Endoscopy International Open最新文献

{"title":"Impact of a training intervention on upper gastrointestinal endoscopy quality over time: Multicenter comparative cohort study.","authors":"Lieke Maria Koggel, Jole P E van Berlo, Fleur A Indemans, Ruud W M Schrauwen, Marten A Lantinga, Peter D Siersema","doi":"10.1055/a-2526-0240","DOIUrl":"10.1055/a-2526-0240","url":null,"abstract":"<p><strong>Background and study aims: </strong>The European Society of Gastrointestinal Endoscopy (ESGE) and British Society of Gastroenterology (BSG) formulated performance measures to improve the detection rate for upper gastrointestinal (UGI) endoscopy. We aimed to assess adherence to and impact of training on adherence to performance measures for UGI endoscopy.</p><p><strong>Methods: </strong>In this multicenter, prospective, cohort study, endoscopists at three centers underwent 1-hour face-to-face training based on ESGE and BSG procedure performance measures (≥ 7-minute inspection time; photodocumentation of ≥ 10 anatomical landmarks + abnormalities; standardized terminology; biopsy protocols). A self-developed quality assessment score was used to assess diagnostic UGI endoscopies before (control group) and after (intervention group) training. The primary endpoint was improvement in overall quality score (percentage of the maximum score).</p><p><strong>Results: </strong>Of 1,733 consecutive UGI endoscopies, 570 were eligible for inclusion (mean patient age 60 years [standard deviation 15]; male 47%): 285 in the control group and 285 in the intervention group. Overall quality score increased from 60% before to 67% after the training intervention (difference 7%, 95% confidence interval [CI] 5-10, <i>P</i> < 0.001). Male patients (3.2%, 95% CI 0.7-5.7), alarming features (-3.1%, 95% CI -5.6 to -0.5), and endoscopist age (-0.4% increment per year, 95% CI -0.8 to -0.1) were associated with higher quality scores.</p><p><strong>Conclusions: </strong>Adherence to the ESGE and BSG procedure performance measures for UGI endoscopy persistently increased after a 1-hour face-to-face training intervention, suggesting that a simple training intervention tool can improve the quality of UGI endoscopy and potentially could prevent missed lesions.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25260240"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662805","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 technology for automated cleaning of flexible endoscopes.","authors":"Michelle J Alfa","doi":"10.1055/a-2527-4224","DOIUrl":"10.1055/a-2527-4224","url":null,"abstract":"<p><p>Reprocessing of flexible endoscopes is a multi-stage system with many sequential stages. Errors in any one of the stages can result in microbial contamination that persists in patient ready endoscopes despite full reprocessing. One stage that is especially prone to errors is the manual cleaning of channels and exterior surfaces of flexible endoscopes. This editorial discusses the current factors in manual cleaning that lead to errors in cleaning adequacy. It also reviews novel technologies that provide improvements in cleaning of flexible endoscope channels.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25274224"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662835","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":"Prevalence and endoscopic-histological correlation of premalignant gastric lesions at a university hospital in Uruguay.","authors":"Ignacio Moratorio, Adrian Canavesi, Carolina Olano, Klaus Mönkemüller","doi":"10.1055/a-2542-0880","DOIUrl":"10.1055/a-2542-0880","url":null,"abstract":"<p><strong>Background and study aims: </strong>Although chronic atrophic gastritis (CAG), intestinal metaplasia (IM), and dysplasia constitute gastric pre-neoplastic conditions of gastric cancer (GC), data on endoscopic correlation and the prevalence in many South American countries are scarce. The aims of this study were to establish prevalence and perform endoscopic-histological correlation of gastric pre-neoplastic conditions using high-definition white light endoscopy (WLE) and to determine interobserver agreement for endoscopic findings for CAG and IM.</p><p><strong>Patients and methods: </strong>A prospective, observational, descriptive, cross-sectional study was carried out at a Uruguayan hospital during a 6-month period. Risk was stratified according to Operative Link for Gastritis Assessment and Operative Link for Gastric Intestinal Metaplasia stage for CAG and IM, respectively. An independent and blinded second observer was included to determine interobserver endoscopic and histologic agreement.