iGIE最新文献

{"title":"Exploring human–artificial intelligence interactions in a negative pragmatic trial of computer-aided polyp detection","authors":"Kate Watkins BS ,&nbsp;Uri Ladabaum MD, MS ,&nbsp;Esther Olsen MHA ,&nbsp;Jonathan Hoogerbrug MBBS ,&nbsp;Ajitha Mannalithara PhD ,&nbsp;Yingjie Weng MHS ,&nbsp;Blake Shaw MS ,&nbsp;Roger Bohn PhD ,&nbsp;Sara Singer MBA, PhD","doi":"10.1016/j.igie.2024.04.016","DOIUrl":"10.1016/j.igie.2024.04.016","url":null,"abstract":"<div><h3>Background and Aims</h3><p>The progress of artificial intelligence (AI) in endoscopy is at a crossroads. The positive results of randomized controlled trials of computer-aided detection (CADe) have not been replicated in multiple pragmatic CADe trials, including ours. This gap between efficacy and effectiveness remains to be understood. We surveyed and interviewed our trial’s colonoscopists to gain insight into human-AI interactions.</p></div><div><h3>Methods</h3><p>We used a sequential, mixed-methodology design. After the trial, we administered Survey 1, focusing on attitudes and beliefs before and after trying CADe. The trial’s null results were disclosed, and we then administered Survey 2 and conducted open-ended interviews, focusing on reactions to the null results. Responses were analyzed overall and by baseline adenoma detection rate (ADR) tertile. We identified key themes using thematic analysis and qualitative software.</p></div><div><h3>Results</h3><p>Nearly all colonoscopists responded (22 and 21 of 24 [92% and 88%] for Surveys 1 and 2, respectively). Most (96%) regarded endoscopic ability as critical to their professional identity. Large majorities conveyed trust in and enthusiasm for AI before and after trying CADe (82%-87%) and desired to have CADe available (72%). Nearly two-thirds (62%) were surprised by the null results. There were few differences by ADR. No unifying explanation for the null results emerged from surveys or individual interviews. Colonoscopists expressed a range of expectations for AI in endoscopy.</p></div><div><h3>Conclusions</h3><p>Lack of enthusiasm or mistrust of AI/CADe do not explain our pragmatic CADe trial’s null results. AI may need to target dimensions beyond optical recognition to realize its promise in endoscopy.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 274-285.e10"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000499/pdfft?md5=f0f11d67d92c9d30275a2d7055aa931c&pid=1-s2.0-S2949708624000499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel point-of-care capsule to detect upper GI bleeding: initial real-world cases","authors":"Daniel Szvarca MD ,&nbsp;Trent Walradt MD ,&nbsp;Amit Grover MD ,&nbsp;Linda Lee MD","doi":"10.1016/j.igie.2024.02.004","DOIUrl":"10.1016/j.igie.2024.02.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 174-177"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000165/pdfft?md5=bb98406ae27e3b9371a39f154fcc1de6&pid=1-s2.0-S2949708624000165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139880583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathoracic cholecystitis managed with endoscopic gallbladder drainage","authors":"Andrea Huang MBBS, MPH ,&nbsp;Thomas Williams MBBS ,&nbsp;Nivene Saad MBBS ,&nbsp;Adam Frankel MBBS ,&nbsp;Zaki Hamarneh MD ,&nbsp;Shwan Karim MBBS, MSc ,&nbsp;Adrian Maher MD, MMed","doi":"10.1016/j.igie.2024.04.010","DOIUrl":"10.1016/j.igie.2024.04.010","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 191-192"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000438/pdfft?md5=5e6dbe6aec4749a3b586ee033d6f5ecb&pid=1-s2.0-S2949708624000438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Informed consent in endoscopy: Read, understood, or just signed?","authors":"Ana Catarina Carvalho MD ,&nbsp;Ricardo Cardoso MD ,&nbsp;Hugo Marcelo Vieira MD ,&nbsp;Américo Silva MD","doi":"10.1016/j.igie.2024.04.001","DOIUrl":"10.1016/j.igie.2024.04.001","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Although informed consent is a requirement for all interventional procedures such as those in GI endoscopy, its standardization is a challenge. Very thorough documents have been proposed, but it is unknown whether patients actually read them. We evaluated if patients read and understand informed consent forms and information leaflets for GI endoscopy.