Performance and attitudes toward real-time computer-aided polyp detection during colonoscopy in a large tertiary referral center in the United States

Nehme, Fredy; Coronel, Emmanuel; Barringer, Denise A.; Romero, Laura; Shafi, Mehnaz A.; Ross, William A.; Ge, Phillip S.

doi:10.1016/j.gie.2023.02.016

Cited by 27 publications

(12 citation statements)

References 22 publications

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“…Of these studies, 10 were fully published ( 6 – 8 , 11 – 17 ) and 2 ( 18 , 19 ) were abstracts. Of these, 6 (5 fully published, 1 abstract) were prospective ( 6 , 11 – 13 , 16 , 18 ) in design and 6 (5 fully published, 1 abstract) were retrospective ( 7 , 8 , 14 , 15 , 17 – 19 ). Five studies ( 7 , 8 , 12 , 13 , 18 ) used the GI Genius (Medtronic) system (N = 6,892).…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 6 (5 fully published, 1 abstract) were prospective ( 6 , 11 – 13 , 16 , 18 ) in design and 6 (5 fully published, 1 abstract) were retrospective ( 7 , 8 , 14 , 15 , 17 – 19 ). Five studies ( 7 , 8 , 12 , 13 , 18 ) used the GI Genius (Medtronic) system (N = 6,892). On evaluation of quality, all included studies had Newcastle-Ottawa score of 8 or 9 stars (see Supplementary Table 2, http://links.lww.com/CTG/B55 ), indicating high quality.…”

Section: Resultsmentioning

confidence: 99%

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Artificial Intelligence–Assisted Colonoscopy in Real-World Clinical Practice: A Systematic Review and Meta-Analysis

Wei,

Fay,

Yung

et al. 2023

Clin Transl Gastroenterol

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Background: Artificial intelligence (AI) could minimize the operator-dependent variation in colonoscopy quality. Computer-aided detection (CADe) has improved adenoma detection rate (ADR) and adenomas per colonoscopy (APC) in randomized controlled trials (RCTs). There is a need to assess the impact of CADe in real-world settings. Methods: We searched MEDLINE, EMBASE, and Web of Science for non-randomized, real-world studies of CADe in colonoscopy. Random-effects meta-analyses were performed to examine the effect of CADe on ADR and APC. The study is registered under PROSPERO (CRD42023424037). There was no funding for this study. Results: Twelve of 1,314 studies met inclusion criteria. Overall, ADR was statistically significantly higher with vs. without CADe (36.3% vs. 35.8%, risk ratio [RR] 1.13, 95% CI 1.01-1.28). This difference remained significant in subgroup analyses evaluating 6 prospective (37.3% vs 35.2%, RR 1.15, 95% CI 1.01-1.32) but not 6 retrospective (35.7% vs 36.2%, RR 1.12, 95% CI 0.92-1.36) studies. Among 6 studies with APC data, APC rate ratio with vs. without CADe was 1.12 (95% CI 0.95-1.33). In 4 studies with GI Genius (Medtronic), there was no difference in ADR with vs. without CADe (RR 0.96, 95% CI 0.85-1.07). Conclusions: ADR, but not APC, was slightly higher with vs. without CADe among all available real-world studies. This difference was attributed to the results of prospective but not retrospective studies. The discrepancies between these findings vs. those of RCTs call for future research on the true impact of current AI technology on colonoscopy quality, and the subtleties of human-AI interactions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Artificial Intelligence–Assisted Colonoscopy in Real-World Clinical Practice: A Systematic Review and Meta-Analysis

Wei,

Fay,

Yung

et al. 2023

Clin Transl Gastroenterol

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“…There is growing concern that the enthusiasm for testing novel AI algorithms in preliminary studies might overcome the indispensable need for a well-designed and statistically thorough clinical validation [ 34 , 52 , 53 ]. Indeed, the effectiveness of the GI Genius CADe in improving the ADR has been questioned [ 24 , 25 , 26 ]. However, these results have sparked an interesting scientific debate on the appropriate study design for validating the effectiveness of AI in endoscopy procedures [ 40 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this work, we provide an overview of the technology and scientific evidence behind GI Genius, the first AI-empowered medical device for colonoscopy to enter the endoscopy market [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. In the following sections, we briefly describe the technical architecture of the hardware and software configuration, the AI algorithm training and testing strategies, and an update of the regulatory path.…”