</p><p><strong>Results: </strong>A total of 102 patients (mean age 57 years ± 1.6 years, 68.6% woman) were included. Prevalence of histological CAG and IM were 38.2% and IM 31.4%, respectively. Endoscopic-histological correlation for CAG had kappa index 0.063, sensitivity 46%, and specificity 60%. For endoscopic IM, the kappa index was 0.216, sensitivity 22%, and specificity 96%. Interobserver variability was good for gastric fold flattening and very good in the presence of whitish-greyish plaques for CAG and IM, respectively.</p><p><strong>Conclusions: </strong>The endoscopic-histological correlation of both CAG and IM was low, raising the need for biopsy for diagnosis in all cases, regardless of HD-WLE findings. Although prevalence of gastric pre-neoplastic conditions in this group of Uruguayan patients was comparable to those described in countries with a high incidence of GC, a low proportion of high-risk stages (III and IV) was identified.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25420880"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662863","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":"Cost-effectiveness analysis of artificial intelligence-aided colonoscopy for adenoma detection and characterization in Spain.","authors":"Marco Bustamante-Balén, Beatriz Merino Rodríguez, Luis Barranco, Julen Monje, María Álvarez, Sofía de Pedro, Itziar Oyagüez, Nancy Van Lent, María Mareque","doi":"10.1055/a-2509-7278","DOIUrl":"10.1055/a-2509-7278","url":null,"abstract":"<p><strong>Background and study aims: </strong>The aim of this study was to assess the cost-effectiveness of an intelligent endoscopy module for computer-assisted detection and characterization (CADe/CADx) compared with standard practice, from a Spanish National Health System perspective.</p><p><strong>Methods: </strong>A Markov model was designed to estimate total costs, life years gained (LYG), and quality-adjusted life years (QALYs) over a lifetime horizon with annual cycles. A hypothetical cohort of 1,000 patients eligible for colonoscopy (mean age 61.32 years) was distributed between Markov states according to polyp size, location, and histology based on national screening program data. CADe/CADx efficacy was determined based on adenoma miss rates and natural disease evolution was simulated according to annual transition probabilities. Detected polyp management involved polypectomy and histopathology in standard practice, whereas with CADe/CADx leave-in-situ strategy was applied for ≤ 5 mm rectosigmoid non-adenomas and resect-and-discard strategy for the rest of ≤ 5mm polyps. Unit costs (€,2024) included the diagnostic procedure and polyp and colorectal cancer (CRC) management. A 3% annual discount rate was applied to costs and outcomes. Model inputs were validated by an expert panel.</p><p><strong>Results: </strong>CADe/CADx was more effective (16.37 LYG and 14.32 QALYs) than standard practice (16.33 LYG and 14.27 QALYs) over a lifetime horizon. Total cost per patient was €2,300.76 with CADe/CADx and €2,508.75 with colonoscopy alone. In a hypothetical cohort of 1,000 patients, CADe/CADx avoided 173 polypectomies, 370 histopathologies, and 7 CRC cases. Sensitivity analyses confirmed model robustness.</p><p><strong>Conclusions: </strong>The results of this analysis suggest that CADe/CADx would result in a dominant strategy versus standard practice in patients undergoing colonoscopy in Spain.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097278"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662539","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":"Impact of virtual reality distraction during colonoscopy vs intravenous deep sedation: Results of a single-center randomized controlled trial.","authors":"Anastasia Pavlidi, Lotfi Triki, Julien Mortier, Jacques Deviere, Arnaud Lemmers, Vincent Huberty, Patrice Forget, Mark Hannen, Caroline Quolin, Turgay Tuna, Daniel Blero, Marianna Arvanitakis","doi":"10.1055/a-2520-9768","DOIUrl":"10.1055/a-2520-9768","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colonoscopy is associated with discomfort that requires intravenous sedation (IVS). The aim of this randomized controlled trial (RCT) was to explore the feasibility of virtual reality distraction (VRD) for colonoscopy using two primary endpoints: cecal intubation rate and the rate of rescue with IVS.