Establishing key research questions for the implementation of artificial intelligence in colonoscopy: a modified Delphi method.

Journal: Endoscopy
Published Date: Jan 13, 2021

Abstract

BACKGROUND : Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities. METHODS : An established modified Delphi approach for research priority setting was used. Fifteen international experts, including endoscopists and translational computer scientists/engineers, from nine countries participated in an online survey over 9 months. Questions related to AI implementation in colonoscopy were generated as a long-list in the first round, and then scored in two subsequent rounds to identify the top 10 research questions. RESULTS : The top 10 ranked questions were categorized into five themes. Theme 1: clinical trial design/end points (4 questions), related to optimum trial designs for polyp detection and characterization, determining the optimal end points for evaluation of AI, and demonstrating impact on interval cancer rates. Theme 2: technological developments (3 questions), including improving detection of more challenging and advanced lesions, reduction of false-positive rates, and minimizing latency. Theme 3: clinical adoption/integration (1 question), concerning the effective combination of detection and characterization into one workflow. Theme 4: data access/annotation (1 question), concerning more efficient or automated data annotation methods to reduce the burden on human experts. Theme 5: regulatory approval (1 question), related to making regulatory approval processes more efficient. CONCLUSIONS : This is the first reported international research priority setting exercise for AI in colonoscopy. The study findings should be used as a framework to guide future research with key stakeholders to accelerate the clinical implementation of AI in endoscopy.

Authors

  • Omer F Ahmad
    Department of Gastroenterology, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London, NW1 2BU, United Kingdom; Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS), University College London, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, United Kingdom. Electronic address: ofahmad123@gmail.com.
  • Yuichi Mori
    Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, and Department of Transplantation Medicine Oslo University Hospital, Oslo, Norway; Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan. Electronic address: ibusiginjp@gmail.com.
  • Masashi Misawa
    Digestive Disease Center, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, 224-8503, Japan.
  • Shin-Ei Kudo
    Digestive Disease Center, Showa University Northern Yokohama Hospital, Tsuzuki-ku, Yokohama, 224-8503, Japan.
  • John T Anderson
    Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
  • Jorge Bernal
    Image Sequence Evaluation laboratory, Computer Vision Center and Computer Science Department, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain.
  • Tyler M Berzin
    Beth Israel Deaconess Medical Center and Harvard Medical School, Center for Advanced Endoscopy, Boston , MA, USA.
  • Raf Bisschops
    Department of Gastroenterology and Hepatology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium; Department of Translational Research in Gastrointestinal Diseases (TARGID), Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium. Electronic address: raf.bisschops@uzleuven.be.
  • Michael F Byrne
    Division of Gastroenterology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
  • Peng-Jen Chen
    Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
  • James E East
    Translational Gastroenterology Unit, Nuffield Department of Medicine, Experimental Medicine Div., John Radcliffe Hospital, University of Oxford, Oxford, UK.
  • Tom Eelbode
    Department of Electrical Engineering (ESAT/PSI), KU Leuven, Kasteelpark Arenberg 10/2446, 3001, Leuven, Belgium; Medical Imaging Research Center (MIRC), UZ Leuven, Herestraat 49, 3000, Leuven, Belgium. Electronic address: tom.eelbode@kuleuven.be.
  • Daniel S Elson
    The Hamlyn Centre for Robotic Surgery, Imperial College London, London, UK; Department of Surgery and Cancer, Imperial College London, London, UK. Electronic address: daniel.elson@imperial.ac.uk.
  • Suryakanth R Gurudu
  • Aymeric Histace
    ETIS, Université de Cergy-Pontoise, ENSEA, CNRS, Cergy-Pontoise Cedex, France.
  • William E Karnes
    H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology & Hepatology, Department of Medicine, University of California, Irvine, California, USA.
  • Alessandro Repici
    Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Clinical and Research Center IRCCS, Rozzano, 20089, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy.
  • Rajvinder Singh
    Department of Biotechnology, Panjab University, Chandigarh, India.
  • Pietro Valdastri
    School of Electronic and Electrical Engineering, University of Leeds, Leeds, United Kingdom.
  • Michael B Wallace
  • Pu Wang
    Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
  • Danail Stoyanov
    University College London, London, UK.
  • Laurence B Lovat
    Division of Surgery & Interventional Science, University College London, London, UK.

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