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From the Journals

AI-Assisted Quality Control Improves Adenoma Detection in Colonoscopy

An automatic quality control system was associated with a statistically significant increase in adenoma detection rates in routine colonoscopy.

Conexiant

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, PhD, 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 6 centers in China. The AQCS monitored withdrawal time, assessed bowel preparation, and detected polyps, providing real-time visual and auditory prompts to colonoscopists.

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).

In the study, 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.

AQCS use was associated with a higher ADR and improved colonoscopy quality, particularly among lower- and medium-level detectors, with benefits in both academic and non-academic settings. Researchers noted that routine AQCS use may support quality improvement in colorectal cancer screening.

Full disclosures can be found in the published study.