</p><p><strong>Patients and methods: </strong>Patients scheduled for elective colonoscopy with IVS were randomized in a 2:1 ratio in favor of VRD, with rescue IVS by propofol if needed. VRD involved use of a device providing a visual and auditive experience similar to clinical hypnosis.</p><p><strong>Results: </strong>Ninety patients were included (VRD:60, IVS: 30). Cecal intubation rate was similar in both groups (92.8% for VRD vs 100% for IVS, <i>P</i> =0.3). The rate of rescue IVS in the VRD group was 63.6%. There was a decrease in median total dose of propofol per patient in the VRD group (1.15 mg/kg for VRD and 4.41 mg/kg for IVS, <i>P</i> <0.001) and in the subgroup of VRD patients who received IVS rescue (3.17 mg/kg for VRD and 4.41 mg/kg for IVS, <i>P</i> =0.003). The median level of pain was higher and the median level of comfort was lower in the VRD group (respectively 3 vs 0, <i>P</i> <0.001 and 7 vs 10, <i>P</i> <0.001).</p><p><strong>Conclusions: </strong>This RCT provides preliminary data to better understand the feasibility of VRD for colonoscopy. We have not identified differences in procedure outcomes compared with conventional IVS, but nevertheless, higher pain and lower comfort scores were reported.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25209768"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662814","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":"Comparison of traction vs. snare as rescue methods for challenging colorectal endoscopic submucosal dissection: Propensity score-matched study.","authors":"Keitaro Takahashi, Takuya Iwama, Kazuyuki Tanaka, Yuki Miyazawa, Shohei Kuroda, Masashi Horiuchi, Seisuke Saito, Momotaro Muto, Katsuyoshi Ando, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Mikihiro Fujiya","doi":"10.1055/a-2544-3279","DOIUrl":"10.1055/a-2544-3279","url":null,"abstract":"<p><strong>Background and study aims: </strong>To address the challenges of difficult colorectal endoscopic submucosal dissection (ESD), conversion to snare resection (rescue-snare ESD: rSnare), a variant of hybrid ESD, is commonly proposed. However, rSnare is associated with a lower en bloc resection rate compared with conventional ESD. Traction-assisted ESD has emerged as a technique to facilitate dissection, but its effectiveness as a rescue method remains unclear. This study was the first to compare the effectiveness of rSnare and rescue-traction-assisted ESD (rTraction).</p><p><strong>Patients and methods: </strong>This retrospective study involved 1464 consecutive lesions from 1372 patients with superficial colorectal neoplasms across eight institutions. Among these, 162 lesions required rescue methods of rSnare or rTraction. After propensity score matching, 88 lesions treated with either rSnare or rTraction were analyzed.</p><p><strong>Results: </strong>The rTraction group exhibited significantly higher en bloc resection and R0 resection rates (93.2% and 77.3%, respectively) compared with the rSnare group (45.5% and 38.6%, respectively). However, average procedure time was significantly longer in the rTraction group (122.3 ± 72.5 min) compared with the rSnare group (92.2 ± 54.2 min). In the rTraction group, univariable and multivariable analyses identified traction initiation time > 75 minutes as the only independent predictor of procedure durations exceeding 120 minutes.</p><p><strong>Conclusions: </strong>Utilizing a traction device as a rescue technique in difficult colorectal ESD resulted in higher en bloc and R0 resection rates compared with conversion to snare resection. Initiating traction within 75 minutes may contribute to reducing overall procedure time for challenging colorectal ESD cases.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25443279"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663044","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":"Endoscopic band ligation alone and combined with clipping for colonic diverticular bleeding: Retrospective comparative study.","authors":"Noritaka Ozawa, Kenji Yamazaki, Nae Hasebe, Kazuki Yamauchi, Kaori Koide, Hiroyuki Murase, Saeka Hayashi, Takaaki Hino, Daiki Hirota, Atsushi Soga, Kiichi Otani, Naoya Masuda, Hiroki Taniguchi, Shogo Shimizu, Masahito Shimizu","doi":"10.1055/a-2536-7884","DOIUrl":"10.1055/a-2536-7884","url":null,"abstract":"<p><p>Clipping alone or endoscopic band ligation (EBL) alone are the