Effect of Computer-Aided Detection During Colonoscopy on Adenoma Detection Rate in a Community Hospital Setting:...

Area of Science:

• Gastroenterology
• Medical Technology
• Clinical Trials

Background:

• Computer-aided detection (CADe) shows promise for enhancing adenoma detection rates (ADRs) in colonoscopies, particularly in academic settings.
• Its effectiveness in community hospital environments remains less understood.
• This study investigates CADe's impact in a Japanese community hospital.

Purpose of the Study:

• To evaluate the effect of CADe on adenoma detection rates (ADRs) in a Japanese community hospital.
• To assess secondary outcomes including adenomas per colonoscopy (APC) and withdrawal time.

Main Methods:

• A single-center, randomized controlled trial was conducted from September 2022 to August 2023.
• Eligible patients aged 40 or older undergoing colonoscopy were randomized 1:1 to undergo the procedure with or without CADe.
• The primary outcome was ADR, with APC and withdrawal time as secondary outcomes.

Main Results:

• A total of 998 patients (497 control, 501 CADe) were analyzed.
• The ADR was 54.5% in the control group and 50.7% in the CADe group, showing no significant difference (adjusted risk ratio, 0.93; 95% CI, 0.83-1.05).
• The mean number of APC was lower in the CADe group (1.14 vs. 1.34), and withdrawal time was longer (751s vs. 691s, p=0.034).

Conclusions:

• CADe did not significantly improve ADR in this Japanese community hospital setting.
• The high baseline ADR in the control group may have influenced these findings.
• Further research is needed to identify specific settings where CADe is most beneficial.