An interventional study of HD- colonoscopy and HD-colonoscopy assisted by AI in Colorectal Polyp, Colorectal Cancer and Colorectal Adenoma, sponsored by Instituto Ecuatoriano de Enfermedades Digestivas. Recruiting at 1 site in Ecuador. Open to participants aged 45 Years to 89 Years. Per ClinicalTrials.gov, last updated 2023-09-28.
Sponsored by Instituto Ecuatoriano de Enfermedades Digestivas · Not applicable, Interventional, and Diagnostic
Nowadays, colonoscopy is considered the gold standard for the detection of lesions in the colorectal mucosa. However, around 25% of polyps may be missed during the conventional colonoscopy. Based on this, new technological tools aimed to improve the quality of the procedures, diminishing the technical and operator-related factors associated with the missed lesions. These tools use artificial intelligence (AI), a computer system able to perform human tasks after a previous training process from a large dataset. The DiscoveryTM AI-assisted polyp detector (Pentax Medical, Hoya Group, Tokyo, Japan) is a newly developed detection system based on AI. It was designed to alert and direct the attention to potential mucosal lesions. According to its remarkable features, it may increase the polyp and adenoma detection rates (PDR and ADR, respectively) and decrease the adenoma miss rate (AMR).
Based on the above, the investigators aim to assess the real-world effectiveness of the DiscoveryTM AI-assisted polyp detector system in clinical practice and compare the results between expert (seniors) and non-expert (juniors) endoscopists.
Colorectal cancer (CRC) is worldwide the second and third cancer-related cause of death in men and women, respectively. For the detection of lesions in the mucosa (premalignant and malignant), colonoscopy has been considered the gold standard. However, up to 25% of lesions can be missed during conventional colonoscopy. Some technical (i.e., bowel preparation) and operator-related (i.e., expertise, and fatigue) factors are related to these missing lesions.
During the rapid-growing technological era, new tools were launched to improve the quality and performance of colonoscopies. Through the assistance of artificial intelligence (AI) an identification of a pattern can be achieved after a previous training from a large dataset of images. The DiscoveryTM AI-assisted polyp detector (Pentax Medical, Hoya Group, Tokyo, Japan), is a computer-assisted polyp/adenoma detection system based on AI. It detects classic adenomas and flat lesions, distinguished features like mucus cap or rim of debris with the advantage of a real-time and simultaneous multiple polyp detection. It was developed to minimize the missed lesions increasing as a result the polyp detection rate (PDR) and the adenoma detection rate (ADR).
Lately, published data evaluating the AI-assisted polyp detectors has demonstrate high sensitivity, specificity, and interobserver agreement. Due to the importance of CRC diagnosis and prompt treatment, and taking advantage of the newly introduced DiscoveryTM AI system, the investigators aim to assess the real-world effectiveness of this AI-assisted polyp detector system in clinical practice and compare the results between expert (seniors) and non-expert (juniors) endoscopists.
6,541 studies on the registry are indexed under Colorectal Neoplasms; 1,667 are open to participants now.
This study's planned enrollment of 312 is above the median of 76 across 4,800 interventional studies indexed under Colorectal Neoplasms.
Browse Colorectal Neoplasms studies →Instituto Ecuatoriano de Enfermedades Digestivas is the lead sponsor of 39 studies on the registry; 10 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.
Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
This group is comprised by patients \>45 years of age submitted for diagnostic colonoscopy. In the same session a HD-colonoscopy will be performed followed by an HD-colonoscopy with artificial intelligence assistance. The second procedure will be performed by an operator with the same-level-of -expertise in comparison to the initial procedure (expert or non-expert) and blinded to the results of the previous intervention.
Diagnostic Test: HD- colonoscopy · Diagnostic Test: HD-colonoscopy assisted by AI
This group is comprised by patients \>45 years of age submitted for diagnostic colonoscopy. In the same session a HD-colonoscopy assisted by artificial intelligence will be performed followed by an HD-colonoscopy alone.The second procedure will be performed by an operator with the same-level-of -expertise in comparison to the initial procedure (expert or non-expert) and blinded to the results of the previous intervention.
Diagnostic Test: HD- colonoscopy · Diagnostic Test: HD-colonoscopy assisted by AI
HD-colonoscopy performed by an expert or non-expert endoscopist. All lesions will be recorded, assessed, and removed for histological analysis.
HD-colonoscopy with AI-assisted polyp detector. New polyps detected by AI will be recorded, removed, and studied.
Adenoma detection rate (ADR)
The ADR will be determined by every new colonoscopy (second intervention) with at least one adenoma, histologically proven/NBI NICE classification. Results will be compared between experts and non-experts endoscopists.
Time frame: up to one month
Polyp detection rate (PDR)
The PDR will be determined by every new colonoscopy (second intervention) with at least one polyp. Results will be compared between experts and non-experts endoscopists.
Time frame: up to two hours
Diagnostic performance of AI-assisted polyp detector
The diagnostic performance of the AI-assisted system will be assessed by sensitivity, specificity, positive and negative predictive values (PPV and NPV) and observer agreement.
Time frame: up to three years
Adenoma Miss Rate (AMR)
The AMR will be determined by the total number of missed adenomas on initial examination. The diagnosis of adenoma will be made by NBI NICE classification or biopsy.
Time frame: Up to one month
Started Jan 2020 (actual). Primary completion is estimated for Jun 2024, 53 months after the start.
Of 898 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 15 and three quarters within 62. This study's planned 53 months is above that.
Counting every sponsor, half of 955 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.
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
Contact study teamGet an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Instituto Ecuatoriano de Enfermedades Digestivas