Computer-aided Detection Said To Fail in Randomized Controlled Trial, but It Actually Performed Well

Artificial intelligence programs for highlighting or detecting polyps during colonoscopy are designated computer-aided detection (CADe) programs. In general, randomized controlled trials of CADe have been positive for adenoma detection rate (ADR) improvement, with average higher gains than with any other device.

In a study performed by 8 experienced endoscopists in the UK National Health Service Bowel Cancer Screening Programme, 614 patients were randomized to CADe or a control group (standard colonoscopy). Endocuff Vision (Olympus) was used in about 70% of patients in each group. The polyp detection rate was borderline higher in the CADe versus control group (85.7% vs 79.7%; P=.05), and the ADR was not significantly higher with CADe (71.4% vs 65%; P=.09). Adenomas per colonoscopy was 2.4 with CADe versus 2.1 in controls (P=.25). The adenoma plus sessile serrated lesion (SSL) detection rate was higher with CADe (79.2% vs 71.6%; P=.03).