Speedometer for withdrawal time monitoring during colonoscopy: a clinical implementation trial

Abstract

Objectives Meticulous inspection of the mucosa during colonoscopy, represents a lengthier withdrawal time, but has been shown to increase adenoma detection rate (ADR). We investigated if artificial intelligence-aided speed monitoring can improve suboptimal withdrawal time. Methods We evaluated the implementation of a computer-aided speed monitoring device during colonoscopy at a large academic endoscopy center. After informed consent, patients ≥18 years undergoing colonoscopy between 5 March and 29 April 2021 were examined without the use of the speedometer, and with the speedometer between 29 April and 30 June 2021. All colonoscopies were recorded, and withdrawal time was assessed based on the recordings in a blinded fashion. We compared mean withdrawal time, percentage of withdrawal time ≥6 min, and ADR with and without the speedometer. Results One hundred sixty-six patients in each group were eligible for analyses. Mean withdrawal time was 9 min and 6.6 s (95% CI: 8 min and 34.8 s to 9 min and 39 s) without the use of the speedometer, and 9 min and 9 s (95% CI: 8 min and 45 s to 9 min and 33.6 s) with the speedometer; difference 2.3 s (95% CI: −42.3–37.7, p = 0.91). The ADRs were 45.2% (95% CI: 37.6–52.8) without the speedometer as compared to 45.8% (95% CI: 38.2–53.4) with the speedometer (p = 0.91). The proportion of colonoscopies with withdrawal time ≥6 min without the speedometer was 85.5% (95% CI: 80.2–90.9) versus 86.7% (95% CI: 81.6–91.9) with the speedometer (p = 0.75). Conclusions Use of speed monitoring during withdrawal did not increase withdrawal time or ADR in colonoscopy. ClinicalTrials.gov Identifier NCT04710251