A Randomized Controlled Trial Comparing High-Definition White Light Colonoscopy to I-Scan Enhanced Colonoscopy for Adenoma Detection in a Population at Increased Risk of Colorectal Cancer: A Pilot Study
Bibliographic record
Abstract
Purpose: I-scan is an optical enhancement technology that may increase the yield of adenomas in the colon. The primary purpose of this study was to determine the mean adenoma detection rates with high-definition white light and I-scan enhanced colonoscopy in a population at increased risk of colorectal cancer. A secondary objective was to determine if a “second look” of the right colon improves polyp detection, given the higher miss rate in the right colon. Methods: This was a three arm randomized controlled trial comparing high definition white light (HD) colon versus I-scan 1 and 2 colon. Patients received a standard bowel preparation: Polyethylene Glycol (PEG) either given as 4L the day before for morning procedures or split into two 2L doses. Following randomization, the endoscopist inserted and withdrew the colonoscope using either HD colon, I-scan 1 or I-scan 2. A planned “second look” of the right colon involved withdrawing from the cecum to the hepatic flexure, then re-inserting to the cecum and finally withdrawing through the entire colon using the initial optical modality. The primary outcome was the mean adenoma detection rate (ADR), defined as the average of the total number of adenomas found per colonoscopy performed in each arm of the study. A secondary outcome was the proportion of adenomas identified during the second look of the right colon that had been missed during the first look using each imaging modality. Results: In total, 101 patients were included in this analysis. The mean age of the subjects was 52 with no difference between the groups. The mean adenoma detection rate for the HD colon, I-scan 1 and I-scan 2 arms were 0.56, 0.51 and 0.69 respectively (p 0.84). The mean number of polyps for HD colon, i-scan 1 and i-scan 2 were 0.79, 1.00 and 1.50 respectively (p 0.39). A total of 36 adenomas were found from the hepatic flexure to the cecum, of which 11 (42.3%) were identified on the second look. No significant differences in yield of the second look were seen between the study arms. Conclusion: I-scan enhanced colonoscopy does not appear to increase the mean adenoma detection rate in a population at increased risk for colorectal cancer. A planned second look of the right colon is a valuable tool that increases adenoma detection.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".