Endoscopy 2022; 54(08): 757-768
DOI: 10.1055/a-1706-6174
Original article

Effect of an artificial intelligence-based quality improvement system on efficacy of a computer-aided detection system in colonoscopy: a four-group parallel study

Liwen Yao*
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Lihui Zhang*
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Jun Liu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
4   Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, China
,
Wei Zhou
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Chunping He
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Jun Zhang
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Lianlian Wu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Hongguang Wang
5   Department of Gastroenterology, Jilin Renmin Hospital, Jilin, China
,
Youming Xu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Dexin Gong
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Ming Xu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Xun Li
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Yutong Bai
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Rongrong Gong
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
,
Prateek Sharma
6   University of Kansas School of Medicine and Veterans Affairs Medical Center, Kansas City, Missouri, United States
,
Honggang Yu
1   Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
2   Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
3   Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
› Author Affiliations
Supported by: the Project of Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incisio 2018BCC337
Supported by: Hubei Province Major Science and Technology Innovation Project 2018–916–000–008

Trial Registration: ClinicalTrials.gov Registration number (trial ID): NCT04453956 Type of study: Prospective, Randomized, Single-Center Study


Abstract

Background Tandem colonoscopy studies have found that about one in five adenomas are missed at colonoscopy. It remains debatable whether the combination of a computer-aided polyp detection (CADe) system with a computer-aided quality improvement (CAQ) system for real-time monitoring of withdrawal speed results in additional benefits in adenoma detection or if the synergetic effect may be harmed due to excessive visual burden resulting from information overload. This study aimed to evaluate the interaction effect on improving the adenoma detection rate (ADR).

Methods This single-center, randomized, four-group, parallel, controlled study was performed at Renmin Hospital of Wuhan University. Between 1 July and 15 October 2020, 1076 patients were randomly allocated into four treatment groups: control 271, CADe 268, CAQ 269, and CADe plus CAQ (COMBO) 268. The primary outcome was ADR.

Results The ADR in the control, CADe, CAQ, and COMBO groups was 14.76 % (95 % confidence interval [CI] 10.54 to 18.98), 21.27 % (95 %CI 16.37 to 26.17), 24.54 % (95 %CI 19.39 to 29.68), and 30.60 % (95 %CI 25.08 to 36.11), respectively. The ADR was higher in the COMBO group compared with the CADe group (21.27 % vs. 30.6 %, P = 0.024, odds ratio [OR] 1.284, 95 %CI 1.033 to 1.596) but not compared with the CAQ group (24.54 % vs. 30.6 %, P = 0.213, OR 1.309, 95 %CI 0.857 to 2.000, respectively).

Conclusions CAQ significantly improved the efficacy of CADe in a four-group, parallel, controlled study. No significant difference in the ADR or polyp detection rate was found between CAQ and COMBO.

* These authors contributed equally to this work.


Supplementary material



Publication History

Received: 28 June 2021

Accepted after revision: 25 November 2021

Accepted Manuscript online:
25 November 2021

Article published online:
04 February 2022

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