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Zhou Y, Yuan X, Zhang X, Liu W, Wu Y, Yen GG, Hu B, Yi Z. Evolutionary Neural Architecture Search for Automatic Esophageal Lesion Identification and Segmentation. IEEE TRANSACTIONS ON ARTIFICIAL INTELLIGENCE 2022; 3:436-450. [DOI: 10.1109/tai.2021.3134600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Yao Zhou
- Center of Intelligent Medicine, College of Computer Science, Sichuan University, Chengdu, China
| | - Xianglei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaozhi Zhang
- Center of Intelligent Medicine, College of Computer Science, Sichuan University, Chengdu, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Wu
- Center of Intelligent Medicine, College of Computer Science, Sichuan University, Chengdu, China
| | - Gary G. Yen
- School of Electrical and Computer Engineering, Oklahoma State University, Stillwater, OK, USA
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhang Yi
- Center of Intelligent Medicine, College of Computer Science, Sichuan University, Chengdu, China
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Zhao S, Wang S, Pan P, Xia T, Chang X, Yang X, Guo L, Meng Q, Yang F, Qian W, Xu Z, Wang Y, Wang Z, Gu L, Wang R, Jia F, Yao J, Li Z, Bai Y. Magnitude, Risk Factors, and Factors Associated With Adenoma Miss Rate of Tandem Colonoscopy: A Systematic Review and Meta-analysis. Gastroenterology 2019; 156:1661-1674.e11. [PMID: 30738046 DOI: 10.1053/j.gastro.2019.01.260] [Citation(s) in RCA: 360] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/14/2019] [Accepted: 01/30/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS We performed a systematic review and meta-analysis to comprehensively estimate adenoma miss rate (AMR) and advanced AMR (AAMR) and explore associated factors. METHODS We searched the PubMed, Web of Science, and Ovid EMBASE databases for studies published through April 2018 on tandem colonoscopies, with AMR and AAMR as the primary outcomes. We performed meta-regression analyses to identify risk factors and factors associated with outcome. Primary outcomes were AMR and AAMR and secondary outcomes were AMR and AAMR for different locations, sizes, pathologies, morphologies, and populations. RESULTS In a meta-analysis of 43 publications and more than 15,000 tandem colonoscopies, we calculated miss rates of 26% for adenomas (95% confidence interval [CI] 23%-30%), 9% for advanced adenomas (95% CI 4%-16%), and 27% for serrated polyps (95% CI 16%-40%). Miss rates were high for proximal advanced adenomas (14%; 95% CI 5%-26%), serrated polyps (27%; 95% CI 16%-40%), flat adenomas (34%; 95% CI 24%-45%), and in patients at high risk for colorectal cancer (33%; 95% CI 26%-41%). Miss rates could be decreased by adequate bowel preparation and auxiliary techniques (P = .06; P = .04, and P = .01, respectively). The adenoma detection rate (ADR), adenomas per index colonoscopy, and adenomas per positive index colonoscopy (APPC) were independently associated with AMR (P = .02, P = .01, and P = .008, respectively), whereas APPC was the only factor independently associated with AAMR (P = .006). An APPC value greater than 1.8 was more effective in monitoring AMR (31% vs 15% for AMR P < .0001) than an ADR value of at least 34% (27% vs 17% for AMR; P = .008). The AAMR of colonoscopies with an APPC value below 1.7 was 35%, vs 2% for colonoscopies with an APPC value of at least 1.7 (P = .0005). CONCLUSIONS In a systematic review and meta-analysis, we found that adenomas and advanced adenomas are missed (based on AMR and AAMR) more frequently than previously believed. In addition to ADR, APPC deserves consideration as a complementary indicator of colonoscopy quality, if it is validated in additional studies.
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Affiliation(s)
- Shengbing Zhao
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, Naval and Second Military Medical University, Shanghai, China; National Clinical Research Center for Digestive Diseases, Shanghai, China
| | - Shuling Wang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Peng Pan
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Tian Xia
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, Naval and Second Military Medical University, Shanghai, China
| | - Xin Chang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Xia Yang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China; Department of Gastroenterology, Number 905 Hospital of The Chinese PLA, Shanghai, China
| | - Liliangzi Guo
- Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, China
| | - Qianqian Meng
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, Naval and Second Military Medical University, Shanghai, China; National Quality Control Center of Digestive Endoscopy, Shanghai, China
| | - Fan Yang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Wei Qian
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Zhichao Xu
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Yuanqiong Wang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Zhijie Wang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Lun Gu
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Rundong Wang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Fangzhou Jia
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China
| | - Jun Yao
- Department of Gastroenterology, Shenzhen People's Hospital, Shenzhen, China.
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, Naval and Second Military Medical University, Shanghai, China; National Clinical Research Center for Digestive Diseases, Shanghai, China; National Quality Control Center of Digestive Endoscopy, Shanghai, China.
| | - Yu Bai
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University and Naval Medical University, Shanghai, China; Digestive Endoscopy Center, Changhai Hospital, Naval and Second Military Medical University, Shanghai, China; National Clinical Research Center for Digestive Diseases, Shanghai, China.
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