Troya Joel, Fitting Daniel, Brand Markus, Sudarevic Boban, Kather Jakob Nikolas, Meining Alexander, Hann Alexander
Interventional and Experimental Endoscopy (InExEn), Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.
Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
Endoscopy. 2022 Oct;54(10):1009-1014. doi: 10.1055/a-1770-7353. Epub 2022 Feb 14.
Multiple computer-aided systems for polyp detection (CADe) have been introduced into clinical practice, with an unclear effect on examiner behavior. This study aimed to measure the influence of a CADe system on reaction time, mucosa misinterpretation, and changes in visual gaze pattern.
Participants with variable levels of colonoscopy experience viewed video sequences (n = 29) while eye movement was tracked. Using a crossover design, videos were presented in two assessments, with and without CADe support. Reaction time for polyp detection and eye-tracking metrics were evaluated.
21 participants performed 1218 experiments. CADe was significantly faster in detecting polyps compared with participants (median 1.16 seconds [99 %CI 0.40-3.43] vs. 2.97 seconds [99 %CI 2.53-3.77], respectively). However, the reaction time of participants when using CADe (median 2.90 seconds [99 %CI 2.55-3.38]) was similar to that without CADe. CADe increased misinterpretation of normal mucosa and reduced the eye travel distance.
Results confirm that CADe systems detect polyps faster than humans. However, use of CADe did not improve human reaction times. It increased misinterpretation of normal mucosa and decreased the eye travel distance. Possible consequences of these findings might be prolonged examination time and deskilling.
多种用于息肉检测的计算机辅助系统(CADe)已被引入临床实践,但对检查者行为的影响尚不清楚。本研究旨在测量CADe系统对反应时间、黏膜误判以及视觉注视模式变化的影响。
具有不同结肠镜检查经验水平的参与者观看视频序列(n = 29),同时跟踪眼动。采用交叉设计,在有和没有CADe支持的两种评估中呈现视频。评估息肉检测的反应时间和眼动追踪指标。
21名参与者进行了1218次实验。与参与者相比,CADe检测息肉的速度明显更快(中位数分别为1.16秒[99%CI 0.40 - 3.43]和2.97秒[99%CI 2.53 - 3.77])。然而,参与者使用CADe时的反应时间(中位数2.90秒[99%CI 2.55 - 3.38])与不使用CADe时相似。CADe增加了对正常黏膜的误判,并缩短了眼睛移动距离。
结果证实CADe系统检测息肉的速度比人类快。然而,使用CADe并没有提高人类的反应时间。它增加了对正常黏膜的误判,并缩短了眼睛移动距离。这些发现可能导致检查时间延长和技能退化。