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A Study on the Effectiveness of AI-assisted Colonoscopy in Improving the Effect of Colonoscopy Training for Trainees

Not Applicable
Conditions
Artificial Intelligence
Colonoscopy
Gastrointestinal Disease
Interventions
Device: artificial intelligence assistance system
Registration Number
NCT04912037
Lead Sponsor
Renmin Hospital of Wuhan University
Brief Summary

In this study,the AI-assisted system(EndoAngel)has the functions of reminding the ileocecal junction, withdrawal time, withdrawal speed, sliding lens, polyps in the field of vision, etc. These functions can improve the colonoscopy performance of novice physicians and assist the colonoscopy training。

Detailed Description

Colonoscopy is a key technique for detecting and diagnosing lesions of the lower digestive tract.High-quality endoscopy leads to better disease outcomes.However, the demand for endoscopy is high in China, and endoscopy is in short supply.A colonoscopy is a complex technical procedure that requires training and experience for maximal accuracy and safety.Therefore, it is of great significance to improve the colonoscopy ability of novice physicians and shorten the colonoscopy training time for solving the problems such as the lack and uneven distribution of digestive endoscopists and the substandard quality of endoscopy in China.

In recent years, deep learning algorithms have been continuously developed and increasingly mature.They have been gradually applied to the medical field. Computer vision is a science that studies how to make machines "see". Through deep learning, camera and computer can replace human eyes to carry out machine vision such as target recognition, tracking and measurement.Interdisciplinary cooperation in the field of medical imaging and computer vision is also one of the research hotspots in recent years. At present, it is mainly applied to the automatic identification and detection of lesions and quality control, and has achieved good results.

Our preliminary experiments have shown that deep learning has a high accuracy in endoscopic quality monitoring, which can effectively regulate doctors' operations, reduce blind spots and improve the quality of endoscopic examination.At the same time, it can also monitor the doctor's withdrawal time in real time and improve the detection rate of adenoma.In the previous work of our research group, we have successfully developed deep learning-based colonoscopy withdraw speed monitoring and intestinal cleanliness assessment, and verified the effectiveness of the AI-assisted system(EndoAngel) in improving the quality of gastroscopy and colonoscopy in clinical trials.

Based on the above rich foundation of preliminary work, as well as the huge demand in the field of colonoscopy training,By comparing the colonoscopy operation training for novices with and without EndoAngel assistance, we plan to compare the colonoscopy learning effect of novices with and without assistance, including skill results and cognitive level, to explore whether AI can promote the improvement of the colonoscopy operation training for novices.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
385
Inclusion Criteria
  1. Male or female ≥50 years old;
  2. Able to read, understand and sign informed consent
  3. The investigator believes that the subjects can understand the process of the clinical study, are willing and able to complete all study procedures and follow-up visits, and cooperate with the study procedures
  4. Patients requiring colonoscopy
Exclusion Criteria
  1. Have drug or alcohol abuse or mental disorder in the last 5 years
  2. Pregnant or lactating women
  3. Patients with known multiple polyp syndrome;
  4. patients with known inflammatory bowel disease;
  5. known intestinal stenosis or space-occupying tumor;
  6. known colon obstruction or perforation;
  7. patients with a history of colorectal surgery;
  8. Patients with previous history of allergy to pre-used spasmolysis;
  9. Unable to perform biopsy and polyp removal due to coagulation disorders or oral anticoagulants;
  10. High risk diseases or other special conditions that the investigator considers the subject unsuitable for participation in the clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
with AI-assisted systemartificial intelligence assistance systemThe novice doctors are trained in colonoscopy with an artificial intelligence assisted system that can indicate abnormal lesions and the speed of withdrawal in real time, as well as feedback on the percentage of overspeed.
Primary Outcome Measures
NameTimeMethod
CUSUM learning curve for colonoscopy (ACE scoring scale)From the beginning to the end of colonoscopy training
Average test score difference before and after trainingFrom the beginning to the end of colonoscopy training
Secondary Outcome Measures
NameTimeMethod
Average number of adenomas detected per patientA month

The numerator is the total number of adenomas detected by colonoscopy, and the denominator is the total number of patients undergoing colonoscopy.

The average number of large, small and micro adenomas detectedA month

The numerator is the total number of large (≥10 mm), small (6-9 mm) and micro-small (≤5 mm) adenomas detected by colonoscopy, and denominator is the total number of patients undergoing colonoscopy.

The average number of large, small and micro polyps detectedA month

The numerator is the total number of large (≥10 mm), small (6-9 mm) and micro-small (≤5 mm) polyps detected by colonoscopy, and denominator is the total number of patients undergoing colonoscopy.

Detection rate of advanced adenomaA month

The numerator is the number of patients diagnosed with advanced adenomas, and the denominator is the total number of patients undergoing colonoscopy,Advanced adenoma was defined as \> 10mm adenoma, villous adenoma, tubular villous adenoma, high-grade intraepithelial neoplasia, and carcinoma.

Polyp Detection Rate, PDRA month

The numerator is the number of patients with polyps detected by colonoscopy, and the denominator is the total number of patients who underwent colonoscopy

The detection rate of large, small and micro polypsA month

The numerator is the number of patients with large (≥10 mm), small (6-9 mm) and micro-small (≤5 mm) polyps detected by colonoscopy, and the denominator is the total number of patients receiving colonoscopy.

The detection rate of large, small and micro adenomasA month

The numerator is the number of patients with large (≥10 mm), small (6-9 mm) and micro-small (≤5 mm) adenomas detected by colonoscopy, and the denominator is the total number of patients receiving colonoscopy.

The average number of adenomas detected in different sitesA month

The numerator is the total number of adenomas detected in the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, ileocecal region and other sites during colonoscopy, and the denominator is the total number of patients undergoing colonoscopy.

Ratio of ileocecal reachA month

For a period of time, the number of colonoscopies that failed to reach the ileocecal part accounted for the proportion of the total number of colonoscopies.

Number of missed return of the sliding endoscopy/number of successful return of the sliding endoscopyA month

The numerator is the total number of sliding endoscopy during colonoscopy, and the denominator is the number of sliding endoscopy and successful return endoscopy during colonoscopy

Real-time gut cleanliness scoreDuring procedure

During colonoscopy, a real-time intestinal cleanliness score was given by EndoAngel based on the Boston-scale Boreal Preparation Score (BBPS).

The withdraw timeDuring procedure

The time between colonoscopy arrival at ileocecal valve and colonoscopy exit from anus.

The detection rate of adenoma in different sitesA month

The numerator is the number of patients with adenomas detected in the rectum, sigmoid colon, descending colon, transverse colon, ascending colon, ileocecal region and other sites during colonoscopy, and the denominator is the total number of patients receiving colonoscopy.

withdraw overspeed percentageDuring procedure

The ratio of the overspeed duration to the total duration in the process of withdrawal.

Trial Locations

Locations (1)

Renmin hospital of Wuhan University

🇨🇳

Wuhan, Hubei, China

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