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评估人工智能在临床实践中增强结肠镜腺瘤检测的潜力:一项前瞻性观察性试验。

Assessing the potential of artificial intelligence to enhance colonoscopy adenoma detection in clinical practice: a prospective observational trial.

作者信息

Rønborg Søren Nicolaj, Ujjal Suresh, Kroijer Rasmus, Ploug Magnus

机构信息

Department of Surgical Gastroenterology, Esbjerg Hospital, University Hospital of Southern Denmark, Esbjerg, Denmark.

Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark.

出版信息

Clin Endosc. 2024 Nov;57(6):783-789. doi: 10.5946/ce.2024.038. Epub 2024 Aug 23.

Abstract

BACKGROUND/AIMS: This study aimed to evaluate the effectiveness of the GI Genius (Medtronic) module in clinical practice, focusing on the adenoma detection rate (ADR) during colonoscopy. Computer-aided polyp detection (CADe) systems using artificial intelligence have been shown to improve adenoma detection in controlled trials. However, the effectiveness of these systems in clinical practice has recently been questioned.

METHODS

This single-center prospective observational study was conducted at the University Hospital of Southern Denmark and included all individuals referred for colonoscopy between November 2020 and January 2021. The primary outcome was ADR, comparing patients examined with CADe to those examined without it. The selection of patients to be examined with the CADe module was completely random.

RESULTS

A total of 502 patients were analyzed (318 in the control group and 184 in the CADe group). The overall ADR was 32.1% with a slight increase in the CADe group (34.7% vs. 30.5%). Multivariable analysis showed a very modest and statistically insignificant increase in ADR (risk ratio, 1.12; 95% confidence interval, 0.88-1.43).

CONCLUSIONS

The use of CADe in clinical practice did not increase ADR with statistical significance when compared to colonoscopy without CADe. These findings suggest that the impact of CADe systems in everyday clinical practice are modest.

摘要

背景/目的:本研究旨在评估GI Genius(美敦力)模块在临床实践中的有效性,重点关注结肠镜检查期间的腺瘤检出率(ADR)。在对照试验中,使用人工智能的计算机辅助息肉检测(CADe)系统已被证明可提高腺瘤检出率。然而,这些系统在临床实践中的有效性最近受到了质疑。

方法

本单中心前瞻性观察性研究在南丹麦大学医院进行,纳入了2020年11月至2021年1月期间所有接受结肠镜检查的个体。主要结局是ADR,比较使用CADe检查的患者和未使用CADe检查的患者。选择接受CADe模块检查的患者完全是随机的。

结果

共分析了502例患者(对照组318例,CADe组184例)。总体ADR为32.1%,CADe组略有增加(34.7%对30.5%)。多变量分析显示ADR有非常适度且无统计学意义的增加(风险比,1.12;95%置信区间,0.88 - 1.43)。

结论

与未使用CADe的结肠镜检查相比,在临床实践中使用CADe并未使ADR有统计学意义的增加。这些发现表明CADe系统在日常临床实践中的影响不大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4455/11637665/6a4922c1db5b/ce-2024-038f1.jpg

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