Impact of Computer Aided Detection on Trainee Polyp Miss Rates Using a Tandem Colonoscopy Design
Northwestern University
Summary
Based on prior studies, trainee and practicing gastroenterologists miss pre-cancerous polyps (adenomas and serrated polyps) during colonoscopy. The use of computer-aided detection (CADe) systems, a form of artificial intelligence (AI) has been shown to help identify colorectal lesions for practicing gastroenterologists. However, less is known how AI impacts polyp detection for trainees. The investigators are conducting a tandem colonoscopy study wherein a portion of the colon is examined first by the trainee and then the attending physician. For each procedure, randomization will occur which will determine whether or not the trainee will utilize AI for their examination of the colon. At the end of the study, the investigators will determine whether AI helps trainees miss fewer polyps during colonoscopy. The investigators will also conduct interviews with trainees to understand how AI impacts colonoscopy training.
Description
Quality metrics in colonoscopy are useful in determining endoscopist performance. The adenoma detection rate (ADR) has historically been the primary colonoscopy quality indicator of interest, whereby those with a higher ADR have lower rates of interval colon cancers. Other important parameters include the adenoma miss rate (AMR) and the sessile serrated polyp miss rate (SMR). The AMR among practicing gastroenterologists is estimated at around 25% based on tandem-colonoscopy studies, while the SMR may be even higher. Prior tandem colonoscopy studies have also shown that gastroenterology traine…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Adult patients referred for screening or surveillance colonoscopy Exclusion Criteria: * Patients referred for polypectomy or diagnostic colonoscopy * Patients with prior right colon surgery * Prolonged insertion time (\>20 minutes) * Poor bowel preparation (Boston Bowel Preparation Score less than or equal to 6)
Interventions
- DeviceColonoscopy With Computer-Aided Detection
Use of Computer-Aided Detection During Colonoscopy
- ProcedureColonoscopy without Computer-Aided Detection
Colonoscopy without Computer-Aided Detection (AI)
Location
- Northwestern Memorial HospitalChicago, Illinois