Endoscopy
Signal score, how each part rates
ActionabilityPrevalenceStakesEvidence strengthNovelty
See the full rubric →Pragmatic real-world evaluation of computer-aided detection in colonoscopy: A within-endoscopist comparative study.
Clinical takeawayConsider adopting computer-aided detection systems in routine colonoscopy as an adjunctive tool. CADe remains independently associated with improved adenoma detection (aOR 1.31, 95% CI 1.11-1.55, p=0.002) after adjustment for endoscopist variation, confirming incremental benefit beyond endoscopy technique alone.
What it foundComputer-aided detection improved adenoma detection rate from 30.7% to 34.4% (aOR 1.31, 95%CI 1.11-1.55, p=0.002) and adenoma+clinically significant serrated polyp detection from 35.8% to 40.3% in a pragmatic real-world study of 2973 colonoscopies with within-endoscopist comparison.
ContextRandomised trials had shown CADe improves adenoma detection, but real-world translation remained uncertain with inconsistent results across observational studies. This pragmatic multicentre study confirms CADe provides independent benefit (aOR 1.31 after accounting for endoscopist factors), though the effect attenuates with endoscopist adjustment, revealing endoscopist skill as a substantial driver of detection rate.
Refinessuggested applicable standard· U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017
Decision at stakewhether to incorporate computer-aided detection technology during colonoscopy screening
U.S. Multi-Society Task Force on Colorectal Cancer (Rex DK, Boland CR, Dominitz JA, et al.), "Colorectal Cancer Screening: Recommendations for Physicians and Patients From the U.S. Multi-Society Task Force on Colorectal Cancer," Gastroenterology, 2017 · reviewed 2026-07-23 ↗Begin average-risk colorectal cancer screening at age 45 using a patient-centered shared-decision modality choice, colonoscopy every 10 years (preferred) or annual FIT as Tier 1 options, with multi-target stool DNA every 3 years, CT colonography every 5 years, or flexible sigmoidoscopy every 5 to 10 years as Tier 2 alternatives. A positive stool-based test requires diagnostic colonoscopy, and stool tests should not be ordered for patients who would decline follow-up colonoscopy. Generally stop at age 75 with individualized decisions for ages 76-85 and no screening beyond 85.
Bernardes C … Pimentel-Nunes P · Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · IF 4.2 · PubMed ↗