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Role of Artificial Intelligence in Colonoscopy Detection of Advanced Neoplasias. A Randomized Trial.


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Title:
Role of Artificial Intelligence in Colonoscopy Detection of Advanced Neoplasias. A Randomized Trial.
Authors:
Mangas-Sanjuan, Carolina  
de-Castro, Luisa
Cubiella, Joaquín
Díez-Redondo, Pilar
Suárez, Adolfo
Pellisé, María
Fernández, Nereida  
Zarraquiños, Sara
Núñez-Rodriguez, Mª Henar  
Álvarez-García, Verónica
Ortiz, Oswaldo  
Sala-Miquel, Noelia
Zapater, Pedro
JOVER, RODRIGO  
Editor:
ACP (American College of Physicians)
Department:
Departamentos de la UMH::Medicina Clínica
Issue Date:
2023-08-29
URI:
https://hdl.handle.net/11000/30890
Abstract:
Background: The role of computer-aided detection in identifying advanced colorectal neoplasia is unknown. Objective: To evaluate the contribution of computer-aided detection to colonoscopic detection of advanced colorectal neoplasias as well as adenomas, serrated polyps, and nonpolypoid and right-sided lesions. Design: Multicenter, parallel, randomized controlled trial. (ClinicalTrials.gov: NCT04673136) Setting: Spanish colorectal cancer screening program. Participants: 3213 persons with a positive fecal immunochemical test. Intervention: Enrollees were randomly assigned to colonoscopy with or without computer-aided detection. Measurements: Advanced colorectal neoplasia was defined as advanced adenoma and/or advanced serrated polyp. Results: The 2 comparison groups showed no significant difference in advanced colorectal neoplasia detection rate (34.8% with intervention vs. 34.6% for controls; adjusted risk ratio [aRR], 1.01 [95% CI, 0.92 to 1.10]) or the mean number of advanced colorectal neoplasias detected per colonoscopy (0.54 [SD, 0.95] with intervention vs. 0.52 [SD, 0.95] for controls; adjusted rate ratio, 1.04 [99.9% CI, 0.88 to 1.22]). Adenoma detection rate also did not differ (64.2% with intervention vs. 62.0% for controls; aRR, 1.06 [99.9% CI, 0.91 to 1.23]). Computer-aided detection increased the mean number of nonpolypoid lesions (0.56 [SD, 1.25] vs. 0.47 [SD, 1.18] for controls; adjusted rate ratio, 1.19 [99.9% CI, 1.01 to 1.41]), proximal adenomas (0.94 [SD, 1.62] vs. 0.81 [SD, 1.52] for controls; adjusted rate ratio, 1.17 [99.9% CI, 1.03 to 1.33]), and lesions of 5 mm or smaller (polyps in general and adenomas and serrated lesions in particular) detected per colonoscopy. Limitations: The high adenoma detection rate in the control group may limit the generalizability of the findings to endoscopists with low detection rates. Conclusion: Computer-aided detection did not improve colonoscopic identification of advanced colorectal neoplasias. Primary Funding Source: Medtronic.
Type of document:
application/pdf
Access rights:
info:eu-repo/semantics/closedAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
DOI:
https://doi.org/10.7326/M22-2619
Appears in Collections:
Artículos Medicina Clínica



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