Journal article
Cost savings in colonoscopy with artificial intelligence-aided polyp diagnosis: an add-on analysis of a clinical trial (with video)
- Abstract:
-
Background and Aims Artificial intelligence (AI) is being implemented in colonoscopy practice, but no study has investigated whether AI is cost saving. We aimed to quantify the cost reduction using AI as an aid in the optical diagnosis of colorectal polyps.
Methods This study is an add-on analysis of a clinical trial that investigated the performance of AI for differentiating colorectal polyps (ie, neoplastic versus non-neoplastic). We included all patients with diminutive (≤5 mm) rectosigmoid polyps in the analyses. The average colonoscopy cost was compared for 2 scenarios: (1) a diagnose-and-leave strategy supported by the AI prediction (ie, diminutive rectosigmoid polyps were not removed when predicted as non-neoplastic), and (2) a resect-all-polyps strategy. Gross annual costs for colonoscopies were also calculated based on the number and reimbursement of colonoscopies conducted under public health insurances in 4 countries.
Results Overall, 207 patients with 250 diminutive rectosigmoid polyps (104 neoplastic, 144 non-neoplastic, and 2 indeterminate) were included. AI correctly differentiated neoplastic polyps with 93.3% sensitivity, 95.2% specificity, and 95.2% negative predictive value. Thus, 105 polyps were removed and 145 were left under the diagnose-and-leave strategy, which was estimated to reduce the average colonoscopy cost and the gross annual reimbursement for colonoscopies by 18.9% and US$149.2 million in Japan, 6.9% and US$12.3 million in England, 7.6% and US$1.1 million in Norway, and 10.9% and US$85.2 million in the United States, respectively, compared with the resect-all-polyps strategy.
Conclusions The use of AI to enable the diagnose-and-leave strategy results in substantial cost reductions for colonoscopy.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Accepted manuscript, pdf, 709.6KB, Terms of use)
-
(Supplementary materials, mp4, 6.0MB, Terms of use)
-
- Publisher copy:
- 10.1016/j.gie.2020.03.3759
Authors
- Publisher:
- Elsevier
- Journal:
- Gastrointestinal Endoscopy More from this journal
- Volume:
- 92
- Issue:
- 4
- Pages:
- 905-911
- Publication date:
- 2020-03-30
- Acceptance date:
- 2020-03-16
- DOI:
- EISSN:
-
1097-6779
- ISSN:
-
0016-5107
- Pmid:
-
32240683
- Language:
-
English
- Keywords:
- Pubs id:
-
1100170
- Local pid:
-
pubs:1100170
- Deposit date:
-
2020-06-20
- ARK identifier:
Terms of use
- Copyright holder:
- American Society for Gastrointestinal Endoscopy
- Copyright date:
- 2020
- Rights statement:
- Copyright © 2020 by the American Society for Gastrointestinal Endoscopy
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Elsevier at https://doi.org/10.1016/j.gie.2020.03.3759
If you are the owner of this record, you can report an update to it here: Report update to this record