在一个由实习生主导的学术县医院对结肠镜检测结果的计算机辅助检测设备的实用实施研究
Anthony A Xu1,2, Vanessa Catania3, Loan Ho4
1Section of Gastroenterology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. doubleang@gmail.com.
计算机辅助检测 (CADe) 设备在实习生环境中显著提高了腺瘤和形形病变检测率. 这些发现支持将CADe应用于旨在提高多检测和患者结果的实践中.
科学领域:
- 胃肠病学
- 医疗器械
- 临床实施科学
背景情况:
- 随机对照试验表明实时计算机辅助检测 (CADe) 在增加腺瘤和状多体检测方面的有效性.
- 实用性实施研究提出了关于CADe设备在常规临床实践中的实际实用性的问题.
研究的目的:
- 评估实用计算机辅助检测 (CADe) 装置在一个由实习生主导的学术县医院对结肠镜指标的影响.
- 在现实临床环境中评估CADe在改善腺瘤检测率 (ADR) 和状病变检测率 (SSLDR) 的有效性.
主要方法:
- 对CADe实施前一年和实施后一年的结肠镜数据进行了回顾性分析 (1665 vs. 2301 手术).
- 排除标准包括不完整的结肠镜和不充分的肠道准备 (波士顿肠道准备分数< 6,或任何部分< 2).
- 没有强制使用CADe,允许对实用性,非强制性采用进行评估.
主要成果:
- 基线腺瘤检测率 (ADR) 为31. 5%,形形病变检测率 (SSLDR) 为1. 3%.
- 在实施CADe后,ADR增加了7.6% (p < 0. 001),SSLR增加了2. 9% (p < 0. 001).
- 调整后的几率比率显示了较高的腺瘤检测率 (aOR 1.29) 和形形病变检测率 (aOR 3. 10),并控制了共变量.
结论:
- 在一个由实习生占主导地位的学术县医院中,无论设备的使用频率如何,CADe设备的实施都显著改善了ADR和SSLDR.
- 在基线ADR和SSLDR不足的情况下,CADe设备的好处显著.
- 建议在试图提高多体检测率的实践中考虑CADe设备的实施.
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