The use of an automatic quality control system during routine colonoscopy increased adenoma detection rates by 10%, particularly benefiting lower- and medium-level detectors, according to a recent study.

Researchers led by Jing Liu, MD, of the Department of Gastroenterology, Qilu Hospital of Shandong University in China, conducted a multicenter, single-blind, randomized clinical trial to evaluate the efficacy of an automatic quality control system (AQCS) in improving adenoma detection rates (ADR) during a routine colonoscopy. 

The study, published in JAMA Network Open, randomized 1,254 adults to undergo either AQCS-assisted colonoscopy or standard colonoscopy at six centers in China. The AQCS monitored withdrawal time, assessed bowel preparation, and detected polyps, providing real-time visual and auditory prompts to colonoscopies.

ADR was significantly higher in the AQCS-assisted group compared with the standard colonoscopy group (32.7% vs 22.6%). The AQCS group also had higher detection rates for nonadvanced adenomas (30.1% vs 21.2%) and flat or sessile adenomas (29.3% vs 20.4%). Improvements were observed among both lower-level (30.0% vs 20.0%) and medium-level detectors (38.1% vs 27.7%).

ADR increases were observed in both academic (29.3% vs 20.8%;) and nonacademic centers (36.1% vs 24.5%;). The mean number of adenomas detected per colonoscopy was significantly higher in the AQCS group (0.86 vs 0.48).

AQCS use slightly increased withdrawal time (6.78 vs 6.46 minutes). False-positive detections occurred at a rate of 1.3 per procedure, with 72.6% attributed to bowel wall folds and 27.4% due to residual bowel content. No significant colonoscopy-related adverse events occurred, though two cases of anesthesia-related hypoxemia were reported, noted Dr. Liu and colleagues.

Full disclosures can be found in the published study. 

Source:  JAMA Network Open