main endoscopic hemostatic methods for colonic diverticular bleeding (CDB). We have established a novel method combining EBL and clipping (EBL-C) for hemostasis of CDB (Endoscopy E-videos); this study evaluated its usefulness. From March 2019 to July 2024, we endoscopically treated 138 patients for CDB at our institution. We retrospectively compared two groups: those treated with EBL (n = 24) and those treated with EBL-C (n = 56). Risk factors for early rebleeding were also examined in the EBL-C group. The rate of early rebleeding (defined as rebleeding occurring within 30 days) was lower in the EBL-C group than in the EBL group, although this difference was only marginally non-significant (8.9% vs. 25.0%, <i>P</i> = 0.0776). Failure of neck formation was the only independent risk factor for rebleeding (adjusted odds ratio [OR] 0.076; 95% confidence interval [CI] 0.015-0.398; <i>P</i> = 0.0023). Frequency of neck formation was significantly higher in the EBL-C group (EBL-C: 89.3% vs. EBL: 66.7%, <i>P</i> = 0.0235). Undergoing EBL-C was the only independent factor contributing to successful development of neck formation (adjusted OR 7.01; 95%CI 1.41-34.8; <i>P</i> = 0.0095). Previous treatment of the same diverticulum, neck formation failure, and insufficient clipping were risk factors for early rebleeding. Using EBL-C for CDB may be more effective in preventing rebleeding than using EBL alone because it facilitates better ligation of the target diverticulum. Treatment of diverticula that are hard and difficult to manage with suction remains a challenge.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25367884"},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662652","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":"Endoscopic ultrasound gastroenterostomy vs duodenal stenting for malignant gastric outlet obstruction: Cost-effectiveness study.","authors":"Daryl Ramai, Richard Nelson, Nathorn Chaiyakunapruk, Andrew Ofosu, John C Fang","doi":"10.1055/a-2509-7671","DOIUrl":"10.1055/a-2509-7671","url":null,"abstract":"<p><strong>Background and study aims: </strong>Enteral stenting has been traditionally employed for managing malignant gastric outlet obstruction (GOO). However, concerns regarding high reintervention rates have brought into question its cost-effectiveness. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) with a lumen-apposing metal stent (LAMS) provides an alternative to luminal stenting. The goal of this study was to assess the cost-effectiveness of EUS-GE relative to duodenal stenting.</p><p><strong>Patients and methods: </strong>A decision analysis was performed to analyze costs and survival in patients with unresectable or metastatic GOO. The model was designed with two treatment arms: self-expanding metal stent (SEMS) placement and EUS-GE with LAMS. Costs were derived from Medicare reimbursement rates (US$) while effectiveness was measured by quality-adjusted life years (QALYs). The primary outcome measure was the incremental cost-effectiveness ratio (ICER). Probabilistic sensitivity analyses were performed.</p><p><strong>Results: </strong>Endoscopic stenting resulted in an average cost of $22,748 and 0.31 QALYs whereas EUS-GE cost $32,254 and yielded 0.53 QALYs, which yielded a difference of $9,507 in cost and 0.23 in QALY. EUS-GE was found to be a cost-effective strategy over duodenal stenting (ICER, $41994/QALY) at a willingness-to-pay of $100,000/QALY. In 10,000 Monte-Carlo simulations, EUS-GE was favored 62% of the time. Using a tornado diagram, the model was most sensitive to the probability of mortality in patients with duodenal stents compared with EUS-GE.</p><p><strong>Conclusions: </strong>In patients with malignant GOO, EUS-GE is a cost-effective palliative intervention compared with duodenal stenting.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097671"},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662699","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":"Endoscopic transpapillary gallbladder stenting vs percutaneous cholecystostomy for managing acute cholecystitis: Nationwide propensity score study.","authors":"Chun-Wei Pan, Daryl Ramai, Azizullah Beran, Yichen Wang, Yuting Huang, John Morris","doi":"10.1055/a-2521-0084","DOIUrl":"10.1055/a-2521-0084","url":null,"abstract":"<p><strong>Background and study aims: </strong>Cholecystectomy is the standard treatment for acute cholecystitis, but it may not be suitable for all patients. For those who cannot undergo surgery, a percutaneous cholecystostomy tube (PCT) and ERCP-guided transpapillary gallbladder drainage are viable options. We aimed to perform a nationwide study to assess 30-day readmission rates, adverse events (AEs), and mortality rates in these two cohorts.