New monitoring system reduces blind spots during esophagogastroduodenoscopy

By Will Boggs MD

NEW YORK (Reuters Health) - 1/4/2019

The new WISENSE monitoring system reduces blind-spot rates during esophagogastroduodenoscopy (EGD), researchers from China report.

"Our (artificial intelligence) system shows higher accuracy than human beings in detecting different parts of the digestive tract," Dr. Hong Gang Yu from Renmin Hospital of Wuhan University told Reuters Health by email. "It can (identify) the blind spots and tell endoscopists where they haven't reached in the digestive tract."

EGD is a critical element in the diagnosis of upper gastrointestinal lesions. But with variations in the EGD performance among endoscopists, the diagnosis rate of early gastric cancer remains below 20% in China and other parts of the world.

Dr. Yu and colleagues used two methods of deep learning to construct a real-time quality-improvement system for monitoring EGD blind spots and, in the current study, investigated whether WISENSE would reduce the rate of blind spots during EGD.

The WISENSE system monitored blind spots with an average accuracy of 90% (range, 70% to 100% during 107 real EGD videos), with an average sensitivity of 88% and average specificity of 95%, the researchers report in Gut, March 11.

In a randomized trial, the blind-spot rate was significantly lower among 153 patients assigned to WISENSE (5.9%) than among the 150 patients assigned to the control group (22.5%).

Mean inspection time during the EGD procedure was significantly longer in the WISENSE group (5.03 minutes) than in the control group (4.24 minutes), but the completeness of photodocumentation generated by WISENSE (90.64%) was significantly higher than that of endoscopists in the control group (79.14%).

The percent of patients being ignored was significantly lower in the WISENSE group than in the control group for most anatomical sites.

"Doctors are sometimes overconfident and the actual situation may be unexpected," Dr. Yu said. "If there is a monitor 'accompanying' endoscopists, their operation could be more stable, and the quality of everyday endoscopy could be improved. (Artificial intelligence) can't replace doctors, but it can help doctors with diagnosis and detection."

"We hope this device goes into clinical routine quickly because it is safe and it has good performance in our clinical trial," he said. "Using WISENSE in day-to-day clinical practice could guarantee the competence of gastroscopy and thus improve disease detection. Discovering an early gastric cancer could save a life."

The study did not have commercial funding, and the authors declared no competing interests.

SOURCE: https://bit.ly/2FBUuQj

Gut 2019.

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