Prospective evaluation of artificial intelligence-assisted monitoring of the effective withdrawal time on adenoma detection.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-03-18 DOI:10.5217/ir.2025.00262

Thomas Ka Luen Lui, Carla Pui-Mei Lam, Vivien Wai-Man Tsui, Rex Wan-Hin Hui, Elvis Wai-Pan To, Loey Lung-Yi Mak, Michael Kwan-Lung Ko, Kevin Sze-Hang Liu, Cynthia Ka-Yin Hui, Jing Jia Liu, Xiao Xiao, Wai K Leung

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引用次数: 0

Abstract

Background/aims: Standard withdrawal time (SWT) is a recognized colonoscopy quality metric but may not capture mucosal examination quality. We developed an artificial intelligence (AI)-derived metric, effective withdrawal time (EWT), to quantify clear mucosal visualization. This study prospectively evaluated EWT versus SWT on adenoma detection rate (ADR) and other metrics.

Methods: In this prospective single-center study, patients undergoing colonoscopy were enrolled. EWT was calculated in real-time using an AI system with endoscopists blinded to results. Multivariable analyses assessed the association of EWT and SWT with binary (e.g., ADR) and count outcomes (e.g., adenoma or polyp per colonoscopy [APC or PPC]), adjusting for patient and procedural characteristics.

Results: We analyzed 193 colonoscopies by 16 endoscopists. After adjustment, each 1-minute EWT increase was associated with higher odds of adenoma detection (ADR: odds ratio [OR], 1.38; 95% confidence interval [CI], 1.15-1.67) and a > 2-fold increase in adenomas detected per procedure (APC: incidence rate ratio [IRR], 2.14; 95% CI, 1.97-2.32). Both parameters were significantly better with EWT than SWT (OR, 1.38 vs. 1.06; P< 0.01 for ADR; IRR, 2.14 vs. 1.15; P= 0.02 for APC). EWT demonstrated stronger correlation with APC (R2 = 0.97) and PPC (R2 = 0.96) than SWT (R2 = 0.67 and 0.68, respectively; P< 0.01).

Conclusions: AI-derived EWT is a novel quality indicator reflecting mucosal examination thoroughness, serving as a stronger, more independent predictor of ADR than SWT. (Clinical Trials.gov identifier: NCT06063720).

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人工智能辅助监测腺瘤检测有效退出时间的前瞻性评价。

背景/目的：标准停药时间（SWT）是公认的结肠镜检查质量指标，但可能不能反映粘膜检查质量。我们开发了一种人工智能（AI）衍生的度量，有效撤离时间（EWT），以量化清晰的粘膜可视化。本研究前瞻性地评估了EWT与SWT在腺瘤检出率（ADR）和其他指标上的差异。方法：在这项前瞻性单中心研究中，纳入了接受结肠镜检查的患者。使用人工智能系统实时计算EWT，内窥镜师对结果不知情。多变量分析评估了EWT和SWT与二元（例如，不良反应）和计数结果（例如，每次结肠镜检查腺瘤或息肉[APC或PPC]）的关系，并根据患者和程序特征进行了调整。结果：我们分析了16名内镜医师的193例结肠镜检查。调整后，EWT每增加1分钟，腺瘤的检出率就会增加（不良反应：比值比[OR]， 1.38； 95%可信区间[CI]， 1.15-1.67），每次手术中腺瘤的检出率增加1.5倍（APC：发病率比[IRR]， 2.14; 95% CI, 1.97-2.32）。EWT的这两个参数均明显优于SWT （OR, 1.38 vs. 1.06； ADR的IRR， 2.14 vs. 1.15； APC的IRR， P= 0.02）。EWT与APC （R2 = 0.97）、PPC （R2 = 0.96）的相关性强于SWT （R2 = 0.67、0.68，P< 0.01）。结论：人工智能衍生的EWT是一种反映粘膜检查彻彻性的新型质量指标，与SWT相比，它是更强、更独立的不良反应预测指标。（临床试验。gov识别码：NCT06063720）。

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

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.