This trial is evaluating whether Computer-aided polypectomy decision support by Artificial Intelligence will improve 4 primary outcomes in patients with Adenomatous Polyps. Measurement will happen over the course of 3 weeks.
This trial requires 605 total participants across 2 different treatment groups
This trial involves 2 different treatments. Computer-aided Polypectomy Decision Support By Artificial Intelligence is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Treatment for adenomatous polyps can include lifestyle modification, dietary modification to improve nutrition, medications for management of comorbidities, and endoscopic removal. Surgery is reserved for those that are refractory to medications or have a high-risk of malignancy.
In this large population-based study (n = 12,957), a lower prevalence of AP was found among males and those ≤60 years old. AP were associated with some environmental factors such as smoking and alcoholic drinking. It showed that men with AP had a greater risk of gastric cancer than women. AP were detected by colonoscopy, but gastric cancer was confirmed by histological examination of the gastric biopsy specimens.
Results from a recent clinical trial demonstrates that endoscopic removal of polyps with adequate margins significantly decreases the incidence of subsequent adenomatous polyp recurrence. In the absence of clinical or histologic recurrence it may be appropriate to recommend surgery as primary therapy in selected patients.
About 1 in 100,000 Americans over age 40 have at least one adenomatous rectal polyp a year. Adenoma is a major precancerous lesion, the adenomatous polyp being the earliest stage of lesion. The incidence is relatively higher than other polyps in the distal colon.
Most adenomatous polyps are asymptomatic and are discovered during colonoscopy for other reasons. A polyp is distinguished by the presence of villous or flat features. A villous adenomatous polyp is an obvious sign of adenomatous polyp, where as a flat adenomatous polyp and adenomatous hyperplasia without villous component can be missed.
Adenomatous polyps are a common finding in individuals between the ages of 40 and 50; the average age of presentation is approximately 45. They are most commonly seen in Caucasians, but they can be seen in other races. Adenomatous polyps are associated with a number of complications, and treatment is usually needed. Adenomatous polyp is an adenocarcinoma.
The use of artificial intelligence does not allow any recommendation for removal of an adenomatous polyp, if the procedure is only performed by the endoscopist.
Physicians have strong motives for participating in clinical trials that include prevention of illness (for example, colorectal cancer for polyps at risk), a disease state that is already known to be troublesome or harmful, and that will be exacerbated by the development of the disease in the absence of treatment. Physicians, not physicians' patients, are the primary target of clinical trials aiming at preventing adenomatous polyps.
AI decision support is feasible in clinical polyp detection. The overall polyp detection rate was equivalent between the computer-supported and conventional methods. AI-supported polyp detection is preferable in detecting small polyps of <4 mm. The automated polyp detection method has the potential to reduce operator error and increase the accuracy of polyp diagnosis.
Computerized methods of polyp detection may improve the accuracy of polypectomy. This result suggests that artificial intelligence techniques could be used to help in achieving a more appropriate amount of polyp removal for individual patients.
About 40% of patients with polyps in general do not have any identifiable cause for polyps. In most of these patients the principal risk factor is tobacco. However, 10% of patients with polyps do not smoke. In this latter group, about 15% of the patients are from the group where other risk factors for colon cancer such as family history have been found. The major risk factors for either smoking or familial occurrence of colon cancer are related to genetic abnormalities. The identification of these genes may help us to clarify the pathology of adenomatous polyps and of the development of colon cancer.
Artificial intelligence and computer-aided polypectomy decision support systems are capable of improving the detection of adenomatous polyps, the prediction of histopathologic features of polyps, and the prediction of surgical difficulty.