Artificial Intelligence as a Surrogate for Inspection Time to Assess Completeness in Esophagogastroduodenoscopy: A Prospective, Randomized, Noninferiority Study.

IF 3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Translational Gastroenterology Pub Date : 2025-03-25 DOI:10.14309/ctg.0000000000000839

Xia Tan, Liwen Yao, Zehua Dong, Yanxia Li, Yuanjie Yu, Xin Gao, Kai Zhu, Wenhao Su, Haisen Yin, Wen Wang, Chaijie Luo, Jialing Li, Hang You, Huiyan Hu, Wei Zhou, Honggang Yu

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引用次数: 0

Abstract

Introduction: The completeness of esophagogastroduodenoscopy (EGD) is a prerequisite for detecting lesions. This study aims to explore whether the quality of complete examinations assisted by artificial intelligence (AI) would be comparable with those conducted within the guideline-recommended inspection time.

Methods: Patients referred for diagnostic, screening, or surveillance EGD were enrolled at Renmin Hospital of Wuhan University. Patients were randomly assigned to 2 groups in a 1:1 ratio. In the AI-assisted group, endoscopists completed observation of the entire upper gastrointestinal tract with AI assistance. In the control group, endoscopists were instructed to spend no less than 7 minutes on each procedure. The primary outcome was the detection rate of neoplastic lesions. Noninferiority was confirmed when the lower bound of the 95% confidence interval (CI) was greater than the margin of -1.5%.

Results: A total of 1,723 patients were prospectively enrolled between July 3, 2023, and April 7, 2024. Seven hundred ninety-six and 763 patients in the AI-assisted and control groups were included in the final analysis, respectively. The detection rates of neoplastic lesions in the AI-assisted and control groups were 3.14% and 2.36%, respectively, resulting in an absolute proportion difference of 0.78% (95% CI -0.58% to 2.14%; odds ratio 1.342 [95% CI 0.726-2.480]). The median inspection time was reduced by 1.5 minutes in the AI-assisted group (6.18 [2.87] vs 7.70 [1.90], P < 0.001).

Discussion: Inspection time of complete EGD can be significantly shortened by AI without compromising its quality. These findings provide crucial evidence to support that AI-assisted procedural completeness serves as an objective and effective quality indicator for EGD.

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人工智能作为检查时间的替代品来评估食管胃十二指肠镜检查的完整性：一项前瞻性、随机、非劣效性研究。

简介：食管胃十二指肠镜检查（EGD）的完全性是发现病变的先决条件。本研究旨在探讨人工智能（AI）辅助下的完整检查质量是否与指南推荐的检查时间内进行的检查质量相当。方法：选择武汉大学人民医院诊断、筛查或监测的EGD患者。患者按1:1的比例随机分为两组。在人工智能辅助组，内镜医师在人工智能辅助下完成对整个上胃肠道（UGI）的观察。在对照组中，内窥镜医师被要求每次手术花费不少于7分钟（min）。主要观察指标为肿瘤病变的检出率。当95%置信区间（CI）的下界大于-1.5%时，证实非劣效性。结果：1723名患者在2023年7月3日至2024年4月7日期间前瞻性入组。人工智能辅助组和对照组分别有796例和763例患者纳入最终分析。人工智能辅助组和对照组的肿瘤病变检出率分别为3.14%和2.36%，绝对比例差异为0.78% (95%CI, -0.58%-2.14%；或1.342 [95%ci, 0.726-2.480])。人工智能辅助组的中位检查时间缩短了1.5 min （6.18[2.87] vs 7.70[1.90], P < 0.001）。结论：人工智能可在不影响EGD质量的前提下，显著缩短EGD全检时间。这些发现为支持人工智能辅助程序完整性作为EGD客观有效的质量指标提供了关键证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Translational Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.00

自引率

0.00%

发文量

114

审稿时长

16 weeks

期刊介绍： Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease. Colon and small bowel Endoscopy and novel diagnostics Esophagus Functional GI disorders Immunology of the GI tract Microbiology of the GI tract Inflammatory bowel disease Pancreas and biliary tract Liver Pathology Pediatrics Preventative medicine Nutrition/obesity Stomach.