Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2025
Incremental value of mucosal exposure device to computer-aided detection in colonoscopy: A meta-analysis and trial sequential analysis.
СтатьяМетаанализОбзорНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Brigida Mattia, Spadaccini Marco, Maida Marcello, Almuhaidb Aymen, Gadour Eyad, Crinò Stefano Francesco, Dell'Anna Giuseppe, Donatelli Gianfranco, Andrisani Gianluca, Stasi Elisa, Dell'Anna Armando, Hassan Cesare, Mori Yuichi, Facciorusso Antonio
Аннотация
BACKGROUND: It is unknown if mucosal exposure device improves the adenoma detection rate (ADR) of computer-aided detection (CAD)-assisted colonoscopy.
AIMS: We performed a meta-analysis of randomized-controlled trials (RCTs) to compare the diagnostic outcomes of these two approaches.
METHODS: We identified 4 RCTs (2968 patients). ADR was the primary outcome. Advanced ADR (aADR), sessile serrated ADR (SSDR) and adenoma per colonoscopy (APC) were also compared. The results were expressed in terms of mean difference (MD) or risk ratio (RR) and 95% confidence intervals (CIs), and we used trial sequential analysis (TSA) to assess if the required information size (RIS) was reached.
RESULTS: There was no difference in terms of ADR both in the overall series (RR 1.05, 0.98-1.12; p=0.16) and in screening colonoscopy (RR 1.15, 0.72-1.82; p=0.56). Although the RIS (3829 participants) was not reached, the futility boundaries were crossed suggesting a high likelihood of futility in further comparison of ADR. No difference was observed in terms of aADR (RR 1.13, 0.90-1.44; p=0.30) and SSDR (RR 1.11, 0.92-1.35; p=0.27). APC was significantly higher in the combined group (MD 0.14, 0.05 to 0.22; p=0.002).
CONCLUSIONS: The addition of mucosal exposure devices does not increase ADR, aADR, and SSDR but increases APC.
AIMS: We performed a meta-analysis of randomized-controlled trials (RCTs) to compare the diagnostic outcomes of these two approaches.
METHODS: We identified 4 RCTs (2968 patients). ADR was the primary outcome. Advanced ADR (aADR), sessile serrated ADR (SSDR) and adenoma per colonoscopy (APC) were also compared. The results were expressed in terms of mean difference (MD) or risk ratio (RR) and 95% confidence intervals (CIs), and we used trial sequential analysis (TSA) to assess if the required information size (RIS) was reached.
RESULTS: There was no difference in terms of ADR both in the overall series (RR 1.05, 0.98-1.12; p=0.16) and in screening colonoscopy (RR 1.15, 0.72-1.82; p=0.56). Although the RIS (3829 participants) was not reached, the futility boundaries were crossed suggesting a high likelihood of futility in further comparison of ADR. No difference was observed in terms of aADR (RR 1.13, 0.90-1.44; p=0.30) and SSDR (RR 1.11, 0.92-1.35; p=0.27). APC was significantly higher in the combined group (MD 0.14, 0.05 to 0.22; p=0.002).
CONCLUSIONS: The addition of mucosal exposure devices does not increase ADR, aADR, and SSDR but increases APC.