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Implementation of Optical Diagnosis of Diminutive Colorectal Polyps: DISCARD3 Study (Incorporating AI-DETECT)

Not Applicable
Completed
Conditions
Colonic Polyp
Interventions
Diagnostic Test: CAD polyp-detection system
Registration Number
NCT04710693
Lead Sponsor
London North West Healthcare NHS Trust
Brief Summary

This is a prospective feasibility study. The aim of this work is to assess the acceptability and feasibility of optical diagnosis-led care in bowel cancer screening patients undergoing colonoscopy. This study will determine whether bowel cancer screening colonoscopists are able to consistently record and diagnose diminutive adenomas suitable for a resect and discard strategy allowing assignment of surveillance intervals according to Preservation and Incorporation of Valuable Endoscopic Innovations (PIVI) criteria. A practical quality assurance program around optical diagnosis will be introduced. The use of a CAD polyp-detection system will also be evaluated (AI-DETECT).

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
614
Inclusion Criteria
  • Patients aged 60-74

    • with +ve Faecal Occult Blood/Faecal Immunochemical test attending for screening colonoscopy within BCSP (Bowel Cancer Screening Programme)
    • with an established history of adenomas attending for surveillance colonoscopy within BCSP
  • Patients aged 55 - referred for screening colonoscopy following positive Bowel Scope Screening flexible sigmoidoscopy

Exclusion Criteria
  • Patients with a risk profile (due to family history or other) whose follow-up will be outside standard BCSP
  • Patients with inflammatory bowel disease
  • Unable to consent
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
CAD polyp-detection systemCAD polyp-detection systemIn this arm, a CAD polyp detection system will be used during the colonoscopy.
Primary Outcome Measures
NameTimeMethod
Proportion of cases where optical diagnosis derived surveillance intervals concur with histopathology derived surveillance intervals2 weeks for each participant

For each participant, the surveillance interval according to international guidelines (UK, US, European) will be determined based on optical diagnoses alone and then separately based on histopathology results alone. The proportion of cases where both optical diagnosis derived and histopathology derived surveillance intervals agree will be calculated.

Learning curve to achieve accurate optical diagnosisThrough study completion, approximately 18-24 months

The investigators will assess endoscopist learning curve by calculating percentage of accurate optical diagnoses of diminutive polyps (when compared with histopathology) for all endoscopists over the course of the study.

Polyp detection rate (AI-DETECT)2 weeks for each participant

The investigators will assess the impact on polyp detection rate when using a CAD polyp-detection system.

Secondary Outcome Measures
NameTimeMethod
Adenoma detection rate (AI-DETECT)2 weeks for each participant

The investigators will assess the impact on adenoma detection rate when using a CAD polyp-detection system.

Sensitivity of optical diagnosis2 weeks for each participant

The sensitivity of optical diagnosis will be assessed for polyps identified during the course of the study.

Specificity of optical diagnosis2 weeks for each participant

The specificity of optical diagnosis will be assessed for polyps identified during the course of the study.

Serrated polyp detection rate (AI-DETECT)2 weeks for each participant

The investigators will assess the impact on serrated polyp detection rate when using a CAD polyp-detection system.

Trial Locations

Locations (1)

St Mark's Hospital

🇬🇧

Harrow, United Kingdom

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