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Effect of a deep learning-based automatic upper gastrointestinal endoscopic reporting system: a randomized crossover study

  • Lihui Zhang
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Zihua Lu
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Liwen Yao
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Zehua Dong
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
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  • Wei Zhou
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Chunping He
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
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  • Renquan Luo
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Mengjiao Zhang
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Jing Wang
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Yanxia Li
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Yunchao Deng
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Chenxia Zhang
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
    Search for articles by this author
  • Xun Li
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Renduo Shang
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Ming Xu
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Junxiao Wang
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Yu Zhao
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Lianlian Wu
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
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  • Honggang Yu
    Correspondence
    Correspondence to: Professor Honggang Yu, Department of Gastroenterology, Renmin Hospital of Wuhan University. 99 Zhangzhidong Road, Wuhan, Hubei Province, China.
    Affiliations
    Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

    Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China

    Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China
    Search for articles by this author
Published:February 24, 2023DOI:https://doi.org/10.1016/j.gie.2023.02.025
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      Abstract

      Background and Aims

      Esophagogastroduodenoscopy (EGD) is essential for gastrointestinal disorders, and reports are pivotal to facilitating post-procedure diagnosis and treatment. Manual report generation lacks sufficient quality and is labor intensive. We first reported and validated an artificial intelligence-based endoscopy automatic reporting system (AI-EARS).

      Methods

      The AI-EARS was designed for automatic report generation, including real-time image capturing, diagnosis and textual description. It was developed using multicenter datasets from eight hospitals in China, including 252111 images for training, 62706 images and 950 videos for testing.Twelve endoscopists and 44 endoscopy procedures were consecutively enrolled to evaluate the effect of AI-EARS in a multi-reader multi-case (MRMC) crossover study. The precision and completeness of the reports were compared between endoscopists using AI-EARS and conventional reporting systems.

      Results

      In video validation, AI-EARS achieved completeness of 98.59% and 99.69% for esophageal and gastric abnormality records, accuracies of 87.99% and 88.85% for esophageal and gastric lesion location records, and 73.14% and 85.24% for diagnosis.Compared to the conventional reporting systems, AI-EARS achieved greater completeness (79.03% vs. 51.86%, p<0.001), accuracy (64.47% vs. 42.81%, p<0.001) of the textual description, and completeness of the photo-documents of landmarks (92.23% vs. 73.69%, p<0.001). The mean reporting time for an individual lesion was significantly reduced (80.13±16.12 vs. 46.47±11.68 seconds, P<0.001) after AI-EARS assistance.

      Conclusions

      AI-EARS showed its efficacy in improving the accuracy and completeness of the EGD reports. It might facilitate the generation of complete endoscopy reports and post-endoscopy patient management. (ClinicalTrails.gov, number NCT05479253)

      Keywords

      Acronyms and abbreviations:

      EGD (Esophagogastroduodenoscopy), AI (artificial intelligence), AI-EARS (artificial intelligence-based endoscopy automatic reporting system), MRMC study (multi-reader multi-case study), DCNN (Diffusion-Convolutional Neural Networks), SD (standard deviation), AG (atrophic gastritis)
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