Azizullah Beran, Tarek Nayfeh, Daryl Ramai, Almaza Albakri, Nasir Saleem, Marco Spadaccini, Cesare Hassan, Alessandro Repici, John J Guardiola, Douglas K Rex
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Pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model.</p><p><strong>Results: </strong>Three RCTs with 2404 subjects were included (n = 1198 Endocuff+AI vs. n = 1206 AI alone). ADR was significantly higher in the Endocuff+AI group than in the AI alone group (54% vs. 48%, respectively) (RR 1.12, 95% CI 1.03-1.21, <i>P</i> = 0.01, I <sup>2</sup> = 0%). There was a trend toward higher AADR (12.3% vs. 10%, RR 1.23, 95% CI 0.96-1.59, <i>P</i> = 0.10, I <sup>2</sup> = 17%) and SSLDR (17.6% vs. 15.5%, RR 1.16, 95% CI 0.96-1.40, <i>P</i> = 0.13, I <sup>2</sup> = 0%) in the Endocuff+AI group compared with the AI alone group, but it did not reach statistical significance. Both cecal intubation time (MD -0.61 minutes; 95% CI -1.54-0.33; <i>P</i> = 0.20; I <sup>2</sup> = 87%) and withdrawal time (MD -0.42 minutes; 95% CI -1.01-0.17; <i>P</i> = 0.17, I <sup>2</sup> = 60%) were similar between the two groups.</p><p><strong>Conclusions: </strong>Endocuff combined with AI was superior to AI alone in improving the adenoma detection rate without increasing intubation or withdrawal times.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26764144"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417794/pdf/","citationCount":"0","resultStr":"{\"title\":\"Artificial Intelligence-Assisted Colonoscopy With or Without Mucosal Exposure Device for Detection of Colorectal Adenomas: A Meta-Analysis.\",\"authors\":\"Azizullah Beran, Tarek Nayfeh, Daryl Ramai, Almaza Albakri, Nasir Saleem, Marco Spadaccini, Cesare Hassan, Alessandro Repici, John J Guardiola, Douglas K Rex\",\"doi\":\"10.1055/a-2676-4144\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and study aims: </strong>Artificial intelligence (AI) and mucosal exposure devices like Endocuff have independently improved the adenoma detection rate (ADR) during colonoscopy. This meta-analysis evaluated the combined effect of Endocuff and AI versus AI alone on colorectal neoplasia detection rates.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Web of Science for randomized controlled trials (RCTs) comparing the impact of Endocuff+AI versus AI alone on colorectal neoplasia detection. Primary outcome was ADR; secondary outcomes included advanced adenoma detection rate (AADR), sessile serrated lesion detection rate (SSLDR), cecal intubation time, and withdrawal time. Pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model.</p><p><strong>Results: </strong>Three RCTs with 2404 subjects were included (n = 1198 Endocuff+AI vs. n = 1206 AI alone). ADR was significantly higher in the Endocuff+AI group than in the AI alone group (54% vs. 48%, respectively) (RR 1.12, 95% CI 1.03-1.21, <i>P</i> = 0.01, I <sup>2</sup> = 0%). There was a trend toward higher AADR (12.3% vs. 10%, RR 1.23, 95% CI 0.96-1.59, <i>P</i> = 0.10, I <sup>2</sup> = 17%) and SSLDR (17.6% vs. 15.5%, RR 1.16, 95% CI 0.96-1.40, <i>P</i> = 0.13, I <sup>2</sup> = 0%) in the Endocuff+AI group compared with the AI alone group, but it did not reach statistical significance. Both cecal intubation time (MD -0.61 minutes; 95% CI -1.54-0.33; <i>P</i> = 0.20; I <sup>2</sup> = 87%) and withdrawal time (MD -0.42 minutes; 95% CI -1.01-0.17; <i>P</i> = 0.17, I <sup>2</sup> = 60%) were similar between the two groups.