</p></div><div><h3>Methods</h3><p>This single-center, prospective, observational study was performed between April 2021 and April 2022 and included adult patients proposed for outpatient elective EGD and colonoscopy. Informed consent forms and information leaflets were mailed to patients, with a small text instruction added to the informed consent form. Before endoscopy, we assessed whether patients adequately read the informed consent form, based on patient signature, table questionnaire completion, and performance of the text instruction.</p></div><div><h3>Results</h3><p>The study included 232 patients (50.6% men; mean age, 63.8 ± 12.76 years). Most had only a basic education (78.0%) and had previously undergone GI endoscopy (90.6%). Of the patients, 86.6% stated they had read the form and 13.4% did not. Although most signed the form (83.6%), only 24.6% adequately read and understood it. No statistically significant association between an adequate reading of the informed consent form and any of the assessed variables was found.</p></div><div><h3>Conclusions</h3><p>Despite the timely provision of information, most patients do not read or adequately understand the provided documents. It is necessary to develop new strategies to enhance patients’ involvement in decision-making, thus improving the doctor–patient relationship in obtaining informed consent. (Clinical trial registration number: NCT05414435.)</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 222-229"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000347/pdfft?md5=32c726985f9cbaf47d32df66dd0807c5&pid=1-s2.0-S2949708624000347-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemosuccus pancreaticus treated using EUS-guided coil embolization and glue injection","authors":"Harishankar Gopakumar MD,&nbsp;Hasan Shoaib MD,&nbsp;Srinivas R. Puli MD","doi":"10.1016/j.igie.2024.02.008","DOIUrl":"https://doi.org/10.1016/j.igie.2024.02.008","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 186-187"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000207/pdfft?md5=e15c5b843602a514537f52c19bccf18e&pid=1-s2.0-S2949708624000207-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dueling capsules: novel devices for GI bleeding diagnostics","authors":"Shuji Mitsuhashi MBBS,&nbsp;Andrew C. Storm MD","doi":"10.1016/j.igie.2024.04.018","DOIUrl":"https://doi.org/10.1016/j.igie.2024.04.018","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 178-179"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000517/pdfft?md5=6265d4b7b2806db2f3ddc7de71017873&pid=1-s2.0-S2949708624000517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Through-stent enterography”: first experience with a novel technique intended to improve safety in endosonography-guided gastroenterostomy","authors":"Markus Heilmaier MD ,&nbsp;Dominik Schulz MD ,&nbsp;Christoph Schlag MD ,&nbsp;Rami Abbassi MD ,&nbsp;Mayada Elnegouly MD ,&nbsp;Marc Ringelhan MD ,&nbsp;Tobias Lahmer MD ,&nbsp;Ulrich Mayr MD ,&nbsp;Roland M. Schmid MD ,&nbsp;Matthias Treiber MD ,&nbsp;Mohamed Abdelhafez MD","doi":"10.1016/j.igie.2024.04.006","DOIUrl":"10.1016/j.igie.2024.04.006","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Endosonography-guided gastroenterostomy (EUS-GE) is a novel technique to manage symptoms of gastric outlet obstruction. Major challenges are the high mobility of intestinal loops and the transient loss of endosonographic visibility during the puncture. This can lead to stent misdeployment, which can be associated with potentially fatal adverse events. By injecting contrast medium through the guidewire channel of the lumen-apposing metal stent application system under fluoroscopic guidance, a positive enterogram can confirm the position of the stent inside the intestinal lumen before its deployment. The aim of this study was to describe this novel technique and to assess its feasibility.</p></div><div><h3>Methods</h3><p>The data of 39 consecutive patients undergoing EUS-GE with “through-stent-enterography” from July 2020 to March 2022 were retrospectively collected and analyzed. The primary end point was technical success. Secondary end points were adverse events, reinterventions, and clinical success.