Computer-Aided Diagnosis for Leaving Colorectal Polyps In Situ: A Systematic Review and Meta-analysis
Open accessAbstract
BACKGROUND: Computer-aided diagnosis (CADx) allows prediction of polyp histology during colonoscopy, which may reduce unnecessary removal of nonneoplastic polyps. However, the potential benefits and harms of CADx are still unclear. PURPOSE: To quantify the benefit and harm of using CADx in colonoscopy for the optical diagnosis of small (≤5-mm) rectosigmoid polyps. DATA SOURCES: Medline, Embase, and Scopus were searched for articles published before 22 December 2023. STUDY SELECTION: Histologically verified diagnostic accuracy studies that evaluated the real-time performance of physicians in predicting neoplastic change of small rectosigmoid polyps without or with CADx assistance during colonoscopy. DATA EXTRACTION: The clinical benefit and harm were estimated on the basis of accuracy values of the endoscopist before and after CADx assistance. The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework. The outcome measure for benefit was the proportion of polyps predicted to be nonneoplastic that would avoid removal with the use of CADx. The outcome measure for harm was the proportion of neoplastic polyps that would be not resected and left in situ due to an incorrect diagnosis with the use of CADx. Histology served as the reference standard for both outcomes. DATA SYNTHESIS: Ten studies, including 3620 patients with 4103 small rectosigmoid polyps, were analyzed. The studies that assessed the performance of CADx alone (9 studies; 3237 polyps) showed a sensitivity of 87.3% (95% CI, 79.2% to 92.5%) and specificity of 88.9% (CI, 81.7% to 93.5%) in predicting neoplastic change. In the studies that compared histology prediction performance before versus after CADx assistance (4 studies; 2503 polyps), there was no difference in the proportion of polyps predicted to be nonneoplastic that would avoid removal (55.4% vs. 58.4%; risk ratio [RR], 1.06 [CI, 0.96 to 1.17]; moderate-certainty evidence) or in the proportion of neoplastic polyps that would be erroneously left in situ (8.2% vs. 7.5%; RR, 0.95 [CI, 0.69 to 1.33]; moderate-certainty evidence). LIMITATION: The application of optical diagnosis was only simulated, potentially altering the decision-making process of the operator. CONCLUSION: Computer-aided diagnosis provided no incremental benefit or harm in the management of small rectosigmoid polyps during colonoscopy. PRIMARY FUNDING SOURCE: European Commission. (PROSPERO: CRD42023402197).
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Written from the paper’s full text.
TL;DR
This systematic review and meta-analysis found that computer-aided diagnosis (CADx) provided no incremental benefit or harm when used to support optical diagnosis of small (≤5-mm) rectosigmoid polyps during colonoscopy. Compared with endoscopists' unassisted predictions, CADx did not significantly change the proportion of nonneoplastic polyps left in situ or the proportion of neoplastic polyps erroneously left in situ.
Key findings
- Across 10 studies (3620 patients, 4103 small rectosigmoid polyps), studies assessing CADx alone (9 studies; 3237 polyps) showed a sensitivity of 87.3% (95% CI, 79.2%–92.5%) and specificity of 88.9% (95% CI, 81.7%–93.5%) for predicting neoplastic change.
- In the 4 studies comparing performance before versus after CADx assistance (2503 polyps), there was no difference in the proportion of polyps predicted to be nonneoplastic that would avoid removal (55.4% vs. 58.4%; RR, 1.06 [95% CI, 0.96–1.17]; moderate-certainty evidence).
- There was also no difference in the proportion of neoplastic polyps erroneously left in situ (8.2% vs. 7.5%; RR, 0.95 [95% CI, 0.69–1.33]; moderate-certainty evidence).
- Conclusion: CADx provided no incremental benefit or harm in the management of small rectosigmoid polyps during colonoscopy.
Methods
- Design: Systematic review and meta-analysis of histologically verified diagnostic accuracy studies evaluating real-time physician performance in predicting neoplastic change of small rectosigmoid polyps without or with CADx assistance during colonoscopy.
