Thiruvengadam CADe
The Efficacy of Real-time Computer-aided Detection of Colonic Neoplasia in Community Practice: A Pragmatic Randomized Controlled Trial
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 1,100 patients undergoing colonoscopy for screening, surveillance, a positive FIT or diagnostic indications at one community-based centre, real-time computer-aided detection increased the adenoma detection rate compared with traditional colonoscopy.
N
1 100
Schéma
Single-centre pragmatic RCT, community practice
Critère
Adenoma detection rate (ADR)
Pertinence
2
RésultatADR 42.5% vs 34.4% (P=0.005); adenomas per colonoscopy 0.89 vs 0.60 (P<0.001); sessile serrated lesion detection 4.7% vs 2.0% (P=0.01). The ADR gain was confined to the first half of the trial (47.2% vs 33.7%; P=0.002) and absent in the second half (38.7% vs 34.9%; P=0.33).
Thiruvengadam NR, et al. Clin Gastroenterol Hepatol. 2024;22(11):2221-2230.e15. 10.1016/j.cgh.2024.02.021
Discussion et critique
Primary endpoint met: CADe modestly raised ADR among average-detector community endoscopists, where real-world implementation studies had failed to show benefit. Single centre, open-label, a gain driven by <5 mm adenomas, and an effect that faded in the second half of the trial — a hint of novelty or learning effects that tempers the headline result.