Chenxia Zhang, Xiao Tao, Jie Pan, Li Huang, Zehua Dong, Jiejun Lin, Huang Su, Yijie Zhu, Hongliu Du, Bing Xiao, Mingkai Chen, Lianlian Wu, Honggang Yu
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Four propensity score-matched cohorts were established: Cohort 1: pre-CADe matched with dual-monitor CADe-assisted group; Cohort 2: dual-monitor CADe-assisted with single-monitor CADe-assisted group; Cohort 3: pre-CADe with single-monitor CADe-assisted group; and Cohort 4: pre-CADe with CADe period. ADR was set as the primary outcome.</p><p><strong>Results: </strong>There were 5390, 6083, and 6131 eligible patients in the pre-CADe group, dual-monitor group, and single-monitor group, respectively. In the matched analysis, results indicated that regardless of the monitor setup, CADe-assisted groups showed a trend of increased ADR compared with the pre-CADe period (CADe period: OR 1.141, 95% CI 1.047-1.243; p = 0.003; dual-monitor: OR 1.178, 95% CI 1.069-1.299, p = 0.001; single-monitor: OR 1.094, 95% CI 0.998-1.200, p = 0.056). Moreover, no significant difference between different monitor approaches was observed, although dual-monitor setup showed an increasing tendency on ADR compared with single-monitor setup (OR 1.069, 95% CI 0.985-1.161, p = 0.109).</p><p><strong>Conclusion: </strong>CADe shows great potential to improve ADR during colonoscopy in the real world. Meanwhile, changes in monitor setup do not significantly impact the assistance capability of CADe. Further research dedicated to evaluating the unmeasured elements in the AI-clinician hybrid for better implementation of CADe would be beneficial.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Effect of Computer-Aided Device on Adenoma Detection Rate in Different Implement Scenarios: A Real-World Study.\",\"authors\":\"Chenxia Zhang, Xiao Tao, Jie Pan, Li Huang, Zehua Dong, Jiejun Lin, Huang Su, Yijie Zhu, Hongliu Du, Bing Xiao, Mingkai Chen, Lianlian Wu, Honggang Yu\",\"doi\":\"10.1111/jgh.16847\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Several recent studies have found that the efficacy of computer-aided polyp detection (CADe) on the adenoma detection rate (ADR) diminished in real-world settings. The role of unmeasured factors in AI-human interaction, such as monitor approaches, remains unknown. This study aimed to validate the effectiveness of CADe in the real world and assess the impact of monitor approaches.</p><p><strong>Methods: </strong>A retrospective propensity score-matched cohort study was conducted using routine data from a tertiary endoscopy center in China before and after the implementation of CADe. Four propensity score-matched cohorts were established: Cohort 1: pre-CADe matched with dual-monitor CADe-assisted group; Cohort 2: dual-monitor CADe-assisted with single-monitor CADe-assisted group; Cohort 3: pre-CADe with single-monitor CADe-assisted group; and Cohort 4: pre-CADe with CADe period. ADR was set as the primary outcome.</p><p><strong>Results: </strong>There were 5390, 6083, and 6131 eligible patients in the pre-CADe group, dual-monitor group, and single-monitor group, respectively. 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引用次数: 0
摘要
背景：最近的几项研究发现，计算机辅助息肉检测（CADe）对腺瘤检出率（ADR）的影响在现实环境中有所下降。未测量因素在人工智能-人类互动中的作用，如监测方法，仍然未知。本研究旨在验证CADe在现实世界中的有效性，并评估监测方法的影响。方法：采用回顾性倾向评分匹配队列研究，使用中国三级内镜中心实施CADe前后的常规数据。建立4个倾向评分匹配的队列：队列1:cade前与双监测cade辅助组匹配；队列2：双监测cade辅助组和单监测cade辅助组；队列3:cade前与单监视器cade辅助组；队列4:CADe前期和CADe期。ADR作为主要观察指标。结果：cade前组、双监测组和单监测组分别有5390例、6083例和6131例符合条件的患者。在匹配分析中，结果显示，无论监测设置如何，与CADe前相比，CADe辅助组出现了不良反应增加的趋势(CADe期：OR 1.141, 95% CI 1.047-1.243；p = 0.003；双监视器：OR 1.178, 95% CI 1.069 ~ 1.299, p = 0.001；单监视器：OR 1.094, 95% CI 0.998-1.200, p = 0.056)。此外，不同监测方式之间无显著差异，尽管双监测设置比单监测设置有增加不良反应的趋势（OR 1.069, 95% CI 0.985-1.161, p = 0.109）。结论：凯德在改善结肠镜不良反应方面具有很大的潜力。同时，监视器设置的变化不会显著影响CADe的辅助能力。进一步的研究致力于评估人工智能-临床混合系统中未测量的元素，以更好地实施CADe将是有益的。
The Effect of Computer-Aided Device on Adenoma Detection Rate in Different Implement Scenarios: A Real-World Study.
Background: Several recent studies have found that the efficacy of computer-aided polyp detection (CADe) on the adenoma detection rate (ADR) diminished in real-world settings. The role of unmeasured factors in AI-human interaction, such as monitor approaches, remains unknown. This study aimed to validate the effectiveness of CADe in the real world and assess the impact of monitor approaches.
Methods: A retrospective propensity score-matched cohort study was conducted using routine data from a tertiary endoscopy center in China before and after the implementation of CADe. Four propensity score-matched cohorts were established: Cohort 1: pre-CADe matched with dual-monitor CADe-assisted group; Cohort 2: dual-monitor CADe-assisted with single-monitor CADe-assisted group; Cohort 3: pre-CADe with single-monitor CADe-assisted group; and Cohort 4: pre-CADe with CADe period. ADR was set as the primary outcome.
Results: There were 5390, 6083, and 6131 eligible patients in the pre-CADe group, dual-monitor group, and single-monitor group, respectively. In the matched analysis, results indicated that regardless of the monitor setup, CADe-assisted groups showed a trend of increased ADR compared with the pre-CADe period (CADe period: OR 1.141, 95% CI 1.047-1.243; p = 0.003; dual-monitor: OR 1.178, 95% CI 1.069-1.299, p = 0.001; single-monitor: OR 1.094, 95% CI 0.998-1.200, p = 0.056). Moreover, no significant difference between different monitor approaches was observed, although dual-monitor setup showed an increasing tendency on ADR compared with single-monitor setup (OR 1.069, 95% CI 0.985-1.161, p = 0.109).
Conclusion: CADe shows great potential to improve ADR during colonoscopy in the real world. Meanwhile, changes in monitor setup do not significantly impact the assistance capability of CADe. Further research dedicated to evaluating the unmeasured elements in the AI-clinician hybrid for better implementation of CADe would be beneficial.
期刊介绍：
Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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