AI_Colonoscopy_for_Fellows

The proposed study is a randomized controlled trial to evaluate the efficacy of AI assisted colonoscopies in improving colonoscopy quality indices for gastroenterology fellows.

The subjects for this study will be the gastroenterology fellows in their first, second or third year of training. Each fellow during their VA endoscopy rotation will be randomized to perform colonoscopies using AI or following conventional methods. If randomized to AI, the endoscopy technician in the procedural room will be responsible for turning on the GI Genius software (Medtronic AI device) during the procedure. The fellow will identify whether AI was used in the procedural note documented under Provation MD software. Otherwise, all colonoscopies will be performed in the standard fashion under moderate sedation or monitored anesthesia care. Procedures will not be affected by study participation. All procedures will be performed at the Oklahoma City VA Medical Center during normal procedural times. Information such as indication for the procedure and quality indices mentioned above (such as ADR, SSLDR, withdrawal time) will be obtained from chart review and calculated using data from Provation MD retrospectively, at a later time. Other information such as patient's medical history and family history as it relates to the colonoscopy procedure will also be collected retrospectively from CPRS chart records. This will be used to exclude patients undergoing colonoscopy secondary to genetic cancer syndromes (ex: polyposis), inflammatory bowel disease, for therapy of known neoplasms or undergoing non-colonoscopy screening tests (fecal immunochemical test, CT colonography) from this study. No identifiable patient information will be saved in any format. In addition, data such as polyp size, location of polyp and histological information will be collected from CPRS charts.

• AI assisted colonoscopy (Device): The gastroenterology fellows assigned to AI assisted colonoscopy will use the GI genius device while performing colonoscopies.
• Conventional Colonoscopy (Other): The gastroenterology fellows assigned to conventional colonoscopy will be performing colonoscopies without the use of AI device.

Primary outcomes

• Adenoma detection rate [over 18 months]: We hypothesize that an AI assisted colonoscopy done by a gastroenterology fellow will have a higher ADR as compared to conventional colonoscopy done by the same fellow and these results will be more significant among junior fellows compared to senior fellows.

Secondary outcomes

• Sessile serrated lesion detection rate [Over 18 months]: We hypothesize that an AI assisted colonoscopy done by a gastroenterology fellow will have a higher sessile serrated lesion detection rate as compared to conventional colonoscopy done by the same fellow and these results will be more significant among junior fellows compared to senior fellow.
• Withdrawal time [Over 18 months]: Total withdrawal time will likely be longer in the AI assisted colonoscopy group compared to conventional colonoscopy group.

Sex: All, accepts healthy volunteers

Inclusion Criteria:

* All adult gastroenterology fellows at the University of Oklahoma, except for the fellow conducting research will be included in the study.

Exclusion Criteria:

* All patients undergoing colonoscopy for genetic cancer syndromes (ex: polyposis), inflammatory bowel disease, for therapy of known neoplasms or undergoing non-colonoscopy screening tests (fecal immunochemical test, CT colonography) will be excluded from this study.

• Mohammad Madhoun, Principal investigator, University of Oklahoma