Influence of artificial intelligence on the adenoma detection rate throughout the day

Background: Artificial intelligence systems recently demonstrated an increase in polyp- and adenoma detection rate. Over the daytime the adenoma detection rate decreases as tiredness leads to a lack of attention. It is not clear if a polyp detection system with artificial intelligence leads to a constant adenoma detection over the day.Methods: We performed a database analysis of screening and surveillance colonoscopies with and without the use of AI. In both groups, patients were investigated with the same endoscopy equipment and by the same endoscopists. Only patients with good bowel preparation (BBPS > 6) were included. We correlated the daytime, the investigational time, day of the week and the adenoma and polyp detection. Results: A total of 303 colonoscopies were analyzed. In the AI+ group 163 endoscopies and in the AI- group 140 procedures were included. In both groups the total adenoma detection rate was equal (AI+ 0.39 vs AI- 0.43). The adenoma detection rate throughout the day had a significant decreasing trend in the group without the use of AI (p=0.015) whereas this trend was not present in the investigations that have been performed with AI (p=0.65). The duration of investigation did not show a significant difference between the groups (8.9 minutes in both groups). No relevant effect was noticed in adenoma detection between single days of the working week with or without the use of AI.Conclusion: AI helps to overcome the decay in adenoma detection over the daytime. This may be attributed to a constant awareness caused by the use of the AI system.