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Computer-Aided Colonoscopy Alert Fatigue and Its Effect on Adenoma Detection.

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Summary
This summary is machine-generated.

Computer-aided detection (CADe) improves adenoma detection rates (ADR) early in colonoscopies. However, alert fatigue may reduce CADe effectiveness later in the day, diminishing ADR gains.

Keywords:
adenoma detection ratealert fatiguecomputer-aided detectionwithdrawal time

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Area of Science:

  • Gastroenterology
  • Medical Imaging
  • Endoscopy

Background:

  • Computer-aided detection (CADe) systems aim to enhance adenoma detection rates (ADR) during colonoscopies.
  • Potential alert fatigue from continuous CADe use may decrease its efficacy over time.
  • Understanding the impact of alert fatigue on ADR is crucial for optimizing CADe implementation.

Purpose of the Study:

  • To investigate whether alert fatigue occurs with CADe use during colonoscopies.
  • To determine how alert fatigue influences ADR throughout an endoscopist's daily schedule.
  • To evaluate the real-world effectiveness of CADe in a pragmatic setting.

Main Methods:

  • Secondary analysis of a prospectively collected cohort of 1,700 colonoscopies (880 with CADe, 820 without).
  • Colonoscopies were analyzed based on their order in the endoscopist's daily schedule.
  • Primary outcome: ADR adjusted for withdrawal time (WT); Secondary outcomes: Adenomas per colonoscopy (APC), ADR by time of day.

Main Results:

  • CADe significantly increased ADR in the first three procedures (49.9%) compared to unassisted procedures (39.4%).
  • ADR in CADe-assisted procedures dropped in later cases (39.9%), showing no benefit over unassisted procedures (40.9%).
  • Adenomas per colonoscopy (APC) gains with CADe were significant early but disappeared in later procedures, suggesting reduced effectiveness due to potential alert fatigue.

Conclusions:

  • CADe initially boosts ADR but its effectiveness diminishes in later-day colonoscopies.
  • The observed decline in ADR suggests that endoscopist alert fatigue may limit responsiveness to CADe prompts.
  • Optimizing CADe alert strategies may be necessary to sustain its benefits throughout the entire colonoscopy procedure list.