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Effective Withdrawal Time and Adenoma Detection Rate

Prospective Evaluation of Artificial Intelligence-assisted Monitoring of Effective Withdrawal Time on Adenoma Detection

Status
Completed
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT06063720
Enrollment
193
Registered
2023-10-02
Start date
2023-11-01
Completion date
2025-01-31
Last updated
2025-09-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Artificial Intelligence, Colon Adenoma, Colonic Polyp

Keywords

Colonic Polyp, Artificial intelligence, Withdrawal time

Brief summary

This study prospectively evaluated the role of EWT versus SWT on adenoma detection rate (ADR) and other key quality metrics. In this prospective single-center study, patients undergoing colonoscopy were enrolled. EWT was calculated in real-time using an AI system with endoscopists blinded to the results. We performed multivariable analyses to assess the association of EWT and SWT with binary (e.g., ADR) and count outcomes (e.g., adenoma per colonoscopy \[APC\]), after adjusting for patient and procedural characteristics.

Detailed description

This was a prospective, single-center observational study designed to determine if an AI-powered metric, Effective Withdrawal Time (EWT), is a superior predictor of colonoscopy quality compared to the traditional Standard Withdrawal Time (SWT). All colonoscopies were performed by qualified endoscopists using high-definition white light video scopes. During the procedure, the scope is first advanced to the start of the large intestine (the cecum). The critical examination phase-the withdrawal-begins as the endoscopist slowly pulls the scope back out, meticulously inspecting the colon lining for abnormalities like polyps. It is during this withdrawal that the key metrics were measured. While SWT is a simple duration timed manually, the AI-measured EWT specifically quantifies the time of high-quality mucosal inspection, automatically excluding periods when the camera view is blurry, obscured, or moving too quickly. A crucial aspect of the methodology was that the endoscopists were blinded to the live EWT measurements to prevent the Hawthorne effect, where individuals alter their behaviour because they are being monitored. The study enrolled adults aged 40 and over, excluding patients with conditions that could confound the findings. The primary goal was to assess the independent impact of EWT on the Adenoma Detection Rate (ADR), a key benchmark based on the detection and removal of precancerous polyps for analysis. To achieve this, researchers used multivariable regression models to isolate EWT's effect from other variables and employed correlation tests to statistically compare whether EWT had a stronger relationship with detection quality than SWT

Interventions

DEVICEEndoscreen QC

Artificial intelligence monitoring of effective withdrawal time

Sponsors

The University of Hong Kong
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

All adult patients, aged 40 or above, undergoing outpatient colonoscopy will be recruited

Exclusion criteria

* history of inflammatory bowel disease * history of colorectal cancer * previous bowel resection (apart from appendectomy) * Peutz-Jeghers syndrome, familial adenomatous polyposis or other polyposis syndromes * bleeding tendency or severe comorbid illnesses for which polypectomy is considered unsafe. * Cecum could not be intubated for various reasons * Poor bowel preparation with Boston Bowel Preparation Scale (BBPS) \< 6

Design outcomes

Primary

MeasureTime frameDescription
Adenoma detection ratesDuring the colonoscopyAdenoma detection rates

Secondary

MeasureTime frameDescription
Serrated lesion detection rateDuring colonoscopySerrated lesion detection rates of that colonoscopy
Advanced adenoma detection rateDuring colonoscopyAdvanced adenoma detection rates of that colonoscopy
Adenoma per colonoscopyDuring colonoscopyAdenoma per colonoscopy
Polyp detection rateDuring that colonoscopyPolyp detection rates of the colonoscopy
Serrated lesion per colonoscopyDuring colonoscopySerrated lesion per colonoscopy
Advanced adenoma per colonoscopyDuring colonoscopyAdvanced adenoma per colonoscopy
Polyp per colonoscopyDuring colonoscopyPolyp per colonoscopy

Countries

Hong Kong

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Mar 19, 2026