Comparing blind spots of unsedated ultrafine, sedated, and unsedated conventional gastroscopy with and without artificial intelligence: a prospective, single-blind, 3-parallel-group, randomized, single-center trial
Comparing blind spots of unsedated ultrafine, sedated, and unsedated conventional gastroscopy with and without artificial intelligence: a prospective, single-blind, 3-parallel-group, randomized, single-center trial
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比较使用和不使用人工智能的无镇静超细胃镜检查、镇静胃镜检查和无镇静传统胃镜检查的盲点：一项前瞻性、单盲、3 平行组、随机、单中心试验
DOI：
10.1016/j.gie.2019.09.016
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发表时间：
2020-02-01
影响因子：
7.7
通讯作者：
Yu, Honggang
中科院分区：
文献类型：
--
作者：
Chen, Di;Wu, Lianlian;Yu, Honggang
背景和目的：EGD 是诊断上消化道病变最重要的方法。我们的目的是比较未镇静超薄经口内窥镜检查 (U-TOE)、未镇静传统 EGD (C-EGD) 和使用或不使用人工智能 (AI) 系统的镇静 C-EGD 的性能。 方法：在这项前瞻性、单盲、3 平行组、随机、单中心试验中，计划接受门诊 EGD 的 437 名患者被随机分配到未镇静 U-TOE，未镇静的 C-EGD 或镇静的 C-EGD，然后将每组分为 2 个亚组：有或没有人工智能系统的帮助来监测 EGD 期间的盲点。主要结果是这三组在人工智能辅助下的盲点率。次要结局是比较未镇静 U-TOE、未镇静和镇静 C-EGD 分别在有或没有 AI 辅助的情况下的盲点率，以及 AI 与内窥镜医师审查之间的一致性。 结果：AI 辅助镇静 C-EGD 的盲点率显着低于未镇静 U-TOE 和未镇静 C-EGD（3.42% vs 21.77% vs分别为 31.23%；P < .05)。所有 3 组中 AI 亚组的盲点率均低于对照组（镇静 C-EGD：3.42% vs 22.46%，P < .001；未镇静 U-TOE：21.77% vs 29.92%，P < .001；未镇静 C-EGD：31.23% vs 42.46%，P < .001） .001).结论：镇静C-EGD的盲点率在3种EGD中最低，AI的添加对镇静C-EGD的效果最大。
Background and Aims: EGD is the most vital procedure for the diagnosis of upper GI lesions. We aimed to compare the performance of unsedated ultrathin transoral endoscopy (U-TOE), unsedated conventional EGD (C-EGD), and sedated C-EGD with or without the use of an artificial intelligence (AI) system.Methods: In this prospective, single-blind, 3-parallel-group, randomized, single-center trial, 437 patients scheduled to undergo outpatient EGD were randomized to unsedated U-TOE, unsedated C-EGD, or sedated C-EGD, and each group was then divided into 2 subgroups: with or without the assistance of an AI system to monitor blind spots during EGD. The primary outcome was the blind spot rate of these 3 groups with the assistance of AI. The secondary outcomes were to compare blind spot rates of unsedated U-TOE, unsedated, and sedated C-EGD with or without the assistance of AI, respectively, and the concordance between AI and the endoscopists' review.Results: The blind spot rate with AI-assisted sedated C-EGD was significantly lower than that of unsedated U-TOE and unsedated C-EGD (3.42% vs 21.77% vs 31.23%, respectively; P < .05). The blind spot rate of the AI subgroup was lower than that of the control subgroup in all 3 groups (sedated C-EGD: 3.42% vs 22.46%, P < .001; unsedated U-TOE: 21.77% vs 29.92%, P < .001; unsedated C-EGD: 31.23% vs 42.46%, P < .001).Conclusions: The blind spot rate of sedated C-EGD was the lowest among the 3 types of EGD, and the addition of AI had a maximal effect on sedated C-EGD.