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Longterm Effectiveness of Artificial Intelligence-assisted Colonoscopy on Adenoma Recurrence

Not Applicable
Recruiting
Conditions
Screening Colonscopy
Interventions
Device: ENDO-AID CADe
Registration Number
NCT06251700
Lead Sponsor
Chinese University of Hong Kong
Brief Summary

We hypothesize that AI-assisted colonoscopy can reduce post-colonoscopy neoplasia incidence after 3 years, over standard colonoscopy. Moreover, this protective effect may allow surveillance intervals to be lengthened, by modifying long-term outcome of high-risk subgroup.

Detailed Description

Between April 2021 and July 2022, our group completed a parallel-group, randomized controlled trial in Hong Kong. \[ENDOAID-TRAIN study; NCT04838951\] 856 subjects undergoing colonoscopies were randomized 1:1 to receive colonoscopies with CADe (ENDO-AID, Olympus Co., Japan) or standard colonoscopies (control). Our study proved that AI-assisted colonoscopies could increase the overall ADR, especially small-to-medium size adenomas. It remains questionable whether the increased detection and removal of these non-advanced adenomas can be translated into any sustained long-term benefit. The impact of this AI-driven intensive surveillance on general population and healthcare system is also largely unknown. In this research project, we aim to assess the long-term effectiveness of AI-assisted colonoscopy on adenoma recurrence and PCCRC prevention, by conducting a real-world, prospective study with longitudinal extension from a randomized trial.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
775
Inclusion Criteria

Subjects are eligible if:

(i) They underwent randomization to receive colonoscopy with/without CADe in ENDOAID-TRAIN study [NCT04838951]; (ii) They are fit and willing to undergo surveillance colonoscopy at year 3; (iii) Written informed consent obtained.

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Exclusion Criteria

Subjects will be excluded from the study if they have any of the followings:

(i) Incomplete colonoscopy during index procedure; (ii) Known residual colorectal neoplasia not removed (except hyperplastic polyps); (iii) Underwent unscheduled interval colonoscopy before year 3; (iv) Contraindications to surveillance colonoscopy at year 3; (v) Advanced comorbid (American Society of Anesthesiologists grade 4 or above); (vi) History of CRC, hereditary polyposis syndrome or inflammatory bowel disease; (vii) History of colectomy at any time point.

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Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Intervention armENDO-AID CADeCADe system will be used during withdrawal phase of colonscopy
Primary Outcome Measures
NameTimeMethod
Post-colonoscopy adenomas at year 3During the colonoscopy

The primary endpoint is the incidence of post-colonoscopy adenomas at year 3, which is the composite of new occurrence and metachronous recurrence of adenomas during surveillance.

Secondary Outcome Measures
NameTimeMethod
Post-colonoscopy AADuring the colonoscopy

Incidence of post-colonoscopy advanced adenomas

Post-colonoscopy advanced neoplasmsDuring the colonoscopy

Incidence of post-colonoscopy advanced neoplasms

Post-colonoscopy SSLDuring the colonoscopy

Incidence of post-colonoscopy SSL

Post-colonoscopy CRCDuring the colonoscopy

Incidence of post-colonoscopy CRC

Post-colonoscopy adenomas and advanced adenomasDuring the colonoscopy

Number of post-colonoscopy adenomas and advanced adenomas

Size and location of post-colonoscopy adenomas and advanced adenomasDuring the colonoscopy

Size and location of post-colonoscopy adenomas and advanced adenomas

High-risk and low-risk group according to USMSTF guidelineDuring the colonoscopy

Proportion of subjects re-classified as high-risk and low-risk groups according to USMSTF guideline

Trial Locations

Locations (1)

Prince of Wales Hospital

🇭🇰

Hong Kong, Hong Kong

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