Endoscopy 2024; 56(S 02): S208
DOI: 10.1055/s-0044-1783164
Abstracts | ESGE Days 2024
Moderated Poster
Novel approaches and novel techniques in the colon 2 26/04/2024, 14:00 – 15:00 Science Arena: Stage 2

Lack of Effectiveness of Computer Aided Detection for Colorectal Neoplasia: A Systematic Review and Meta-analysis of Non-Randomized Studies

Authors

  • H. Patel

    1   Kansas City VA Medical Center, Kansas City, United States of America

  • M. Yuichi

    2   University of Oslo, Oslo, Norway

  • C. Hassan

    3   Humanitas University, Milan, Italy

  • T. rizkala

    4   Humanitas Medical Care, Milano, Italy

  • D. Radadiya

    5   The University Of Kansas Medical Center, Kansas City, United States of America

  • P. Nathani

    6   University of Kansas, Lawrence, United States of America

  • M. Misawa

    7   Showa University Northern Yokohama Hospital, Yokohama, Japan

  • M. Roberta

    8   Humanitas Research Hospital, Cascina Perseghetto, Italy

  • G. Antonelli

    9   Gastroenterology and Digestive Endoscopy Unit, Castelli Hospital, Roma, Italy

  • M. Spadaccini

    8   Humanitas Research Hospital, Cascina Perseghetto, Italy

  • K. Khalaf

    10   St. Michael's Hospital, Toronto, Canada, Toronto, France

  • A. Facciorusso

    11   University of Foggia – Medical Area Departments, Foggia, Italy

  • K. R. Douglas

    12   Indiana University School of Medicine, Indianapolis, United States of America

  • A. Repici

    13   Humanitas Medical Care, Rozzano, Italy

  • P. Sharma

    14   The University Of Kansas Medical Center, Leawood, United States of America
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    Aims Benefits of computer-aided detection (CADe) in detecting colorectal neoplasia were shown in many randomized trials where endoscopists’ behavior was strictly controlled. However, the effect of CADe on endoscopists’ performance in less-controlled setting is unclear. This systematic review and meta-analyses were aimed at clarifying benefits and harms of using CADe in real-world colonoscopy.

    Methods We searched MEDLINE, EMBASE, Cochrane and Google Scholar from inception to August 20, 2023. We included non-randomized studies that compared the effectiveness between CADe-assisted and standard colonoscopy. Two investigators independently extracted study data and quality. Pairwise meta-analysis was performed utilizing Risk ratio (RR) for dichotomous variables and mean difference (MD) for continuous variables with a 95% confidence interval (95% CI).

    Results Eight studies were included, comprising 9,782 patients (4569 with CADe and 5213 without CADe). Regarding benefits, there was neither a difference in adenoma detection rate (44% vs 38%; RR 1.11 [95% CI 0.97 – 1.28]) nor mean adenoma per colonoscopy (0.93 vs 0.79; MD 0.14 [-0.04 – 0.32]) between the CADe-assisted and standard colonoscopy, respectively. Regarding harms, there was no difference in the mean non-neoplastic lesions per colonoscopy (8 studies included for analysis, 0.52 vs 0.47; MD 0.14 [95% CI -0.07 – 0.34]) and withdrawal time (6 studies included for analysis, 14.3 vs 13.4 minutes; MD 0.8 minutes [95% CI -0.18 – 1.90]). There was a substantial heterogeneity, and all outcomes were graded with a very low certainty of evidence.

    Conclusions CADe in colonoscopies neither improves the detection of colorectal neoplasia nor increases burden of colonoscopy in real-world, non-randomized studies, questioning the generalizability of the results of randomized trials.


     

    Conflicts of interest

    CH/AR: Medtronic (equipment loan); Fujifilm (consulting); Olympus (consulting; NEC (equipment loan); Satisfy (equipment loan); Odin (equipment loan); AIM (equipment loan) YM: Olympus (Consultancy, lecture fees, and equipment loan), Cybernet System (Loyalty) MM: Olympus (Consultancy, lecture fees, and equipment loan), Cybernet System (Loyalty) DR: Olympus Corporation, Boston Scientific, Braintree Laboratories, Norgine, Medtronic, Acacia Pharmaceuticals: Consultancy; Research Support: Olympus Corporation, Medivators, Erbe USA Inc, Braintree Laboratories PS: Consultant for Bausch, Boston Scientific Corporation, CDx Labs, Covidien LP, Exact Sciences, Fujifilm Medical Systems USA, Inc, Lucid, Lumendi, Medtronic, Olympus, Phathom, Takeda, and Samsung Bioepis; Grant Support from Cosmo Pharmaceuticals, Covidien, Docbot, ERBE USA Inc, Fujifilm Holdings America Corporation, Ironwood Pharmaceuticals Inc, Medtronic USA, Inc, and Olympus All other authors: None

    Publication History

    Article published online:
    15 April 2024

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