Real-time computer aided colonoscopy versus standard colonoscopy for improving adenoma detection rate: A meta-analysis of randomized-controlled trials.
Real-time computer aided colonoscopy versus standard colonoscopy for improving adenoma detection rate: A meta-analysis of randomized-controlled trials.
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DOI：
10.1016/j.eclinm.2020.100622
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发表时间：
2020-12
影响因子：
15.1
通讯作者：
Adler DG
中科院分区：
文献类型：
--
作者：
Mohan BP;Facciorusso A;Khan SR;Chandan S;Kassab LL;Gkolfakis P;Tziatzios G;Triantafyllou K;Adler DG
最近的前瞻性随机对照试验评估了基于深度卷积神经网络（CNN）的计算机辅助检测（CADe）在实时结肠镜检查中的病变。我们进行了这项meta分析，比较随机对照试验（rct）中基于深度CNN的CADe辅助结肠镜检查和标准结肠镜检查（SC）的腺瘤检出率（ADR）。检索了多个数据库（从建立到2020年5月），并将基于深度CNN的CADe辅助结肠镜检查与SC进行比较的平行随机对照试验纳入该分析。采用Mantel-Haenzel （M-H）随机效应模型，计算合并风险比（pooled risk ratio， RR）和平均差（mean difference， MD）。在两项研究之间，异质性以I2%的值评估。评估的结果包括其他每位患者的腺瘤参数。我们的最终分析中纳入了6项rct，这些rct使用基于深度CNN的CADe系统进行实时结肠镜检查。评估的患者总数为4962例（CADe组2480例，SC组2482例）。基于CADe的结肠镜检查显示有更高的不良反应，RR=1.5 (95% CI 1.3-1.72), p<0.0001, I2=56%；合并PDR， RR=1.42 (95% CI 1.33-1.51), p<0.00001, I2=9%；与SC相比，每名患者的腺瘤检测参数在CADe结肠镜检查中明显更好，撤镜时间增加（平均差异= 0.38,95% CI 0.05-0.72, p = 0.02）。根据我们的荟萃分析，基于深度CNN的CADe结肠镜检查取得了显著更高的ADR指标，尽管与SC相比，撤镜时间增加了。
Recent prospective randomized controlled trials have evaluated deep convolutional neural network (CNN) based computer aided detection (CADe) of lesions in real-time colonoscopy. We conducted this meta-analysis to compare the adenoma detection rate (ADR) of deep CNN based CADe assisted colonoscopy to standard colonoscopy (SC) from randomized controlled trials (RCTs). Multiple databases were searched (from inception to May 2020) and parallel RCTs that compared deep CNN based CADe assisted colonoscopy to SC were included for this analysis. Using Mantel-Haenzel (M-H) random effects model, pooled risk ratios (RR) and mean difference (MD) were calculated. In between study heterogeneity was assessed by I2% values. Outcomes assessed included other per patient adenoma parameters. Six RCTs were included in our final analysis that utilized deep CNN based CADe system in real-time colonoscopy. Total numbers of patients assessed were 4962 (2480 in CADe and 2482 in SC group). CADe based colonoscopy demonstrated statistically higher pooled ADR, RR=1.5 (95% CI 1.3–1.72), p<0.0001, I2=56%; and pooled PDR, RR=1.42 (95% CI 1.33–1.51), p<0.00001, I2=9%; when compared to SC. Per patient adenoma detection parameters were significantly better with CADe colonoscopy when compared to SC, with increased scope withdrawal time (mean difference = 0.38, 95% CI 0.05–0.72, p = 0.02). Based on our meta-analysis, deep CNN based CADe colonoscopy achieved significantly higher ADR metrics, albeit with increased scope withdrawal time when compared to SC.
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影响因子：
29.4
作者：
Repici, Alessandro;Badalamenti, Matteo;Hassan, Cesare
通讯作者：
Hassan, Cesare
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
DOI：
10.1056/nejmoa1309086
发表时间：
2014-04-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Corley DA;Jensen CD;Marks AR;Zhao WK;Lee JK;Doubeni CA;Zauber AG;de Boer J;Fireman BH;Schottinger JE;Quinn VP;Ghai NR;Levin TR;Quesenberry CP
通讯作者：
Quesenberry CP
影响因子：
35.7
作者：
Wang, Pu;Liu, Xiaogang;Zhou, Guanyu
通讯作者：
Zhou, Guanyu
影响因子：
105.7
作者：
Higgins, JPT;Thompson, SG;Altman, DG
通讯作者：
Altman, DG