- Data sources: Medline, Embase, and Scopus searched for articles published before 22 December 2023.
- Analysis: Clinical benefit (proportion of polyps predicted nonneoplastic that would avoid removal) and harm (proportion of neoplastic polyps erroneously left in situ) were estimated from endoscopist accuracy before and after CADx assistance, with histology as the reference standard; certainty of evidence assessed using GRADE.
Limitations
- Stated: The application of optical diagnosis was only simulated, potentially altering the operator's decision-making process.
- Evident from the text: The benefit/harm estimates derive from simulated rather than actual removal decisions, and the before-versus-after comparison rests on only 4 studies (2503 polyps), with confidence intervals for both outcomes crossing the null.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
- Findingown data§ Abstract
In studies assessing CADx alone (9 studies; 3237 polyps), the specificity in predicting neoplastic change was 88.9% (95% CI, 81.7% to 93.5%).
“The studies that assessed the performance of CADx alone (9 studies; 3237 polyps) showed a sensitivity of 87.3% (95% CI, 79.2% to 92.5%) and specificity of 88.9% (CI, 81.7% to 93.5%) in predicting neoplastic change.”
Quote in the paperNot a substantial claim - Findingown data§ Abstract
In studies comparing histology prediction before versus after CADx assistance (4 studies; 2503 polyps), there was no difference in the proportion of polyps predicted to be nonneoplastic that would avoid removal (55.4% vs. 58.4%; RR, 1.06 [CI, 0.96 to 1.17]; moderate-certainty evidence).
“In the studies that compared histology prediction performance before versus after CADx assistance (4 studies; 2503 polyps), there was no difference in the proportion of polyps predicted to be nonneoplastic that would avoid removal (55.4% vs. 58.4%; risk ratio [RR], 1.06 [CI, 0.96 to 1.17]; moderate-certainty evidence) or in the proportion of neoplastic polyps that would be erroneously left in situ”
Quote in the paperSubstantial claim - Findingown data§ Abstract
Ten studies, including 3620 patients with 4103 small rectosigmoid polyps, were analyzed.
“Ten studies, including 3620 patients with 4103 small rectosigmoid polyps, were analyzed.”
Quote in the paperSubstantial claim - Findingown data§ Abstract
In studies assessing CADx alone (9 studies; 3237 polyps), the sensitivity in predicting neoplastic change was 87.3% (95% CI, 79.2% to 92.5%).
“The studies that assessed the performance of CADx alone (9 studies; 3237 polyps) showed a sensitivity of 87.3% (95% CI, 79.2% to 92.5%) and specificity of 88.9% (CI, 81.7% to 93.5%) in predicting neoplastic change.”
Quote in the paperNot a substantial claim - Findingown data§ Abstract
In studies comparing histology prediction before versus after CADx assistance (4 studies; 2503 polyps), there was no difference in the proportion of neoplastic polyps that would be erroneously left in situ (8.2% vs. 7.5%; RR, 0.95 [CI, 0.69 to 1.33]; moderate-certainty evidence).
“or in the proportion of neoplastic polyps that would be erroneously left in situ (8.2% vs. 7.5%; RR, 0.95 [CI, 0.69 to 1.33]; moderate-certainty evidence).”
Quote in the paperSubstantial claim
- Classified as probably not a substantial claim. 3
- May combine two claims. 2
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone given§ AbstractThe certainty of evidence was assessed using the GRADE framework.
“The certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) framework.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone given§ AbstractThe application of optical diagnosis was only simulated, potentially altering the decision-making process of the operator.
“The application of optical diagnosis was only simulated, potentially altering the decision-making process of the operator.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown data§ AbstractComputer-aided diagnosis provided no incremental benefit or harm in the management of small rectosigmoid polyps during colonoscopy.
“Computer-aided diagnosis provided no incremental benefit or harm in the management of small rectosigmoid polyps during colonoscopy.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductnone given§ AbstractHistology served as the reference standard for both outcomes.
