Computer Aided Diagnosis of Colorectal Polyps
Condition: Colonic Polyp; Colorectal Cancer
MeSH terms: Polyps; Colonic Polyps
Study type: Observational

Summary: 
      The purpose of this study is to assess whether computer aided technology (CAD) can help in
      the diagnosis of polyps found the bowel compared with visual inspection alone and therefore
      whether it is beneficial in helping clinicians to decide whether to remove a polyp or not.
      Presently, most endoscopists remove all polyps found and send them to the laboratory for
      testing. The number of colonoscopies is increasing, meaning that more polyps are detected and
      removed. This comes at a significant cost to the health service and increases the time taken
      to complete a colonoscopy.
    

Detailed description: 
      Removing precancerous polyps from the bowel during a colonoscopy (camera test) is the
      cornerstone of colorectal cancer screening and prevents polyps developing into bowel cancer.
      Most polyps develop in the rectosigmoid colon (lower part of the bowel). Many polyps never
      grow into cancer and it can be difficult for the clinicians performing the procedure
      (endoscopists) to tell which ones are precancerous. This means many polyps are removed
      unnecessarily, with a considerable waste of resources.

      A recent preliminary study indicates a novel artificial intelligence system (EndoBRAIN) for
      computer-aided diagnosis may be able to distinguish different types of polyps during
      colonoscopy and therefore help doctors decide which polyps to remove. This study aims to
      compare the in accuracy of artificial intelligence against the endoscopist's assessment for
      diagnosis of diminutive (<5mm) polyps in the lower colon.

      Patients who are age 18 years or older who undergo colonoscopy for any indication at the
      participating clinical centres and are diagnosed with diminutive rectosigmoid polyps are
      eligible for study enrolment. For each detected polyp in the rectosigmoid colon, endoscopists
      will assess the polyp type using standard colonoscopies (cameras) and then with the use of
      the EndoBRAIN technology.

      The polyps will be removed and sent to the laboratory for testing. The difference between
      clinician diagnosis and EndoBRAIN diagnosis will be compared with the laboratory findings. We
      hypothesize that the EndoBRAIN technology provides a superior accuracy in identifying
      precancerous rectosigmoid polyps, compared to endoscopist's own prediction with a standard
      colonoscope.

      If the trial confirms the superior accuracy of the EndoBRAIN system, polyps classified as
      non-cancerous with the EndoBRAIN system no longer need to be removed, meaning a large gain
      for patients and society, due to significantly less polypectomies and pathology reviews.
    

Intervention name(s): Endobrain, Computer Aided Diagnosis (CAD)
Intervention type(s): Diagnostic Test
Intervention description(s): Artificial intelligence
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Any patient 18 years or older scheduled for screening, surveillance, diagnostic, or
        therapeutic colonoscopy at King's College Hospital with diminutive rectosigmoid polyps.