluid samples (from 181 patients) and 401 urine catheter samples (from 168 patients) were analyzed using smart catheters and drains equipped with compact mini-spectrometer sensors. The collected spectral data were fed into 3 different ML models: a random forest, a partial least squares discriminant analysis regression, and a convolutional neural network (CNN). Each model aimed to extract features and differentiate between pathological and healthy urine and drainage samples based on the various biomarkers available from previously conducted laboratory analyses. RESULTS: All 3 approaches (random forest, partial least squares discriminant analysis regression, and CNN) achieved promising results, demonstrating the potential of the overall approach. In particular, the CNN models trained on the drainage biomarkers hemoglobin and bilirubin achieved the best results. Matthews correlation coefficient scores of 0.83 and 0.81 were obtained for hemoglobin and bilirubin, respectively, when differentiating between pathological and healthy samples using the extracted spectral features. CONCLUSIONS: This work demonstrates the potential of spectral-driven ML for smart urinary and drainage catheter systems. This approach offers a real-time, noninvasive method for analyzing excreted fluids, paving the way for improved diagnostics and personalized patient care. Further research will explore the optimal ML model for this application.

References

  1. 1.Poggi, L., Meckler, A., Künert, S., Jeske, J., Siaj, R., Selvamoorthy, T., Berger, M. F., Nensa, F., Kohnke, J., Hosters, B., Brendt-Müller, J., Roser, M., & Hosch, R. (2026). From Flow to Feature Using a Proof-of-Concept Spectral-Driven Machine Learning Approach Using Smart Urinary and Drainage Catheter Systems: Algorithm Development and Validation. *JMIR Medical Informatics*. https://doi.org/10.1016/j.inffus.2021.11.005
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