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人工智能对腺瘤检出率的影响:经验丰富、中等水平和实习内镜医师腺瘤检出率的比较。

The impact of artificial intelligence on the adenoma detection rate : Comparison between experienced, intermediate and trainee endoscopists' adenoma detection rate.

作者信息

Bernhofer Sebastian, Prosenz Julian, Venturi David, Maieron Andreas

机构信息

Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500, Krems, Austria.

Department of Internal Medicine 2 Gastroenterology & Hepatology, University Hospital St. Pölten, Dunant-Platz 1, 3100, St. Pölten, Austria.

出版信息

Wien Klin Wochenschr. 2025 Jun 25. doi: 10.1007/s00508-025-02561-3.

Abstract

BACKGROUND

Artificial intelligence (AI) is a promising tool to achieve a high adenoma detection rate (ADR). The aim of this study is to evaluate the impact of a computer-aided detection (CADe) device on the ADRs of endoscopists with different levels of expertise.

METHODS

Data were collected from patients who underwent colonoscopy with CADe within a 12-month period. Endoscopists were divided into three groups, a trainee group (< 500 colonoscopies), an intermediate group (500-1000 colonoscopies) and an expert group (> 2000 colonoscopies). Endoscopists with the same definition of experience without CADe support served as the control cohort. For the differences in ADR between the groups a 2-sided 95% confidence interval (CI) and odds ratios (OR) were calculated.

RESULTS

In this study 335 patients (155 females, 177 males) with a mean age 62.1 years (SD ± 16.2 years) were included in the CADe cohort. In this cohort 508 polyps were resected. The ADRs for the groups and control groups (without CADe) were as follows: 42.9% (95% CI: 28.5-57.2%) and 21.5% (95% CI: 11.3-31.8%) in the trainee group, 41.3% (95% CI: 33.5-49.0%) and 36.8% (95% CI: 27.9-45.6%) in the intermediate group and 39.8% (95% CI: 30.9-48.8%) and 33.3% (95% CI: 26.3-40.4%) in the expert group. There were no significant differences among the CADe groups when trainees were compared to experts (p = 0.72, OR 1.13, 95% CI: 0.58-2.16) or when intermediate endoscopists were compared to experts (p = 0.81, OR 1.06, 95% CI: 0.65-1.74).

CONCLUSION

The use of AI appears to provide an opportunity to match the ADR-based quality of colonoscopy at an early stage of endoscopy training with experts.

摘要

背景

人工智能(AI)是实现高腺瘤检出率(ADR)的一种很有前景的工具。本研究的目的是评估计算机辅助检测(CADe)设备对不同专业水平内镜医师ADR的影响。

方法

收集在12个月内接受了使用CADe结肠镜检查的患者的数据。内镜医师分为三组,即实习组(<500例结肠镜检查)、中级组(500 - 1000例结肠镜检查)和专家组(>2000例结肠镜检查)。将没有CADe支持但经验定义相同的内镜医师作为对照队列。计算各组之间ADR的差异的双侧95%置信区间(CI)和优势比(OR)。

结果

本研究中,CADe队列纳入了335例患者(155例女性,177例男性),平均年龄62.1岁(标准差±16.2岁)。该队列中切除了508枚息肉。各研究组及对照组(无CADe)的ADR如下:实习组为42.9%(95%CI:28.5 - 57.2%)和21.5%(95%CI:11.3 - 31.8%);中级组为41.3%(95%CI:33.5 - 49.0%)和36.8%(95%CI:27.9 - 45.6%);专家组为39.8%(95%CI:30.9 - 48.8%)和33.3%(95%CI:26.3 - 40.4%)。当比较实习医师与专家时(p = 0.72,OR 1.13,95%CI:0.58 - 2.16),或比较中级内镜医师与专家时(p = 0.81,OR 1.06,95%CI:0.65 - 1.74),各CADe组之间无显著差异。

结论

使用人工智能似乎为在内镜培训早期使实习医师的结肠镜检查基于ADR的质量达到专家水平提供了一个机会。

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