Multi-Centre, Open-label, Randomised, Prospective Trial to Assess Efficacy and Safety of the CADDIE Artificial Intelligence System for Improving Endoscopic Detection of Colonic Polyps in Real-time.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Polyps
- Sponsor
- University College, London
- Enrollment
- 739
- Locations
- 1
- Primary Endpoint
- To Evaluate Whether Using the CADDIE System Improves Endoscopist Detection of Adenomas During Colonoscopy.
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Background:
Colonoscopy is accepted to be the gold standard for screening of colorectal cancer (CRC). Most CRCs develop from adenomatous polyps, with colonoscopy accepted to be the gold standard for screening of CRC. An endoscopist's ability to detect polyps is assessed in the form of an Adenoma Detection Rate (ADR). Each 1.0% increase in ADR is associated with a 3.0% decrease in the risk of the patient developing an interval CRC. There remains a wide variation in endoscopist ADR.
More recently, the use of artificial intelligence (AI) and computer aided diagnosis in endoscopy has been gaining increasing attention for its role in automated lesion detection and characterisation. AI can potentially improve ADR, but previous AI related work has largely focused on retrospectively assessing still endoscopic images and selected video sequences which may be subject to bias and lack clinical utility. There are only limited clinical studies evaluating the effect of AI in improving ADR.
The CADDIE device uses convolutional neural networks developed for computer assisted detection and computer assisted diagnosis of polyps.
Primary objective: To determine whether the CADDIE artificial intelligence system improves endoscopic detection of adenomas during colonoscopy.
Primary endpoint: The difference in adenoma detection rate (ADR) between the intervention (supported with the CADDIE system) and non-intervention arm
Study design: Multi-Centre, open-label, randomised, prospective trial to assess efficacy and safety of the CADDIE artificial intelligence system for improving endoscopic detection of colonic polyps in real-time.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patient's scheduled to undergo a surveillance or symptomatic colonoscopy with an endoscopist participating in the study phase of the trial.
- •Male and female participants aged 18 years or older at the time of informed consent.
- •Patient's able to comprehend, sign and date the written informed consent document to participate in the study.
Exclusion Criteria
- •Emergency colonoscopies and/or inpatient colonoscopies.
- •Patients with inflammatory bowel disease (IBD)
- •Patients with Colorectal Cancer (CRC)
- •Patients with previous CRC
- •Patients with previous colonic resection
- •Patients returning for a planned elective therapeutic colonoscopy.
- •Polyposis syndromes
- •Current or relevant history of a physical or psychiatric illness or any medical condition that in the opinion of the investigator could affect the patient's safety or interfere with the study assessments
- •Patients with a contraindication for biopsy or polypectomy. These include:
- •Patients who have not withheld medications pre-disposing to bleeding at time of colonoscopy as per local site /national guidelines
Outcomes
Primary Outcomes
To Evaluate Whether Using the CADDIE System Improves Endoscopist Detection of Adenomas During Colonoscopy.
Time Frame: 30 days
The difference in endoscopist ADR between the intervention (CADDIE system) and non-intervention arm.
Secondary Outcomes
- Evaluate the Difference in Number of Adenomas Detected Per Colonoscopy Between Intervention and Non-intervention Arm(30 days)
- To Determine Whether the CADDIE Artificial Intelligence System Improves Endoscopic Detection of All Polyps During Colonoscopy(30 days)
- Compare the Accuracy of Endoscopist Optical Diagnosis of Diminutive Polyps When Using the CADDIE System (Intervention Arm) Compared to Without the CADDIE System (Control Arm)(30 days)
- Compare the Accuracy of Endoscopist Optical Diagnosis to Assign Colonoscopy Surveillance Intervals When Using the CADDIE System (Intervention Arm) Compared to Without the CADDIE System (Control Arm)(30 days)
- Compare the Accuracy of Endoscopist Optical Diagnosis of Diminutive Rectal Polyps When Using the CADDIE System (Intervention Arm) Compared to Without the CADDIE System (Control Arm)(30 days)
- Evaluate the Safety of the CADDIE by Recording Occurrence and Severity of Adverse Events.(30 days)
- Assess Patient Anxiety During the Colonoscopy(30 days)