</p></div><div><h3>Results</h3><p>Technical success was achieved in all cases (n = 39). In 2 cases, a second puncture was required to place the stent successfully. In 1 case, misdeployment could be avoided after a negative enterogram. In the other case, misdeployment occurred despite a positive enterogram and reintervention was needed. Clinical success was achieved in 92.3% (n = 36). No major adverse events or mortalities were encountered.</p></div><div><h3>Conclusions</h3><p>“Through-stent enterography” after the puncture to confirm the correct position of the stent in the small bowel is a novel and simple technique that can potentially reduce the risk of misdeployment of the stent.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 247-253"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000396/pdfft?md5=d874011692bc9fe29db652d513cc2728&pid=1-s2.0-S2949708624000396-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the unsealed: modified Zenker’s peroral endoscopic myotomy with open incision","authors":"Farimah Fayyaz MD,&nbsp;Eric Swei MD,&nbsp;Mouen Khashab MD","doi":"10.1016/j.igie.2024.04.004","DOIUrl":"10.1016/j.igie.2024.04.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 188-190"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000372/pdfft?md5=96d5e5fe774fe6391e14b51f907f4417&pid=1-s2.0-S2949708624000372-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of spray coagulation in first-space endoscopy: a case series","authors":"Marco Alburquerque MD, MSc ,&nbsp;Alba Vargas MD ,&nbsp;Cesar Ledezma MD ,&nbsp;Antonella Smarrelli MD ,&nbsp;Eva Pijoan MD ,&nbsp;Montserrat Figa MD ,&nbsp;Ferrán González-Huix MD, PhD","doi":"10.1016/j.igie.2024.02.007","DOIUrl":"10.1016/j.igie.2024.02.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 182-185"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000190/pdfft?md5=c9000afeb6f2b0edf609bf96f290d8a8&pid=1-s2.0-S2949708624000190-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139821839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve of EUS-guided biliary duct drainage: systematic review and meta-analysis","authors":"Ishaan Vohra MD ,&nbsp;Harishankar Gopakumar MD ,&nbsp;Navjit Singh MD ,&nbsp;Neil Sharma MD ,&nbsp;Srinivas R. Puli MD","doi":"10.1016/j.igie.2024.02.009","DOIUrl":"10.1016/j.igie.2024.02.009","url":null,"abstract":"<div><h3>Background and Aims</h3><p>In recent years, EUS-guided biliary drainage (EUS-BD) has emerged as an alternative to ERCP. However, a recent meta-analysis of randomized controlled trials suggests comparable efficacy and safety between EUS and conventional ERCP for biliary drainage, highlighting the growing preference for EUS-BD. This study aims to contribute to this evolving landscape by investigating the technical and clinical success of EUS-BD and defining its learning curve.</p></div><div><h3>Methods</h3><p>A comprehensive search of electronic databases was conducted from January 2003 to November 2022 for publications evaluating the learning curve of EUS-BD. Pooled proportions were calculated using both fixed-effects and random-effects models, with a 95% confidence interval.</p></div><div><h3>Results</h3><p>The initial search yielded 380 studies, of which 88 relevant articles were reviewed. Data from 3 studies (261 patients) meeting inclusion criteria were analyzed. Proficiency in EUS-BD was achieved at 35.51 procedures. Pooled technical success was 92.45%, and clinical success was 84.84%. Adverse events occurred in 18.46% of cases, with specific rates for bleeding (4.31%), perforation (3.03%), sepsis (7.61%), procedure-related death (.31%), and all-cause mortality (2.29%). No bias was detected using the Egger bias indicator, which gave a value of –6.0 with a <em>P</em> = .17.</p></div><div><h3>Conclusions</h3><p>Our analysis revealed an EUS-BD proficiency at around 35 procedures, with a mean postproficiency procedure length of 68.07 minutes. Adverse events notably decrease after 66 procedures, informing a safety-driven recommendation: Endosonographers should complete a minimum of 60 supervised procedures before independent EUS-BD practice, enhancing procedural safety and proficiency.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 202-209"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000219/pdfft?md5=e91cf7e5e7f7276e716b733718cd18b8&pid=1-s2.0-S2949708624000219-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}