“Histology served as the reference standard for both outcomes.”
Quote in the paperSubstantial claim
The paper relies on this without support.
Computer-aided diagnosis allows prediction of polyp histology during colonoscopy.
“Computer-aided diagnosis (CADx) allows prediction of polyp histology during colonoscopy”
The paper relies on this without support.
The potential benefits and harms of CADx are still unclear.
“However, the potential benefits and harms of CADx are still unclear.”
Cites
GRADE: an emerging consensus on rating quality of evidence and strength of recommendations
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008) · BMJ · doi:10.1136/bmj.39489.470347.ad · Cited by 23,305 · cited 1× · see citing works
“We rated the certainty of the evidence according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) (19, 20) approach.”
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575 · see citing works
QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies
Whiting, P. F., Rutjes, A. W. S., Westwood, M. E., Mallett, S., Deeks, J. J., Reitsma, J. B., Leeflang, M. M. G., Sterne, J. A. C., Bossuyt, P. M. M., & the QUADAS-2 Group* (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-155-8-201110180-00009 · Cited by 14,199 · see citing works
Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death
Bretthauer, M., Løberg, M., Wieszczy, P., Kalager, M., Emilsson, L., Garborg, K., Rupinski, M., Dekker, E., Spaander, M., Bugajski, M., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2208375 · Cited by 817 · see citing works
Self-citationRex, D. K., Kahi, C., O'Brien, M., Levin, T. R., Pohl, H., Rastogi, A., Burgart, L., Imperiale, T., Ladabaum, U., Cohen, J., et al. (2011) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2011.01.023 · Cited by 629 · see citing works
Self-citationMori, Y., Kudo, S.-E., Misawa, M., Saito, Y., Ikematsu, H., Hotta, K., Ohtsuka, K., Urushibara, F., Kataoka, S., Ogawa, Y., et al. (2018) · Annals of Internal Medicine · doi:10.7326/m18-0249 · Cited by 509 · see citing works
Self-citationIgnjatovic, A., East, J. E., Suzuki, N., Vance, M., Guenther, T., & Saunders, B. P. (2009) · The Lancet Oncology · doi:10.1016/s1470-2045(09)70329-8 · Cited by 366 · see citing works
A Resect and Discard Strategy Would Improve Cost-Effectiveness of Colorectal Cancer Screening
Hassan, C., Pickhardt, P. J., & Rex, D. K. (2010) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2010.05.018 · Cited by 294 · see citing works
Self-citationExperimental evidence of effective human–AI collaboration in medical decision-making
Reverberi, C., Rigon, T., Solari, A., Hassan, C., Cherubini, P., GI Genius CADx Study Group, Antonelli, G., Awadie, H., Bernhofer, S., Carballal, S., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-18751-2 · Cited by 235 · see citing works
Self-citationRees, C. J., Rajasekhar, P. T., Wilson, A., Close, H., Rutter, M. D., Saunders, B. P., East, J. E., Maier, R., Moorghen, M., Muhammad, U., et al. (2017) · Gut · doi:10.1136/gutjnl-2015-310584 · Cited by 211 · see citing works
Kessler, W. R., Imperiale, T. F., Klein, R. W., Wielage, R. C., & Rex, D. K. (2011) · Endoscopy · doi:10.1055/s-0030-1256381 · Cited by 164 · see citing works
Self-citationRisk of cancer in small and diminutive colorectal polyps
Ponugoti, P. L., Cummings, O. W., & Rex, D. K. (2016) · Digestive and Liver Disease · doi:10.1016/j.dld.2016.06.025 · Cited by 157 · see citing works
Self-citationRondonotti, E., Hassan, C., Tamanini, G., Antonelli, G., Andrisani, G., Leonetti, G., Paggi, S., Amato, A., Scardino, G., Di Paolo, D., et al. (2023) · Endoscopy · doi:10.1055/a-1852-0330 · Cited by 128 · see citing works
Self-citationReal-Time Artificial Intelligence–Based Optical Diagnosis of Neoplastic Polyps during Colonoscopy
