在随机对照试验中,计算机辅助检测对腺瘤检测率的影响的变化:元回归分析
Marco Spadaccini1, Cesare Hassan1, Yuichi Mori2
1Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Italy; Humanitas Clinical and Research Center -IRCCS-, Endoscopy Unit, Rozzano, Italy.
概括
计算机辅助检测 (CADe) 系统可以提高结肠镜检查期间腺瘤检测率 (ADR). 诸如患者年龄,对照组的ADR和戒断时间等因素会影响CADe.
科学领域:
- 胃肠病学 胃肠病学
- 医疗成像医学成像
- 卫生技术评估 卫生技术评估
背景情况:
- 计算机辅助检测 (CADe) 系统在结肠镜中用于提高腺瘤检测率 (ADR).
- 以前的随机对照试验 (RCT) 已经显示出关于CADe系统疗效的可变结果.
- 调查导致这种异质性的因素对于优化CADe实施至关重要.
研究的目的:
- 识别和分析影响CADe辅助结肠镜检查有效性的变量.
- 了解患者和程序因素在使用CADe系统时如何影响腺瘤检测率 (ADR).
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Scopus) 进行了系统的文献搜索,截至2023年7月.
- 对23项涉及19077名患者的RCT进行了一项随机效应元分析,以组合腺瘤检测率 (ADR).
- 使用元回归分析 (单变量和多变量) 来探索异质性,检查患者人口统计学,结肠镜指示,对照组的ADR和停药时间等因素.
主要成果:
- 与标准结肠镜检查 (38%) 相比,CADe辅助结肠镜检查导致了较高的ADR (46%),风险比为1.22.
- 观察到显著的异质性 (I2 = 67.69%),表明CADe在不同研究的影响的变化.
- 超回归确定了患者年龄,对照组的ADR和戒断时间作为CADe对ADR影响的显著预测因素.
结论:
- 在CADe的有效性中的异质性与结肠镜质量指标的变化有关.
- 对照组的腺瘤检测率和退出时间被确定为影响CADe系统性能的关键因素.
- 优化结肠镜检查质量可能会增强CADe辅助手术的好处.
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