Safety of artificial intelligence-assisted optical diagnosis for leaving colorectal polyps in situ during colonoscopy (PRACTICE): a non-inferiority, randomised controlled trial.

Background: Guidelines recommend leaving in situ rectosigmoid polyps diagnosed during colonoscopy that are 5 mm or smaller if the endoscopist optically predicts them to be non-neoplastic. However, no randomised controlled trial has been done to examine the efficacy and safety of this strategy.

Methods: This open-label, multicentre, non-inferiority, randomised controlled trial enrolled adults age 18 years or older undergoing colonoscopy for screening, surveillance, or clinical indications across four Italian centres.

Endoscopist deskilling risk after exposure to artificial intelligence in colonoscopy: a multicentre, observational study.

Background: It is not known if continuous exposure to artificial intelligence (AI) changes endoscopists' behaviour when conducting colonoscopy. We assessed how endoscopists who regularly used AI performed colonoscopy when AI was not in use.

Methods: We conducted a retrospective, observational study at four endoscopy centres in Poland taking part in the ACCEPT (Artificial Intelligence in Colonoscopy for Cancer Prevention) trial.

Fecal Microbiota Transplantation Versus Vancomycin for Primary Infection : A Randomized Controlled Trial.

Background: Fecal microbiota transplantation (FMT) is recommended for recurrent infection (CDI), but its role in primary CDI is unclear.

Objective: To investigate the efficacy and safety of FMT in primary CDI.

Design: Randomized, open-label, noninferiority, multicenter trial.

Artificial intelligence and colorectal neoplasia detection performances in patients with positive fecal immunochemical test: Meta-analysis and systematic review.

Objectives: The combination of fecal immunochemical test (FIT) followed by colonoscopy has established itself as one of the preferred population-based screening strategies. Despite extensive exploration of various techniques and technologies, their impact on adenoma detection rate has shown inconsistency across studies in this specific setting "FIT+ population." We aimed to assess the impact of the computer-aided detection (CADe) system in all randomized trials focused on this subpopulation.

Effect of colonoscopy screening on risks of colorectal cancer and related death: instrumental variable estimation of per-protocol effects.

We recently reported per-protocol estimates of colonoscopy screening on colorectal cancer incidence and mortality in NordICC, a large-scale randomized trial. Our results may be affected by residual confounding due to lack of detailed information on confounders. Here, we supplement our per-protocol analyses with instrumental variable (IV) estimates whose validity relies on an alternate set of assumptions but does not depend on the availability of confounder data.

Benefits, burden, and harms of computer aided polyp detection with artificial intelligence in colorectal cancer screening: microsimulation modelling study.

Objective: To estimate the benefits, burden, and harms of implementing computer aided detection (CADe) of polyps in colonoscopy of population based screening programmes for colorectal cancer.

Design: Microsimulation modelling study.

Setting: Cost effectiveness working package in the OperA (optimising colorectal cancer prevention through personalised treatment with artificial intelligence) project.

Gastroenterology/Hepatology: What You May Have Missed in 2024.

This article highlights selected major advances in gastroenterology and hepatology from 2024 that are relevant for internal medicine specialists. In colorectal cancer (CRC) screening, new developments include a head-to-head comparison of different fecal immunochemical tests and a new blood-based DNA screening test, benefits and harms of artificial intelligence-assisted colonoscopy, and adenoma detection rate improvement and risk for cancer. Treatment options for metabolic dysfunction-associated steatotic liver disease now include resmetirom, a recently approved drug for treatment of patients with moderate-to-severe fibrosis, and liver transplantation may now be an option in patients with unresectable colorectal liver metastases.

Temporal trends in characteristics and management of inflammatory bowel disease.

Background And Aims: Inflammatory bowel disease (IBD) requires complex clinical management. Despite substantial advancements in endoscopy and in pharmacotherapies for patients with IBD, it remains unclear how these developments have influenced IBD incidence and clinical care. We aim to describe changes in diagnostic and therapeutic practices in IBD management.

Leaving colorectal polyps in situ with endocytoscopy assisted by computer-aided diagnosis: a cost-effectiveness study.

Background:  Computer-aided diagnosis (CADx) enables the distinction between neoplastic and non-neoplastic polyps during colonoscopy. We aimed to estimate the patient-level benefit and harm of CADx.

Methods:  We conducted a comparative analysis on data from the EndoBRAIN international clinical trial, evaluating the effect of optical diagnosis during colonoscopy with and without CADx.

Adenoma Detection Rates by Physicians and Subsequent Colorectal Cancer Risk.

Importance: Patients of physicians with higher adenoma detection rates (ADRs) during colonoscopy have lower colorectal cancer (CRC) risk after screening colonoscopy (ie, postcolonoscopy CRC). Among physicians with an ADR above the recommended threshold, it is unknown whether improving ADR is associated with a lower incidence of CRC in their patients.

Objective: To determine the association of improved ADR in physicians with a range of ADR values at baseline with CRC incidence among their patients.

Prediction of metachronous advanced colorectal neoplasia by KRAS mutation in polyps.

Background: The potential of molecular markers in the removed polys as reliable predictors of metachronous lesions is still uncertain.

Aim: Our aim was to evaluate the role of somatic mutations in KRAS in polyps of patients with high-risk adenomas to predict the risk of advanced polyps or colorectal cancer (CRC) within 3 years.

Methods: A total of 518 patients were prospectively enrolled.

Surgical treatment of benign colorectal polyps 2008-21.

Background: Colorectal cancer is one of the most common forms of cancer in Norway, and typically develops from colorectal polyps. For benign colorectal polyps, endoscopic removal is recommended to avoid unnecessary surgery. This study identifies the extent of surgical treatment of benign polyps in the period 1 January 2008-31 December 2021.