Barua, I., Wieszczy, P., Kudo, S.-E., Misawa, M., Holme, Ø., Gulati, S., Williams, S., Mori, K., Itoh, H., Takishima, K., et al. (2022) · NEJM Evidence · doi:10.1056/evidoa2200003 · Cited by 119 · see citing works
Self-citationArtificial Intelligence Allows Leaving-In-Situ Colorectal Polyps
Hassan, C., Balsamo, G., Lorenzetti, R., Zullo, A., & Antonelli, G. (2022) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2022.04.045 · Cited by 119 · see citing works
Self-citationHouwen, B. B. S. L., Hassan, C., Coupé, V. M. H., Greuter, M. J. E., Hazewinkel, Y., Vleugels, J. L. A., Antonelli, G., Bustamante-Balén, M., Coron, E., Cortas, G. A., et al. (2022) · Endoscopy · doi:10.1055/a-1689-5130 · Cited by 99 · see citing works
Self-citationWadhwa, V., Alagappan, M., Gonzalez, A. J., Gupta, K., Brown, J. R. G., Cohen, J., Sawhney, M., Pleskow, D. K., & Berzin, T. M. (2020) · Endoscopy International Open · doi:10.1055/a-1223-1926 · Cited by 82 · see citing works
Self-citationRastogi, A. N., Rao, D. S., Gupta, N., Grisolano, S. W., Buckles, D. C., Sidorenko, E. I., Bonino, J. A., Matsuda, T., Dekker, E., Kaltenbach, T. R., et al. (2013) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2013.07.032 · Cited by 81 · see citing works
Self-citationGRADE Guidance: 31. Assessing the certainty across a body of evidence for comparative test accuracy
Yang, B., Mustafa, R. A., Bossuyt, P. M., Brożek, J., Hultcrantz, M., Leeflang, M., Schünemann, H. J., & Langendam, M. W. (2021) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2021.04.001 · Cited by 71 · see citing works
Wisse, P. H. A., Erler, N. S., de Boer, S. Y., den Hartog, B., Pool, M. O., Droste, J. S. T. S., Verveer, C., Meijer, G. A., Lansdorp‐Vogelaar, I., Kuipers, E. J., et al. (2022) · Annals of Internal Medicine · doi:10.7326/m22-0301 · Cited by 69 · see citing works
Self-citationLi, J. W., Wu, C. C. H., Lee, J. W. J., Liang, R., Soon, G. S. T., Wang, L. M., Koh, X. H., Koh, C. J., Chew, W. D., Lin, K. W., et al. (2023) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002282 · Cited by 61 · see citing works
Self-citationRex, D. K., Bhavsar‐Burke, I., Buckles, D. C., Burton, J. R., Cartee, A. K., Comar, K. M., Edwards, A. L., Fennimore, B. P., Fischer, M., Gerich, M. E., et al. (2024) · Annals of Internal Medicine · doi:10.7326/m24-0086 · Cited by 51 · see citing works
Self-citationAdenoma Detection Rate and Colorectal Cancer Risk in Fecal Immunochemical Test Screening Programs
Zorzi, M., Antonelli, G., Amidei, C. B., Battagello, J., Germanà, B., Valiante, F., Benvenuti, S., Tringali, A., Bortoluzzi, F., Cervellin, E., et al. (2023) · Annals of Internal Medicine · doi:10.7326/m22-1008 · Cited by 50 · see citing works
Self-citationHouwen, B. B. S. L., Hazewinkel, Y., Giotis, I., Vleugels, J. L. A., Mostafavi, N. S., van Putten, P., Fockens, P., Dekker, E., & POLAR Study Group (2023) · Endoscopy · doi:10.1055/a-2009-3990 · Cited by 48 · see citing works
Self-citationHassan, C., Sharma, P., Mori, Y., Bretthauer, M., Rex, D. K., Spadaccini, M., Selvaggio, C., Antonelli, G., Khalaf, K., Rizkala, T., et al. (2023) · Gastroenterology · doi:10.1053/j.gastro.2022.10.021 · Cited by 46 · see citing works
Self-citationMinegishi, Y., Kudo, S., Miyata, Y., Nemoto, T., Mori, K., Misawa, M., Mori, Y., Mochida, K., Akimoto, Y., Ishiyama, M., et al. (2022) · Gastroenterology · doi:10.1053/j.gastro.2022.03.053 · Cited by 42 · see citing works
Self-citationBaumer, S., Streicher, K., Alqahtani, S. A., Brookman-Amissah, D., Brunner, M., Federle, C., Muehlenberg, K., Pfeifer, L., Salzberger, A., Schorr, W., et al. (2023) · Endoscopy International Open · doi:10.1055/a-2096-2960 · Cited by 23 · see citing works
Optical biopsy and sessile serrated polyps: Is DISCARD dead? Long live DISCARD-lite!
