Artificial Intelligence Aid Systems in Colorectal Adenoma Detection

Study Overview
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Brief Summary
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The main purpose of the study to evaluate the usefulness of the Endo-AID artificial intelligence system in the detection of colorectal adenomas in consecutive patients for outpatient colonoscopy. The secondary aims were: To evaluate the benefit of Endo-AID in adenoma detection rate by comparing endoscopists with high and low adenoma detection rate. To evaluate serrated detection rate, advanced adenoma detection rate, adenoma detection rate according to the size (<= 5mm, 6-9mm,> = 10mm) and number of adenomas by colonoscopy. Stratification by location and morphology.

Detailed Description
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Priority guidelines have been established regarding IA applied to gastrointestinal endoscopy. Regarding the priority uses for their development, there are applications that improve vision, placing computer-assisted lesion detection (CADe) as one of the most necessary priorities, given the importance of colorectal cancer screening (CRC) and post-polypectomy surveillance. The evaluation of these systems in different clinical practices and patient groups has been recommend. In this regard, studies in the western population are limited and have been carried out by expert endoscopists. It has not been evaluated in endoscopists with different adenoma detection rates. In addition, there are no studies with the recent CADe Endo-AID system (Olympus Corp. Tokyo). The main purpose of the study to evaluate the usefulness of the Endo-AID artificial intelligence system in the detection of colorectal adenomas in consecutive patients for outpatient colonoscopy. In addition, the benefit of the CADe system will be assessed according to the endoscopist ADR. A randomized controlled trial will be carried out in consecutive outpatients meeting the inclusion criteria and none of the exclusion criteria. Patients with be randomized to one of the four groups: CADe system and high ADR endoscopist; CADe system and low ADR endoscopist; Control and high ADR endoscopist; Control and low ADR endoscopist. For the sample size calculation a 14.4 of difference in favor of the CADe system was considered. Taking onto account an alpha error of 0.05 in a unilateral contrast, a power of 80% and a loss of 10%, 165 patients per group would be required.

Official Title
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Usefulness of the Endo-AID Artificial Intelligence System in the Detection of Colorectal Adenomas. a Randomized Controlled Trial

Conditions
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Adenoma Detection Rate

Intervention / Treatment
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* Device: Computed adenoma detection system (CADe)
* Behavioral: Control group (regular colonoscopy)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 years. Patients referred for outpatient colonoscopy Exclusion Criteria: Colonic resection Taking anticoagulants or antiagregants that contraindicate the performance of therapy Patients with a recent colonoscopy (<6 months) of good quality (e.g. cited for endoscopic therapy) Inflammatory bowel disease Patients with incomplete colonoscopy Patients with inadequate preparation using the Boston Colonic Preparation Scale (BBPS). A cleaning quality of less than 2 points in any of the 3 colonic sections will be considered inadequate. Patients with polyposis syndromes Refusal to participate in the study.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Computed adenoma detection system (CADe)<br>Tis system can detect in the screen suspicion areas of adenomatous polyps. This is an additional help for the endoscopist for the detection of lesions | Device: Computed adenoma detection system (CADe)<br>* This is a computed system that helps the endoscopist to increase the detection of colorectal polyps<br>|
| Active Comparator: Control group (absence of CADe)<br>This is the control group. As in the routine colonoscopy the endoscopist is in charge of the detection of the lesions. | Behavioral: Control group (regular colonoscopy)<br>* It is exclusively the endoscopist in charge of the detection of the polyps (usual practice)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Adenoma detection rate | Number of colonoscopies with colorectal adenoma/Number of total colonoscopies | [Time frame: 1 years][Designated as safety issue: No] | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Serrated detection rate | Number of colonoscopies with serrated adenoma/Number of total colonoscopies | [Time Frame: 1 years][Designated as safety issue: No] | 
| Advanced adenoma detection rate | Number of colonoscopies with advanced adenoma/Number of total colonoscopies | [Time Frame: 1 years][Designated as safety issue: No] |