</p><p><strong>Conclusions: </strong>Endocuff combined with AI was superior to AI alone in improving the adenoma detection rate without increasing intubation or withdrawal times.</p>\",\"PeriodicalId\":11671,\"journal\":{\"name\":\"Endoscopy International Open\",\"volume\":\"13 \",\"pages\":\"a26764144\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417794/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endoscopy International Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2676-4144\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endoscopy International Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/a-2676-4144","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景与研究目的：人工智能（AI）和endocff等粘膜暴露设备各自提高了结肠镜检查时腺瘤的检出率（ADR）。本荟萃分析评估了恩多夫联合人工智能与单独使用人工智能对结直肠肿瘤检出率的影响。方法：我们检索了PubMed、Embase和Web of Science的随机对照试验（rct），比较endocff +AI与单独AI对结直肠肿瘤检测的影响。主要结局为不良反应；次要结局包括晚期腺瘤检出率（AADR）、无底锯齿状病变检出率（SSLDR）、盲肠插管时间和停药时间。采用随机效应模型计算合并风险比（rr）和95%置信区间（ci）的平均差异（md）。结果：纳入3个随机对照试验，共2404名受试者（n = 1198 endocff +AI vs n = 1206 AI单独）。endocff +AI组不良反应明显高于单独使用AI组（54% vs 48%） （RR 1.12, 95% CI 1.03 ~ 1.21, P = 0.01, i2 = 0%）。endocff +AI组的AADR （12.3% vs. 10%, RR 1.23, 95% CI 0.96 ~ 1.59, P = 0.10, i2 = 17%）和SSLDR （17.6% vs. 15.5%, RR 1.16, 95% CI 0.96 ~ 1.40, P = 0.13, i2 = 0%）均高于单纯AI组，但差异无统计学意义。两组间盲肠插管时间（MD -0.61 min; 95% CI -1.54 ~ 0.33; P = 0.20; i2 = 87%）和停药时间（MD -0.42 min; 95% CI -1.01 ~ 0.17; P = 0.17, i2 = 60%）相似。结论：恩多夫联合人工智能在提高腺瘤检出率方面优于单独人工智能，且不增加插管和停药次数。
Artificial Intelligence-Assisted Colonoscopy With or Without Mucosal Exposure Device for Detection of Colorectal Adenomas: A Meta-Analysis.
Background and study aims: Artificial intelligence (AI) and mucosal exposure devices like Endocuff have independently improved the adenoma detection rate (ADR) during colonoscopy. This meta-analysis evaluated the combined effect of Endocuff and AI versus AI alone on colorectal neoplasia detection rates.
Methods: We searched PubMed, Embase, and Web of Science for randomized controlled trials (RCTs) comparing the impact of Endocuff+AI versus AI alone on colorectal neoplasia detection. Primary outcome was ADR; secondary outcomes included advanced adenoma detection rate (AADR), sessile serrated lesion detection rate (SSLDR), cecal intubation time, and withdrawal time. Pooled risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model.
Results: Three RCTs with 2404 subjects were included (n = 1198 Endocuff+AI vs. n = 1206 AI alone). ADR was significantly higher in the Endocuff+AI group than in the AI alone group (54% vs. 48%, respectively) (RR 1.12, 95% CI 1.03-1.21, P = 0.01, I 2 = 0%). There was a trend toward higher AADR (12.3% vs. 10%, RR 1.23, 95% CI 0.96-1.59, P = 0.10, I 2 = 17%) and SSLDR (17.6% vs. 15.5%, RR 1.16, 95% CI 0.96-1.40, P = 0.13, I 2 = 0%) in the Endocuff+AI group compared with the AI alone group, but it did not reach statistical significance. Both cecal intubation time (MD -0.61 minutes; 95% CI -1.54-0.33; P = 0.20; I 2 = 87%) and withdrawal time (MD -0.42 minutes; 95% CI -1.01-0.17; P = 0.17, I 2 = 60%) were similar between the two groups.
Conclusions: Endocuff combined with AI was superior to AI alone in improving the adenoma detection rate without increasing intubation or withdrawal times.
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