Atkinson, N. S. S., & East, J. E. (2015) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2015.01.059 · Cited by 22 · see citing works
Okamoto, Y., Oka, S., Tanaka, S., Kamigaichi, Y., Tamari, H., Shimohara, Y., Nishimura, T., Inagaki, K., Tanaka, H., Matsumoto, K., et al. (2021) · BMC Gastroenterology · doi:10.1186/s12876-021-01676-x · Cited by 11 · see citing works
Orlović, M., Ahmad, A., & Saunders, B. P. (2023) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2023.01.054 · Cited by 11 · see citing works
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Self-citationMakar, J., Abdelmalak, J., Con, D., Hafeez, B., & Garg, M. (2024) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2024.08.033 · Cited by 135 · see citing works
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Self-citationRizkala, T., Hassan, C., Mori, Y., Spadaccini, M., Antonelli, G., Dekker, E., Houwen, B. B. S. L., Pech, O., Baumer, S., Rondonotti, E., et al. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.08.021 · Cited by 20 · see citing works
Self-citationAng, T. L., Dao, H. V., Li, J. W., Ho, J. C. L., Sy‐Janairo, M. L. L., Ali, R. A. R., Makharia, G. K., Sundaram, S., Chantarojanasiri, T., Kim, H. G., et al. (2025) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16896 · Cited by 17 · see citing works
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Self-citationChen, S., Peng, Y., Liu, Y., Wang, P., & Liu, T. (2025) · Diagnostics · doi:10.3390/diagnostics15161988 · Cited by 14 · see citing works
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Tong, Y., Chen, Z., Zhou, Z., Hu, Y., Li, X., & Qiao, X. (2024) · Bioengineering · doi:10.3390/bioengineering11100959 · Cited by 12 · see citing works
Shinozaki, S., Watanabe, J., Kanno, T., Yuan, Y., Yano, T., & Yamamoto, H. (2025) · Digestive Endoscopy · doi:10.1111/den.15047 · Cited by 9 · see citing works
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Antonelli, G., Desideri, F., Scarozza, P., Andrisani, G., Zerboni, G., Furnari, M., Bevilacqua, N., Cossignani, M., Fonzo, M. D., Cereatti, F., et al. (2025) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(25)00140-2 · Cited by 8 · see citing works
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Wallace, M. B. (2025) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2025.08.038 · Cited by 1 · see citing works
Gimeno‐García, A. Z., Hernández-Pérez, A., Negrín, D. H., Rodríguez-Hernández, E., Lorenzo, G., Mon, J., Romero, R., Jiménez, A., Felipe, V., Adrián, Z., et al. (2026) · Gastroenterología y Hepatología · doi:10.1016/j.gastrohep.2026.502757 · Cited by 1 · see citing works
Medawar, E., Oleksiw, M., Rex, D. K., Hassan, C., Djinbachian, R., Michal, V., Battat, R. J., Deslandres, É., Bouin, M., Kiow, J. L. C., et al. (2026) · Endoscopy · doi:10.1055/a-2882-7665 · Cited by 1 · see citing works
Self-citationKang, H. Y., Kang, S., Chung, G. E., Baek, D. H., Lee, H. S., Park, J., Yang, S. Y., Lim, S. H., Choi, J. M., Kim, J., et al. (2026) · Gut and Liver · doi:10.5009/gnl250331
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Hann, A. (2025) · Die Gastroenterologie · doi:10.1007/s11377-024-00846-z
