Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis

Title: Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis
Authors: Sivananthan, A
Nazarian, S
Ayaru, L
Patel, K
Ashrafian, H
Darzi, A
Patel, N
Item Type: Journal Article
Abstract: Background/Aims Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions. Methods A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling. Results Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07). Conclusions CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.
Issue Date: 12-May-2022
Date of Acceptance: 14-Dec-2021
DOI: 10.5946/ce.2021.228
ISSN: 2234-2400
Publisher: Hoon Jai Chun
Start Page: 355
End Page: 364
Journal / Book Title: Clinical Endoscopy
Volume: 55
Issue: 3
Copyright Statement: Copyright © 2022 Korean Society of Gastrointestinal Endoscopy. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publication Status: Published
Online Publication Date: 2022-05-12
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Department of Surgery and Cancer
Institute of Global Health Innovation

This item is licensed under a Creative Commons License Creative Commons