Endoscopists' knowledge, perceptions and attitudes toward the use of artificial intelligence in endoscopy: A systematic review.

Abstract

Background & aims: Artificial Intelligence (AI) is rapidly evolving in the field of gastrointestinal endoscopy. This systematic review aims to summarise the current perspectives of endoscopists on AI in endoscopy, as well as to identify its challenges.

Methods: Electronic databases were searched to identify studies conducted on endoscopists' opinions on the use of AI in endoscopy. Qualitative synthesis of included studies was conducted by categorizing into five domains: 1) Knowledge, perception and attitude toward AI, 2) Impacts of AI on endoscopic performance, 3) Impact of AI on endoscopists, 4) Impact of AI on patients and 5) Barriers toward the implementation of AI.

Results: Ten studies were included, comprising 1587 endoscopists across Europe (32.6%), North America (42.8%), and Asia (24.6%). Domain 1: Most (69-100%) had basic knowledge of AI. Majority (79.5-87.5%) expressed interest and optimism. Domain 2: Most (62.5-97%) felt that AI would positively impact endoscopic performance and quality. Domain 3: There were mixed perceptions, 6.2-62.8% suggested that AI would lead to operator dependence. 21-81.3% felt that AI would prolong procedural time. Most (71-100%) disagreed that AI would replace them. Domain 4: Majority (81.3%) felt that AI would improve patient care. Domain 5: Most (75.2-91%) identified costs as barriers to AI implementation. Opinions on ethics and regulation varied (12.5-100% and 35-88%, respectively), with majority advocating for clear guidelines and regulations.

Conclusion: There is a positive attitude toward the use of AI in endoscopy. Concerns regarding the impact on clinical practice, costs and medicolegal considerations remain. Establishing robust regulatory frameworks is crucial to the integration of AI into endoscopy.