Artificial Intelligence for Leaving in Situ Colorectal Polyps: results from a Randomised Trial
Antonelli, G., Desideri, F., Scarozza, P., Andrisani, G., Zerboni, G., Furnari, M., Bevilacqua, N., Cossignani, M., Fonzo, M. D., Cereatti, F., et al. (2025) · Endoscopy · doi:10.1055/s-0045-1805104
Self-citationOptical diagnosis of colorectal neoplasms from an Eastern perspective
Ichimasa, K., Kudo, S.-E., Kouyama, Y., Okumura, T., Yasuharu, M., Hayashi, T., Wakamura, K., Yeoh, K. G., Nemoto, T., & Misawa, M. (2025) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2025.102016
Self-citationArtificial Intelligence in Gastroenterology
Rizkala, T., & Hassan, C. (2025) · Digestive and Liver Disease · doi:10.1016/j.dld.2025.09.001
Self-citationManagement of colorectal polyps: update and future directions
Gauci, J. L., & Bourke, M. J. (2026) · Frontline Gastroenterology · doi:10.1136/flgastro-2025-103152
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Gimpaya, N., Landy, J. S., Tran, W. T., & Grover, S. C. (2026) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/j.giec.2026.01.012
Huang, M., Sun, L., Weng, Y., Hu, H., Yang, Q., Lei, J., Tang, W., & Han, L. (2026) · Surgical Endoscopy · doi:10.1007/s00464-026-12757-x
Nabil, H. R., Prity, F. S., Hasan, M. M., & Mridha, M. F. (2026) · Computer Methods and Programs in Biomedicine Update · doi:10.1016/j.cmpbup.2026.100252
Oleksiw, M., Medawar, E., Rex, D. K., Hassan, C., Djinbachian, R., Michal, V., Battat, R. J., Deslandres, É., Bouchard, S., Bouin, M., et al. (2026) · Endoscopy · doi:10.1055/s-0046-1820800
Self-citationDownes, N., Dadswell, C., Ip, S., Mackenzie, I., Wakefield, V., & Edwards, S. J. (2026) · BMJ Digital Health & AI · doi:10.1136/bmjdh-2026-000046
Jans, A., & Bisschops, R. (2026) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2026.102125
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Wu, Z., Ou, W., Zhang, L., Tan, P.-S., Wu, D., Zhao, J., Fang, W., & Phan, R. C. ‐. (2026) · Lecture notes in computer science · doi:10.1007/978-3-032-31397-3_24
Salman, A. (2026) · Journal of Digestive Endoscopy · doi:10.1055/s-0046-1829025
Artificial Intelligence-enhanced Polyp Detection and Characterization in Colonoscopy
Rizkala, T., Khalaf, K., Spadaccini, M., Repici, A., & Hassan, C. (2026) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2026.08.002
Self-citationSuchánek, Š., Ambrožová, M., Grega, T., Chloupková, R., Májek, O., Seifert, B., Kocna, P., Bureš, J., Dušek, L., & Zavoral, M. (2026) · Cancers · doi:10.3390/cancers18193082
Cheang, W., Han, Z., & 介建政 (2026) · Frontiers in Oncology · doi:10.3389/fonc.2026.1947280
Xue, W., Wang, X., Yang, T., & Yu, H. (2026) · EngMedicine · doi:10.1016/j.engmed.2026.100168
AI-coaching and well-being in sales: a theory of tools perspective
Childs, D. R. N., Good, V., Fehl, A. G., Tanner, E., & Lee, N. (2026) · Journal of Personal Selling & Sales Management · doi:10.1080/08853134.2026.2738649
Gimeno‐García, A. Z., Hernandez, A., Negrín, D. H., Rodríguez, E., Lorenzo, G., Mon, J., Romero, R., Jiménez, A., Felipe, V., Adrián, Z., et al. (2026) · Gastroenterología y Hepatología (English Edition) · doi:10.1016/j.gastre.2026.502757
Oleksiw, M., Djinbachian, R., & Von Renteln, D. (2025) · Endoscopy · doi:10.1055/s-0045-1805444 · Cited by 2 · see citing works
