AQCS-Assisted Colonoscopy
Trial question
What is the effect of an automatic quality control system on adenoma detection rate during routine colonoscopy?
Study design
Multi-center
Single blinded
RCT
Population
Characteristics of study participants
46.0% female
54.0% male
N = 1254
1254 patients (580 female, 674 male).
Inclusion criteria: adults aged 18-80 years undergoing routine colonoscopy.
Key exclusion criteria: history of IBD, advanced CRC, or polyposis syndrome; colorectal polyps without complete removal previously; history of colorectal surgery; stenosis or obstruction with contraindication for biopsy or prior failed colonoscopy; pregnancy or lactation.
Interventions
N=627 AQCS-assisted colonoscopy (colonoscopy examination with the assistance of automatic quality control system).
N=627 standard colonoscopy (conventional standard colonoscopy without the assistance of automatic quality control system).
Primary outcome
Detection of adenoma
32.7%
22.6%
32.7 %
24.5 %
16.4 %
8.2 %
0.0 %
AQCS-assisted
colonoscopy
Standard
colonoscopy
Significant
increase ▲
NNT = 9
Significant increase in detection of adenoma (32.7% vs. 22.6%; RR 1.6, 95% CI 1.23 to 2.09).
Secondary outcomes
Significant increase in detection of adenuma during suboptimal colonoscopy (26.3% vs. 12%; RR 2.97, 95% CI 1.24 to 7.13).
Significant increase in adenomas per colonoscopy (0.86 adenomas vs. 0.48 adenomas; RR 1.5, 95% CI 1.17 to 1.91).
Significant increase in mean withdrawal time without intervention (6.78 minutes vs. 6.46 minutes; RR 1.38, 95% CI 1.26 to 1.52).
Safety outcomes
No significant difference in adverse events.
Conclusion
In adults aged 18-80 years undergoing routine colonoscopy, AQCS-assisted colonoscopy was superior to standard colonoscopy with respect to detection of adenoma.
Reference
Jing Liu, Ruchen Zhou, Chengxia Liu et al. Automatic Quality Control System and Adenoma Detection Rates During Routine Colonoscopy: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jan 2;8(1):e2457241.
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