在现场留下结肠直肠息肉的计算机辅助诊断:系统审查和元分析
Cesare Hassan1, Masashi Misawa2, Tommy Rizkala3
1Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, and Humanitas Clinical and Research Center IRCCS, Endoscopy Unit, Rozzano, Italy (C.H., M.S., A.R.).
Annals of internal medicine
|May 20, 2024
概括
计算机辅助诊断 (CADx) 并不能改善结肠镜检查期间的多胞体切除决策. 这项分析没有发现使用CADx治疗小直肠状肌肉多的显著益处或危害.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 诊断技术 诊断技术的使用
背景情况:
- 计算机辅助诊断 (CADx) 旨在预测结肠镜检查期间的多组织学,可能减少不必要的非新生体多的去除.
- 在结肠镜检查中与CADx相关的实际临床益处和危害仍然不确定.
研究的目的:
- 量化使用CADx在结肠镜检查过程中用于光学诊断小 (≤5毫米) 直筒形息肉的临床益处和危害.
主要方法:
- 组织学验证的诊断准确性研究的系统审查和元分析,评估实时的医生表现,有或没有CADx协助.
- 在Medline,Embase和Scopus数据库中搜索2023年12月22日之前发表的相关研究.
- 使用精度值估计了临床益处和危害,用组织学作为参考标准. 在GRADE框架中,评估了证据的确定性.
主要成果:
- 十项研究分析了3620名患者中的4103个小直指性肌肉息肉. 单独CADx显示了87.3%的灵敏度和88.9%的特异性,用于预测瘤变化.
- 在CADx辅助前后进行性能比较时,在避免去除非瘤息肉 (55.4%与58.4%) 或错误地将瘤息肉留在现场 (8.2%与7.5%) 中没有显著差异.
- 这些结果的证据确定性中等.
结论:
- 计算机辅助诊断 (CADx) 在结肠镜检查过程中没有在小直肠杆菌状息肉的管理中提供额外的益处或危害.
- 在研究中模拟应用光学诊断可能影响了操作员的决策,这代表了一个局限性.
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