- Authors
- Hassan, C., Misawa, M., Rizkala, T., Mori, Y., Sultan, S., Facciorusso, A., Antonelli, G., Spadaccini, M., Houwen, B. B. S. L., Rondonotti, E., Patel, H., Khalaf, K., Li, J. W., Fernandez, G. M., Bhandari, P., Dekker, E., Gross, S., Berzin, T., Vandvik, P. O., Correale, L., Kudo, S.-E., Sharma, P., Rex, D. K., Repici, A., Foroutan, F., & CADx Analysis Study Group
- Affiliations
- Humanitas University (IT)
- SHOWA Medical University Northern Yokohama Hospital (JP)
- IRCCS Humanitas Research Hospital (IT)
- Oslo University Hospital (NO)
- University of Minnesota (US)
- University of Foggia (IT)
- Sapienza University of Rome (IT)
- Amsterdam University Medical Centers (NL)
- Ospedale Valduce (IT)
- Kansas City VA Medical Center (US)
- St. Michael's Hospital (CA)
- SingHealth (SG)
- Endoscopy Unit, Gastroenterology Department, Clinical Institute of Digestive and Metabolic Disease, Hospital Clínic de Barcelona, University of Barcelona, Barcelona, Spain (G.M.F.)
- Queen Alexandra Hospital (GB)
- NYU Langone Health (US)
- Beth Israel Deaconess Medical Center (US)
- Lovisenberg Diakonale Sykehus (NO)
- Indiana University Hospital (US)
- University Health Network (CA)
- Corresponding author
- Hassan, Cesare
- Misawa, Masashi
- Repici, Alessandro
- Foroutan, Farid
- ORCID
- Hassan, Cesare
- Misawa, Masashi
- Rizkala, Tommy
- Mori, Yuichi
- Sultan, Shahnaz
- Facciorusso, Antonio
- Antonelli, Giulio
- Spadaccini, Marco
- Houwen, Britt B.S.L.
- Rondonotti, Emanuele
- Patel, Harsh
- Khalaf, Kareem
- Li, James Weiquan
- Fernandez, Gloria M.
- Bhandari, Pradeep
- Dekker, Evelien
- Gross, Seth
- Berzin, Tyler
- Vandvik, Per Olav
- Correale, Loredana
- Kudo, Shin-ei
- Sharma, Prateek
- Rex, Douglas K.
- Repici, Alessandro
- Foroutan, Farid
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2024-07
- Volume
- 177
- Issue
- 7
- Pages
- 919-928
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W4398131119
- Semantic Scholar
- 0b684b72e2b55fadab961570cd855cadbd64cbf0
- Cited by
- 56
- References
- 30
- Citations by year
- 2026: 19 · 2025: 27 · 2024: 10
- FWCI
- 2.99
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- European Commission (101057099)
- Associazione Italiana per la Ricerca sul Cancro (27843)
- HORIZON EUROPE Framework Programme (101057099)
- Japan Society for the Promotion of Science (23K02744)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Physical Sciences › Computer Science › Artificial Intelligence › AI in cancer detection
- Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
- Keywords
- computer-aided diagnosis, colorectal polyps, rectosigmoid polyps, polyp histology prediction, neoplastic polyps, polypectomy, colonoscopy, diagnostic accuracy, benefits and harms, small polyps, endoscopic diagnosis, colorectal cancer prevention, overdiagnosis
- MeSH terms
- Colonic Polyps, Colonoscopy, Diagnosis, Computer-Assisted, Humans, Colorectal Neoplasms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-11-03.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-11-03.
Statistics and arithmetic are recomputed, not judged.
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