Document Type : Systematic Review and Meta-analysis
Authors
1
Department of Internal Medicine, Faculty of Medicine, Universitas Sam Ratulangi/Prof. dr. R. D. Kandou Hospital, Manado, Indonesia.
2
S.K Lerik Regional Public Hospital, Kupang, East Nusa Tenggara, Indonesia.
3
Division of Gastroenterology-Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sam Ratulangi/Prof. dr. R. D. Kandou Hospital, Manado, Indonesia.
4
Department of Internal Medicine, Abdi Waluyo Hospital, Jakarta, Indonesia.
5
Division of Gastroenterology, Pancreatobiliary and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Abstract
Introduction: Colonoscopy may detect colorectal polyp and facilitate its removal in order to prevent colorectal cancer. However, substantial miss rate for colorectal adenomas detection still occurred during screening colonoscopy procedure. Nowadays, artificial intelligence (AI) have been employed in trials to improve polyp detection rate (PDR) and adenoma detection rate (ADR). Therefore, we would like to determine the impact of AI in increasing PDR and ADR. Methods: The present study adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 (PRISMA 2020) statement. To identify relevant literature, comprehensive searches were conducted on major scientific databases, including Pubmed, EBSCO-host, and Proquest. The search was limited to articles published up to November 30, 2022. Inclusion criteria for the study encompassed full-text accessibility, articles written in the English language, and randomized controlled trials (RCTs) that reported both ADR and PDR values, comparing conventional diagnostic methods with AI-aided approaches. To synthesize the data, we computed the combined pooled odds ratio (OR) using a random-effects model. This model was chosen due to the expectation of considerable heterogeneity among the selected studies. To evaluate potential publication bias, the Begg’s funnel diagram was employed. Results: A total of 13 studies were included in this study. Colonoscopy with AI had significantly higher PDR compared to without AI (pooled OR 1.46, 95% CI 1.13-1.89, p = 0.003) and higher ADR (pooled OR 1.58, 95% CI 1.37-1.82, p < 0.00001). PDR analysis showed moderate heterogeneity between included studies (p = 0.004; I2=63%). Furthermore, ADR analysis showed moderate heterogeneity (p < 0.007; I2 = 57%). Additionally, the funnels plot of ADR and PDR analysis showed an asymmetry plot and low publication bias. Conclusion: AI may improve colonoscopy result quality through improving PDR and ADR.
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