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Creating a standardized tool for the evaluation and comparison of artificial intelligence–based computer-aided detection programs in colonoscopy: a modified Delphi approach - 14/06/25

Doi : 10.1016/j.gie.2024.11.042 
Sanjay R.V. Gadi, MD 1, , Yuichi Mori, MD, PhD 2, 3, 4, Masashi Misawa, MD, PhD 2, James E. East, MD 5, 6, Cesare Hassan, MD, PhD 7, 8, Alessandro Repici, MD 7, 8, Michael F. Byrne, MD 9, 10, Daniel von Renteln, MD 11, David G. Hewett, MBBS, PhD, MSc 12, Pu Wang, MD 13, Yutaka Saito, MD, PhD 14, Carolina Ogawa Matsubayashi, MD 15, 16, Omer F. Ahmad, MBBS 17, Prateek Sharma, MBBS 18, Seth A. Gross, MD 19, Neil Sengupta, MD 20, Nabil Mansour, MD 21, Andrea Cherubini, PhD 22, Nhan Ngo Dinh 22, Xiao Xiao, PhD 23, Peter Mountney, PhD 24, 25, Juana González-Bueno Puyal, PhD 24, 25, Greg Little, MBA 25, Shawn LaRocco, MBA 25, Sailesh Conjeti, PhD 25, Hannes Seibt, MS 26, Dror Zur, PhD 27, Hitoshi Shimada, BEE 28, Tyler M. Berzin, MD , 29, Jeremy R. Glissen Brown, MD, MSc , 30
1 Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA 
2 Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan 
3 Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway 
4 Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway 
5 Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford, United Kingdom 
6 Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, United Kingdom 
7 Department of Biomedical Sciences Humanitas University, Pieve Emanuele, Milan, Italy 
8 IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy 
9 Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada 
10 Satisfai Health, Vancouver, British Columbia, Canada 
11 Division of Gastroenterology, Montréal University Hospital and Research Center, Montréal, Québec, Canada 
12 School of Medicine, The University of Queensland, Brisbane, Queensland, Australia 
13 Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China 
14 Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan 
15 Gastrointestinal Endoscopy Unit, Gastroenterology Department, University of São Paulo Medical School, São Paulo, Brazil 
16 AI Medical Services Inc., Tokyo, Japan 
17 Wellcome/EPSRC Centre for Interventional & Surgical Sciences, University College London, London, United Kingdom 
18 Division of Gastroenterology and Hepatology, University of Kansas School of Medicine and VA Medical Center, Kansas City, Kansas, USA 
19 Division of Gastroenterology and Hepatology, New York University Langone Health System, New York, New York, USA 
20 Section of Gastroenterology, University of Chicago Medicine, Chicago, Illinois, USA 
21 Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, Texas, USA 
22 Cosmo Intelligent Medical Devices, Dublin, Ireland 
23 Wision AI, Palo Alto, California, USA 
24 Odin Vision, London, United Kingdom 
25 Olympus Corporation, Tokyo, Japan 
26 Pentax Medical Europe, Hamburg, Germany 
27 Magentiq Eye, Haifa, Israel 
28 FUJIFILM Healthcare Americas Corporation, Lexington, Massachusetts, USA 
29 Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA 
30 Division of Gastroenterology, Duke University Medical Center, Durham, North Carolina, USA 

Reprint requests: Sanjay R. V. Gadi, MD, Department of Medicine, Duke University School of Medicine, 2301 Erwin Rd, Durham, NC 22710.Department of MedicineDuke University School of Medicine2301 Erwin RdDurhamNC22710

Abstract

Background and Aims

Multiple computer-aided detection (CADe) software programs have now achieved regulatory approval in the United States, Europe, and Asia and are being used in routine clinical practice to support colorectal cancer screening. There is uncertainty regarding how different CADe algorithms may perform. No objective methodology exists for comparing different algorithms. We aimed to identify priority scoring metrics for CADe evaluation and comparison.

Methods

A modified Delphi approach was used. Twenty-five global leaders in CADe in colonoscopy, including endoscopists, researchers, and industry representatives, participated in an online survey over the course of 8 months. Participants generated 121 scoring criteria, 54 of which were deemed within the study scope and distributed for review and asynchronous e-mail–based open comment. Participants then scored criteria in order of priority on a 5-point Likert scale during ranking round 1. The top 11 highest priority criteria were re-distributed, with another opportunity for open comment, followed by a final round of priority scoring to identify the final 6 criteria.

Results

Mean priority scores for the 54 criteria ranged from 2.25 to 4.38 after the first ranking round. The top 11 criteria after round 1 of ranking yielded mean priority scores ranging from 3.04 to 4.16. The final 6 highest priority criteria, including a tie for first-place ranking, were (1, tied) sensitivity (average, 4.16) and (1, tied) separate and independent validation of the CADe algorithm (average, 4.16); (3) adenoma detection rate (average, 4.08); (4) false-positive rate (average, 4.00); (5) latency (average, 3.84); and (6) adenoma miss rate (average, 3.68).

Conclusions

This is the first reported international consensus statement of priority scoring metrics for CADe in colonoscopy. These scoring criteria should inform CADe software development and refinement. Future research should validate these metrics on a benchmark video dataset to develop a validated scoring instrument.

Le texte complet de cet article est disponible en PDF.

Abbreviations : ADR, AI, AMR, CADe, CRC, dBox, GTBox, IoU, LIS, NLIS, SSL


Plan


 DIVERSITY, EQUITY, AND INCLUSION: One or more of the authors of this paper self-identifies as an under-represented gender minority in science. One or more of the authors of this paper self-identifies as an under-represented ethnic minority in science. The author list of this paper includes contributors from the location where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.


© 2025  American Society for Gastrointestinal Endoscopy. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 102 - N° 1

P. 109 - juillet 2025 Retour au numéro
Article précédent Article précédent
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  • David Beaton, Linda Sharp, Nigel Trudgill, Mo Thoufeeq, Brian D. Nicholson, Peter Rogers, Allan John Morris, Matthew Rutter

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