An interventional study of GI-Genius artificial intelligence in Colorectal Neoplasms, sponsored by Hospital Universitario La Fe. Status unknown at 1 site in Spain. Per ClinicalTrials.gov, last updated 2023-05-31.
Sponsored by Hospital Universitario La Fe · Not applicable, Interventional, and Diagnostic
Artificial intelligence is a promising tool that may have a role in characterizing colon epithelial lesions (CADx), helping to get a reliable optical diagnosis regardless of the endoscopist experience. Performances of the different CADx systems are variable but it seems that, in most cases, high accuracy and sensitivities are achieved. However, these CADx systems have been developed and validated using still pictures or videos, and a real-world accurate test is lacking. No clinical trials have tested this technology in clinical practice and, therefore, performance in real colonoscopies, practical problems, applicability, and cost are unknown.
The resect-and-discard (R\&D) and diagnose-and-leave (D\&L) strategies have been proposed as a means to reduce costs in the evaluation of colorectal polyps avoiding a substantial number of pathology evaluations. A pre-requisite for this paradigm shift is an accurate optical diagnosis (HOD). However, performance results for HOD have been highly variable among endoscopists representing a barrier for the adoption of the R\&D and the D\&L strategies.
Artificial intelligence is a promising tool that may have a role in characterizing colon epithelial lesions (CADx), helping to get a reliable optical diagnosis regardless of the endoscopist experience. Performances of the different CADx systems are variable but it seems that, in most cases, high accuracy and sensitivities are achieved. However, these CADx systems have been developed and validated using still pictures or videos, and a real-world accurate test is lacking. No clinical trials have tested this technology in clinical practice and, therefore, performance in real colonoscopies, practical problems, applicability, and cost are unknown.
Methods and analysis: The ODDITY trial is a European multicenter randomized, parallel-group superiority trial comparing GI-Genius artificial intelligence optical diagnosis (AIOD) to human optical diagnosis (HOD) of colon lesions ≤ 5 mm performed by endoscopists, using histopathology as the gold standard. A total of 643 patients attending a colonoscopy within a CRC screening program (either FIT- or colonoscopy-based) or because of post-polypectomy surveillance will be randomized to the ADI group or the HOD (control) group. A computer-generated 1:1 blocking randomization scheme stratified for center and endoscopist will be used.
5,738 studies on the registry are indexed under Colorectal Neoplasms; 1,481 are open to participants now.
This study's planned enrollment of 643 is above the median of 77 across 4,222 interventional studies indexed under Colorectal Neoplasms.
Browse Colorectal Neoplasms studies →Hospital Universitario La Fe is the lead sponsor of 39 studies on the registry; 5 are open to participants now.
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The examinator will provide a HOD for every lesion (regardless of their size) found during the examination (adenoma vs non-adenoma) following one of the available validated classifications (NICE, JNET, BASIC). He/she will also give a level of confidence in his/her diagnosis (high/low confidence). However, only diminutive lesions will be considered when analyzing the main outcome. The time to get a HOD will be recorded. An in situ surveillance interval will be provided if possible.
GI-Genius will provide an artificial intelligence diagnosis (AIOD) for every lesion detected (adenoma vs non-adenoma). Only diminutive lesions will be considered for the analysis of the main outcome. However, data on larger lesions will be recorded to describe GI-Genius´ performance in detail (secondary outcome). The time to get an AIOD will be recorded. An in situ surveillance interval will be provided if possible
Device: GI-Genius artificial intelligence
The software allows for the real-time characterization of framed polyps during a colonoscopy classifying them on adenoma or non-adenoma.
Comparison of the AIOD and HOD accuracy of the post-polypectomy surveillance interval assignment with respect to the surveillance interval assigned by pathology
A surveillance interval will be assigned using optical diagnosis of ≤ 5 mm polyps (Arm 1: AIOD; Arm 2: HOD of polyps diagnosed with high confidence) plus histopathology of \> 5 mm polyps and polyps ≤ 5 mm diagnosed with low confidence. For each patient included, the optical-diagnosis surveillance assignment will be matched with the histology-directed one, and a concordance rate will be calculated. The post-polypectomy surveillance interval will be calculated using the ESGE 2020 and the USMSTF 2020 guidelines. Per-patient analysis.
Time frame: At the end of the study (2 years)
Comparison of the AIOD and HOD negative predictive value (NPV) for adenoma in rectosigmoid polyps ≤ 5 mm with respect to histology
The optical diagnosis of ≤ 5 mm rectosigmoid polyps (Arm 1: AIOD; Arm 2: HOD, only high-confidence diagnosis) reliability on ruling out the presence of an adenoma will be calculated using histopathology as the gold standard. Per-lesion analysis. NPV = number of confirmed hyperplastic polyps/number of hyperplastic optical diagnosis
Time frame: At the end of the study (2 years)
Comparison of the AIOD and HOD diagnostic accuracy parameters of polyps ≤ 5 mm (Arm 1: AIOD; Arm 2: HOD) with respect to histology
Operative characteristics (sensitivity, specificity, positive and negative predictive value and positive likely hood ratio) using histopathology as the gold standard. Per-lesion analysis
Time frame: Interim analysis (when half of the sample size had been included). At the end of the study (2 years)
Cost-effectiveness of AIOD
The economic burden of applying the AIOD and HOD to assign the post-polypectomy surveillance intervals compared to the histology-driven strategy. A direct cost evaluation will be performed including medical and non-medical costs. Per-patient analysis.
Time frame: At the end of the study (2 years)
Comparison of the proportion of adverse events in colonoscopies with and without the AIOD device.
The occurrence and severity of adverse events in colonoscopies with and without the AIOD device will be monitored during the 30-days period after the procedure. Adverse events are defined as: abdominal pain or discomfort, post-polypectomy bleeding, perforation, post-polypectomy syndrome and infection. Per-patient analysis
Time frame: 30 days after the colonoscopy (Day 30)
Proportion of patients accepting to have their polyps diagnosed by the AI system or human optical diagnosis (designed questionnaire)
The proportion of patients willing to have their polyps diagnosed by an AI system or HOD will be assessed using a structured questionnaire. Per-patient analysis.
Time frame: Day of colonoscopy (Day 1)
Plan to share: Undecided
No publications or documents are linked to this record.
Started Feb 2023 (actual). Primary completion is estimated for May 2024, 15 months after the start.
Of 801 non-industry interventional studies with no phase under Colorectal Neoplasms, half reached primary completion within 32 months of starting (the median), counting those still running; a quarter within 14 and three quarters within 60. This study's planned 15 months is below that.
Counting every sponsor, half of 845 studies reached it within 32 months; a quarter within 14 and three quarters within 60.
How these figures are worked out, and which studies are left out of them.
This study is status unknown, as verified in May 2023. You cannot join it, but the record below documents what was studied.
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Hospital Universitario La Fe