Influence of artificial intelligence on the diagnostic performance of endoscopists in the assessment of Barrett's esophagus: a tandem randomized and video trial.

Autor:	Meinikheim M; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Mendel R; Regensburg Medical Image Computing, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany., Palm C; Regensburg Medical Image Computing, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany., Probst A; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Muzalyova A; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Scheppach MW; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Nagl S; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Schnoy E; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Römmele C; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Schulz DAH; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Schlottmann J; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Prinz F; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Rauber D; Regensburg Medical Image Computing, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany., Rückert T; Regensburg Medical Image Computing, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany., Matsumura T; Department of Gastroenterology, Chiba University Graduate School of Medicine, Chiba, Japan., Fernández-Esparrach G; Endoscopy Unit, Gastroenterology Department, ICMDM, Hospital Clínic de Barcelona, Barcelona, Spain.; Faculty of Medicine, University of Barcelona, Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain., Parsa N; Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, United States.; Satisfai Health, Vancouver, Canada., Byrne MF; Satisfai Health, Vancouver, Canada.; Gastroenterology, Vancouver General Hospital, The University of British Columbia, Vancouver, Canada., Messmann H; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany., Ebigbo A; Department of Gastroenterology, University Hospital Augsburg, Augsburg, Germany.
Jazyk:	angličtina
Zdroj:	Endoscopy [Endoscopy] 2024 Sep; Vol. 56 (9), pp. 641-649. Date of Electronic Publication: 2024 Mar 28.
DOI:	10.1055/a-2296-5696
Abstrakt:	Background: This study evaluated the effect of an artificial intelligence (AI)-based clinical decision support system on the performance and diagnostic confidence of endoscopists in their assessment of Barrett's esophagus (BE). Methods: 96 standardized endoscopy videos were assessed by 22 endoscopists with varying degrees of BE experience from 12 centers. Assessment was randomized into two video sets: group A (review first without AI and second with AI) and group B (review first with AI and second without AI). Endoscopists were required to evaluate each video for the presence of Barrett's esophagus-related neoplasia (BERN) and then decide on a spot for a targeted biopsy. After the second assessment, they were allowed to change their clinical decision and confidence level. Results: AI had a stand-alone sensitivity, specificity, and accuracy of 92.2%, 68.9%, and 81.3%, respectively. Without AI, BE experts had an overall sensitivity, specificity, and accuracy of 83.3%, 58.1%, and 71.5%, respectively. With AI, BE nonexperts showed a significant improvement in sensitivity and specificity when videos were assessed a second time with AI (sensitivity 69.8% [95%CI 65.2%-74.2%] to 78.0% [95%CI 74.0%-82.0%]; specificity 67.3% [95%CI 62.5%-72.2%] to 72.7% [95%CI 68.2%-77.3%]). In addition, the diagnostic confidence of BE nonexperts improved significantly with AI. Conclusion: BE nonexperts benefitted significantly from additional AI. BE experts and nonexperts remained significantly below the stand-alone performance of AI, suggesting that there may be other factors influencing endoscopists' decisions to follow or discard AI advice. Competing Interests: N. Parsa is VP of medical affairs at Satisfai Health. M. Byrne is CEO and Founder of Satisfai Health. H. Messmann has received lecture fees from Olympus, Ambu, IPSEN, Medtronic, and Falk, and research grants from Olympus and Satisfai; he is also a consultant for Satisafi. A. Ebigbo has held lectures for Olympus, Fuji, Pentax, Medtronic, Falk, and Ambu. The remaining authors declare that they have no conflict of interest. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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