</p><p><strong>Patients and methods: </strong>We conducted a nationwide cohort study using data from the Nationwide Readmissions Database (NRD) from 2016 to 2019. We identified patients with acute cholecystitis during the index admission who underwent either PCT or ERCP-guided gallbladder drainage. Propensity score matching along with multivariable regression was used to compare cohorts.</p><p><strong>Results: </strong>During the study period, 3,592 patients (average age 63.0 years) underwent endoscopic drainage, whereas 80,372 patients (average 70.8 years) underwent Interventional Radiology drainage. Utilizing multivariate Cox regression analysis, compared with ERCP, PCT had a higher risk for 30-day readmission (adjusted hazard ratio [aHR] 1.47; 95% confidence interval [CI] 1.27 to 1.71; <i>P</i> < 0.001). The PCT group had a significantly higher rate of readmission for acute cholecystitis compared with the ERCP group (2.72% vs 0.86%; <i>P</i> < 0.005). Cox proportional hazard ratio showed a 3.41-fold increased risk (95% CI 1.99 to 5.84) for readmission in the PCT group. ERCP was consistently associated with lower rates of post-procedural AEs compared with PCT including acute hypoxemic respiratory failure ( <i>P</i> < 0.001), acute renal failure ( <i>P</i> < 0.001), shock ( <i>P</i> < 0.001), and need for blood transfusions ( <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Our nationwide analysis revealed that ERCP-guided gallbladder drainage should be the preferred approach for managing acute cholecystitis when unfit for surgery.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25210084"},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523025","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":"Improvement in adenoma detection rate by artificial intelligence-assisted colonoscopy: Multicenter quasi-randomized controlled trial.","authors":"Ronja Maria Birgitta Lagström, Karoline Bendix Bräuner, Julia Bielik, Andreas Weinberger Rosen, Julie Gräs Crone, Ismail Gögenur, Mustafa Bulut","doi":"10.1055/a-2521-5169","DOIUrl":"10.1055/a-2521-5169","url":null,"abstract":"<p><strong>Background and study aims: </strong>Adenoma detection rate (ADR) is a key performance measure with variability among endoscopists. Artificial intelligence (AI) in colonoscopy could reduce this variability and has shown to improve ADR. This study assessed the impact of AI on ADR among Danish endoscopists of varying experience levels.</p><p><strong>Patients and methods: </strong>We conducted a prospective, quasi-randomized, controlled, multicenter trial involving patients aged 18 and older undergoing screening, surveillance, and diagnostic colonoscopy at four centers. Participants were assigned to AI-assisted colonoscopy (GI Genius, Medtronic) or conventional colonoscopy. Endoscopists were classified as experts (> 1000 colonoscopies) or non-experts (≤ 1000 colonoscopies). The primary outcome was ADR. We performed a subgroup analysis stratified on endoscopist experience and a subset analysis of the screening population.</p><p><strong>Results: </strong>A total of 795 patients were analyzed: 400 in the AI group and 395 in the control group. The AI group demonstrated a significantly higher ADR than the control group (59.1% vs. 46.6%, <i>P</i> < 0.001). The increase was significant among experts (59.9% vs. 47.3%, <i>P</i> < 0.002) but not among non-experts. AI assistance significantly improved ADR (74.4% vs. 58.1%, <i>P</i> = 0.003) in screening colonoscopies. Polyp detection rate (PDR) was also higher in the AI group (69.8% vs. 56.2%, <i>P</i> < 0.001). There was no significant difference in the non-neoplastic resection rate (NNRR) (15.1% vs. 17.1%, <i>P</i> = 0.542).</p><p><strong>Conclusions: </strong>AI-assisted colonoscopy significantly increased ADR by 12.5% overall, with a notable 16.3% increase in the screening population. The unchanged NNRR indicates that the higher PDR was due to increased ADR, not unnecessary resections.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25215169"},"PeriodicalIF":2.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523039","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}