Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions i...Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma.The adenoma detection rate is a key performance indicator.Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer.Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection.This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate;minimum withdrawal times,dynamic patient position change and proximal colon retroflexion.展开更多
BACKGROUND Limited data currently exists on the clinical utility of Artificial Intelligence Assisted Colonoscopy(AIAC)outside of clinical trials.AIM To evaluate the impact of AIAC on key markers of colonoscopy quality...BACKGROUND Limited data currently exists on the clinical utility of Artificial Intelligence Assisted Colonoscopy(AIAC)outside of clinical trials.AIM To evaluate the impact of AIAC on key markers of colonoscopy quality compared to conventional colonoscopy(CC).METHODS This single-centre retrospective observational cohort study included all patients undergoing colonoscopy at a secondary centre in Brisbane,Australia.CC outcomes between October 2021 and October 2022 were compared with AIAC outcomes after the introduction of the Olympus Endo-AID module from October 2022 to January 2023.Endoscopists who conducted over 50 procedures before and after AIAC introduction were included.Procedures for surveillance of inflammatory bowel disease were excluded.Patient demographics,proceduralist specialisation,indication for colonoscopy,and colonoscopy quality metrics were collected.Adenoma detection rate(ADR)and sessile serrated lesion detection rate(SSLDR)were calculated for both AIAC and CC.RESULTS The study included 746 AIAC procedures and 2162 CC procedures performed by seven endoscopists.Baseline patient demographics were similar,with median age of 60 years with a slight female predominance(52.1%).Procedure indications,bowel preparation quality,and caecal intubation rates were comparable between groups.AIAC had a slightly longer withdrawal time compared to CC,but the difference was not statistically significant.The introduction of AIAC did not significantly change ADR(52.1%for AIAC vs 52.6%for CC,P=0.91)or SSLDR(17.4%for AIAC vs 18.1%for CC,P=0.44).CONCLUSION The implementation of AIAC failed to improve key markers of colonoscopy quality,including ADR,SSLDR and withdrawal time.Further research is required to assess the utility and cost-efficiency of AIAC for high performing endoscopists.展开更多
As the new year progresses, policymakers around the world are asking themselves the same question: Is it time to halt stimulus policies? But the question seems almost unanswerable now as signs of
文摘Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma.The adenoma detection rate is a key performance indicator.Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer.Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection.This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate;minimum withdrawal times,dynamic patient position change and proximal colon retroflexion.
文摘BACKGROUND Limited data currently exists on the clinical utility of Artificial Intelligence Assisted Colonoscopy(AIAC)outside of clinical trials.AIM To evaluate the impact of AIAC on key markers of colonoscopy quality compared to conventional colonoscopy(CC).METHODS This single-centre retrospective observational cohort study included all patients undergoing colonoscopy at a secondary centre in Brisbane,Australia.CC outcomes between October 2021 and October 2022 were compared with AIAC outcomes after the introduction of the Olympus Endo-AID module from October 2022 to January 2023.Endoscopists who conducted over 50 procedures before and after AIAC introduction were included.Procedures for surveillance of inflammatory bowel disease were excluded.Patient demographics,proceduralist specialisation,indication for colonoscopy,and colonoscopy quality metrics were collected.Adenoma detection rate(ADR)and sessile serrated lesion detection rate(SSLDR)were calculated for both AIAC and CC.RESULTS The study included 746 AIAC procedures and 2162 CC procedures performed by seven endoscopists.Baseline patient demographics were similar,with median age of 60 years with a slight female predominance(52.1%).Procedure indications,bowel preparation quality,and caecal intubation rates were comparable between groups.AIAC had a slightly longer withdrawal time compared to CC,but the difference was not statistically significant.The introduction of AIAC did not significantly change ADR(52.1%for AIAC vs 52.6%for CC,P=0.91)or SSLDR(17.4%for AIAC vs 18.1%for CC,P=0.44).CONCLUSION The implementation of AIAC failed to improve key markers of colonoscopy quality,including ADR,SSLDR and withdrawal time.Further research is required to assess the utility and cost-efficiency of AIAC for high performing endoscopists.
文摘As the new year progresses, policymakers around the world are asking themselves the same question: Is it time to halt stimulus policies? But the question seems almost unanswerable now as signs of
