1. Effectiveness of artificial intelligence assisted colonoscopy on adenoma and polyp miss rate: A meta-analysis of tandem RCTs.
- Author
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Maida M, Marasco G, Maas MHJ, Ramai D, Spadaccini M, Sinagra E, Facciorusso A, Siersema PD, and Hassan C
- Subjects
- Humans, Colonoscopy methods, Colonic Polyps diagnostic imaging, Colonic Polyps diagnosis, Colonic Polyps pathology, Colorectal Neoplasms diagnosis, Colorectal Neoplasms diagnostic imaging, Adenoma diagnosis, Adenoma diagnostic imaging, Randomized Controlled Trials as Topic, Artificial Intelligence, Early Detection of Cancer methods
- Abstract
Background and Aims: One-fourth of colorectal neoplasia is missed at screening colonoscopy, representing the leading cause of interval colorectal cancer (I-CRC). This systematic review and meta-analysis summarizes the efficacy of computer-aided colonoscopy (CAC) compared to white-light colonoscopy (WLC) in reducing lesion miss rates., Methods: Major databases were systematically searched through May 2024 for tandem-design RCTs comparing lesion miss rates in CAC-first followed by WLC vs WLC-first followed by CAC. The primary outcomes were adenoma miss rate (AMR) and polyp miss rate (PMR). The secondary outcomes were advanced AMR (aAMR) and sessile serrated lesion miss rate (SMR)., Results: Six RCTs (1718 patients) were included. AMR was significantly lower for CAC compared to WLC (RR = 0.46; 95 %CI [0.38-0.55]; P < 0.001). PMR was also lower for CAC compared to WLC (RR = 0.44; 95 %CI [0.33-0.60]; P < 0.001). No significant difference in aAMR (RR = 1.28; 95 %CI [0.34-4.83]; P = 0.71) and SMR (RR = 0.44; 95 %CI [0.15-1.28]; P = 0.13) were observed. Sensitivity analysis including only RCTs performed in CRC screening and surveillance setting confirmed lower AMR (RR = 0.48; 95 %CI [0.39-0.58]; P < 0.001) and PMR (RR = 0.50; 95 %CI [0.37-0.66]; P < 0.001), also showing significantly lower SMR (RR = 0.28; 95 %CI [0.11-0.70]; P = 0.007) for CAC compared to WLC., Conclusions: CAC results in significantly lower AMR and PMR compared to WLC overall, and significantly lower AMR, PMR and SMR in the screening/surveillance setting, potentially reducing the incidence of I-CRC., Competing Interests: Declaration of competing interest By this I declare that the authors ave no conflict of interest, including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, our work titled ‘Effectiveness of artificial intelligence assisted colonoscopy on adenoma and polyp miss rate: a meta-analysis of tandem RCTs’., (Copyright © 2024. Published by Elsevier Ltd.)
- Published
- 2025
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