Wang CADe

Real-time automatic detection system increases colonoscopic polyp and adenoma detection rates: a prospective randomised controlled study

Patient / Population Intervention / Exposition Vergleich Endpunkt

In 1,058 consecutive patients undergoing diagnostic colonoscopy, a real-time deep-learning polyp detection system with visual and sound alerts increased the adenoma detection rate compared with standard colonoscopy.

1.058

Design

Open-label RCT

Endpunkt

Adenoma detection rate (ADR)

Relevanz

ErgebnisADR 29.1% vs 20.3% (P<0.001); adenomas per patient 0.53 vs 0.31 (P<0.001). Gain driven by diminutive adenomas (185 vs 102; P<0.001) with no difference in larger adenomas (77 vs 58; P=0.075); hyperplastic polyps also increased (114 vs 52; P<0.001).

Wang P, et al. Gut. 2019;68(10):1813-1819. 10.1136/gutjnl-2018-317500

Diskussion & Kritik

First randomised trial of real-time CADe and the proof of concept for the whole cluster. Open, non-blinded design in a low-ADR population; the gain came almost entirely from diminutive adenomas and hyperplastic polyps, so the clinical value — and the cost of the extra resections — was left for later trials to settle.