Accuracy of pathology and computer-assisted optical diagnosis of diminutive colorectal polyps based on expert image and video audit as the reference standard
Notice bibliographique
Résumé
Aims Optical polyp diagnosis (OD) is less resource-intensive and costly than pathology. Moreover, the increasing use of OD and Computer-assisted OD (CADx) has in recent years shown that pathological diagnosis can be incorrect. Several studies have shown that polyps diagnosed in pathology as mucosal polyps are likely misdiagnoses due to errors in resection, retrieval, embedding, sectioning, or pathology interpretation of the lesions. We were interested in comparing pathology-based diagnosis to CADx using agreement between 3 expert endoscopists as the gold standard for diagnosis. Methods We conducted a prospective study in which three experts (DKR, CH, HP) evaluated all polyps of a large prospective cohort undergoing CADx assisted OD based on image and video material. We assumed that when three experts agree with high confidence on an unanimous polyp diagnosis in a blinded review, that this diagnostic agreement constitutes a hierarchical higher ground-truth than pathology, OD or CADx. Experts were blinded to the initial CADx-assisted OD, pathology result, and each other’s OD. Primary outcome was diagnostic accuracy CADx-assisted OD compared to pathology for diminutive (≤ 5 mm) colorectal polyps using expert image and video audit as the reference standard. We hypothesized that the accuracy of CADx-assisted OD is non-inferior to pathological interpretation for diminutive polyps. Results Among 511 patients recruited in the study, 523 diminutive colorectal polyps were identified. 487 polyps were reviewed by the expert endoscopists. The experts agreed with high confidence on an unanimous polyp diagnosis for 225 polyps. Based on unanimous polyp diagnosis between three experts as reference standard CADx-assisted OD was accurate in 205 of 225 polyps (91.1%) (95% CI: (87.4, 94.8)) and histopathological interpretation was accurate in 173 polyps (76.9%) (95% CI: (71.4, 82.4)), (paired p-value<0.001). CADx-assisted OD agreed with pathology in 165 polyps (73.3%) (95% CI: (67.6, 79.1)). Pathology reported 21 normal tissue specimens among the 225 polyps (9.33%), 7 of which were unanimously diagnosed as hyperplastic polyps by the experts and CADx. The remaining 14 of 21 histologically diagnosed normal mucosa were diagnosed as high-confidence adenomas by the experts. CADx agreed with the experts’ OD in 13 of 14 adenomas (92.9%). Conclusions This study demonstrated a statistically significant higher diagnostic accuracy when CADx-assisted OD is used compared to the standard histopathological assessment for diminutive colorectal polyps. It provides a proof of concept that CADx-assisted OD might indeed outperform pathology in diagnostic accuracy for diminutive polyps. Similar to previous studies, we found that a considerable number of polyps are incorrectly diagnosed as normal mucosa in pathology. Validity of our results is supported by a growing body of evidence showing that reevaluation in pathology of such discrepant findings often lead to revision of the initial pathology diagnosis. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Le tri à trois modèles
les 5 600 travaux triés →Les trois modèles l'ont jugé hors champ.
Diagnostic accuracy study of optical diagnosis of colorectal polyps; abstract absent, and the reference standard question is clinical rather than metaresearch.
It evaluates diagnostic accuracy for colorectal polyps.
Title is a clinical diagnostic-accuracy study of polyp assessment; empty abstract but object is clinical.
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,019 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».