Section: Introductionmentioning

confidence: 99%

A Review of the Technology, Training, and Assessment Methods for the First Real-Time AI-Enhanced Medical Device for Endoscopy

Cherubini

Dinh

2023

Bioengineering

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Artificial intelligence (AI) has the potential to assist in endoscopy and improve decision making, particularly in situations where humans may make inconsistent judgments. The performance assessment of the medical devices operating in this context is a complex combination of bench tests, randomized controlled trials, and studies on the interaction between physicians and AI. We review the scientific evidence published about GI Genius, the first AI-powered medical device for colonoscopy to enter the market, and the device that is most widely tested by the scientific community. We provide an overview of its technical architecture, AI training and testing strategies, and regulatory path. In addition, we discuss the strengths and limitations of the current platform and its potential impact on clinical practice. The details of the algorithm architecture and the data that were used to train the AI device have been disclosed to the scientific community in the pursuit of a transparent AI. Overall, the first AI-enabled medical device for real-time video analysis represents a significant advancement in the use of AI for endoscopies and has the potential to improve the accuracy and efficiency of colonoscopy procedures.

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“…Concerns have been raised regarding false positives and their potential impact on withdrawal time. Despite overall high false positive rates, with a post hoc analysis of an RCT revealing an average of 27 per colonoscopy, the resultant increase in total withdrawal time was a negligible 1%[ 133 ]. Additional concerns were raised related to the use of CADe potentially leading to an elevated detection of polyps with uncertain clinical significance and subsequently escalating the rates of polypectomies and histopathological examinations.…”

Section: Promising Screening Testsmentioning

confidence: 99%

Colorectal cancer screening: A review of current knowledge and progress in research

Lopes,

Martins,

Santos

et al. 2024

World J Gastrointest Oncol

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Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide, being the third most commonly diagnosed malignancy and the second leading cause of cancer-related deaths globally. Despite the progress in screening, early diagnosis, and treatment, approximately 20%-25% of CRC patients still present with metastatic disease at the time of their initial diagnosis. Furthermore, the burden of disease is still expected to increase, especially in individuals younger than 50 years old, among whom early-onset CRC incidence has been increasing. Screening and early detection are pivotal to improve CRC-related outcomes. It is well established that CRC screening not only reduces incidence, but also decreases deaths from CRC. Diverse screening strategies have proven effective in decreasing both CRC incidence and mortality, though variations in efficacy have been reported across the literature. However, uncertainties persist regarding the optimal screening method, age intervals and periodicity. Moreover, adherence to CRC screening remains globally low. In recent years, emerging technologies, notably artificial intelligence, and non-invasive biomarkers, have been developed to overcome these barriers. However, controversy exists over the actual impact of some of the new discoveries on CRC-related outcomes and how to effectively integrate them into daily practice. In this review, we aim to cover the current evidence surrounding CRC screening. We will further critically assess novel approaches under investigation, in an effort to differentiate promising innovations from mere novelties.

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Performance and attitudes toward real-time computer-aided polyp detection during colonoscopy in a large tertiary referral center in the United States

Cited by 27 publications

References 22 publications

Artificial Intelligence–Assisted Colonoscopy in Real-World Clinical Practice: A Systematic Review and Meta-Analysis

Artificial Intelligence–Assisted Colonoscopy in Real-World Clinical Practice: A Systematic Review and Meta-Analysis

A Review of the Technology, Training, and Assessment Methods for the First Real-Time AI-Enhanced Medical Device for Endoscopy

Colorectal cancer screening: A review of current knowledge and progress in research

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