Effectiveness of artificial intelligence assisted colonoscopy on adenoma and polyp miss rate: A meta-analysis of tandem RCTs.

Artificial intelligence CADe Colonoscopy Colorectal cancer Miss rate Screening

Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
24 Sep 2024
Historique:
received: 23 07 2024
revised: 20 08 2024
accepted: 01 09 2024
medline: 26 9 2024
pubmed: 26 9 2024
entrez: 25 9 2024
Statut: aheadofprint

Résumé

One-fourth of colorectal neoplasia is missed at screening colonoscopy, representing the leading cause of interval colorectal cancer (I-CRC). This systematic review and meta-analysis summarizes the efficacy of computer-aided colonoscopy (CAC) compared to white-light colonoscopy (WLC) in reducing lesion miss rates. Major databases were systematically searched through May 2024 for tandem-design RCTs comparing lesion miss rates in CAC-first followed by WLC vs WLC-first followed by CAC. The primary outcomes were adenoma miss rate (AMR) and polyp miss rate (PMR). The secondary outcomes were advanced AMR (aAMR) and sessile serrated lesion miss rate (SMR). Six RCTs (1718 patients) were included. AMR was significantly lower for CAC compared to WLC (RR = 0.46; 95 %CI [0.38-0.55]; P < 0.001). PMR was also lower for CAC compared to WLC (RR = 0.44; 95 %CI [0.33-0.60]; P < 0.001). No significant difference in aAMR (RR = 1.28; 95 %CI [0.34-4.83]; P = 0.71) and SMR (RR = 0.44; 95 %CI [0.15-1.28]; P = 0.13) were observed. Sensitivity analysis including only RCTs performed in CRC screening and surveillance setting confirmed lower AMR (RR = 0.48; 95 %CI [0.39-0.58]; P < 0.001) and PMR (RR = 0.50; 95 %CI [0.37-0.66]; P < 0.001), also showing significantly lower SMR (RR = 0.28; 95 %CI [0.11-0.70]; P = 0.007) for CAC compared to WLC. CAC results in significantly lower AMR and PMR compared to WLC overall, and significantly lower AMR, PMR and SMR in the screening/surveillance setting, potentially reducing the incidence of I-CRC.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE
One-fourth of colorectal neoplasia is missed at screening colonoscopy, representing the leading cause of interval colorectal cancer (I-CRC). This systematic review and meta-analysis summarizes the efficacy of computer-aided colonoscopy (CAC) compared to white-light colonoscopy (WLC) in reducing lesion miss rates.
METHODS METHODS
Major databases were systematically searched through May 2024 for tandem-design RCTs comparing lesion miss rates in CAC-first followed by WLC vs WLC-first followed by CAC. The primary outcomes were adenoma miss rate (AMR) and polyp miss rate (PMR). The secondary outcomes were advanced AMR (aAMR) and sessile serrated lesion miss rate (SMR).
RESULTS RESULTS
Six RCTs (1718 patients) were included. AMR was significantly lower for CAC compared to WLC (RR = 0.46; 95 %CI [0.38-0.55]; P < 0.001). PMR was also lower for CAC compared to WLC (RR = 0.44; 95 %CI [0.33-0.60]; P < 0.001). No significant difference in aAMR (RR = 1.28; 95 %CI [0.34-4.83]; P = 0.71) and SMR (RR = 0.44; 95 %CI [0.15-1.28]; P = 0.13) were observed. Sensitivity analysis including only RCTs performed in CRC screening and surveillance setting confirmed lower AMR (RR = 0.48; 95 %CI [0.39-0.58]; P < 0.001) and PMR (RR = 0.50; 95 %CI [0.37-0.66]; P < 0.001), also showing significantly lower SMR (RR = 0.28; 95 %CI [0.11-0.70]; P = 0.007) for CAC compared to WLC.
CONCLUSIONS CONCLUSIONS
CAC results in significantly lower AMR and PMR compared to WLC overall, and significantly lower AMR, PMR and SMR in the screening/surveillance setting, potentially reducing the incidence of I-CRC.

Identifiants

DOI: 10.1016/j.dld.2024.09.003 PMID: 39322447
pubmed: 39322447
pii: S1590-8658(24)01001-6
doi: 10.1016/j.dld.2024.09.003
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Ltd.

Déclaration de conflit d'intérêts

Declaration of competing interest By this I declare that the authors ave no conflict of interest, including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, our work titled ‘Effectiveness of artificial intelligence assisted colonoscopy on adenoma and polyp miss rate: a meta-analysis of tandem RCTs’.

Auteurs

M Maida (M)

Department of Medicine and Surgery, University of Enna 'Kore', Enna, Italy; Gastroenterology Unit, Umberto I Hospital, Enna, Italy. Electronic address: marcello.maida@unikore.it.

G Marasco (G)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliera Universitaria di Bologna, Bologna, Italy.

M H J Maas (MHJ)

Department of Gastroenterology & Hepatology, Radboud University Medical Center, Nijmegen, the Netherlands.

D Ramai (D)

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

M Spadaccini (M)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Endoscopy Unit, Humanitas Clinical and Research Hospital, IRCCS, Rozzano, Italy.

E Sinagra (E)

Gastroenterology Unit, Fondazione Istituto San Raffaele Giglio, Cefalù, Italy.

A Facciorusso (A)

Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

P D Siersema (PD)

Depatment of Gastroenterology and Hepatology, Erasmus MC - University Medical Center, Rotterdam, the Netherlands.

C Hassan (C)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Endoscopy Unit, Humanitas Clinical and Research Hospital, IRCCS, Rozzano, Italy.

Classifications MeSH