COLO-DETECT: Can an Artificial Intelligence Device Increase Detection of Polyps During Colonoscopy?

NCT ID: NCT04723758

Last Updated: 2023-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2032 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-03-29

Study Completion Date

2023-04-20

Brief Summary

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COLO-DETECT is a clinical trial to evaluate whether an Artificial Intelligence device ("GI Genius", manufactured by Medtronic) can identify more polyps (pre-cancerous growths of the bowel lining) during colonoscopy (large bowel camera test) than during colonoscopy without it.

Detailed Description

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Colorectal cancer is common, affecting 1 in 15 men and 1 in 18 women in the UK in their lifetime. Many colorectal cancers develop from polyps via the adenoma-carcinoma sequence: there is a pre-cancerous stage (adenoma) during which it is possible to remove the polyp and therefore prevent it from progressing to colorectal cancer. The gold standard tool for doing this is colonoscopy. However, colonoscopy does not pick up all polyps, particularly flat polyps.

Missed polyps can result in colorectal cancer, so it is imperative to detect and remove as many polyps as possible. Many different interventions have been introduced to improve polyp detection, the most recent of which is artificial intelligence devices. GI Genius is an artificial intelligence device which integrates with existing colonoscopy equipment and analyses the video feed from the colonoscope camera in real time. Any areas that may represent an abnormality are then highlighted (without any lag) within a green box, alerting the colonoscopist to its presence. The potential abnormality can then be assessed more closely by the colonoscopist to decide whether it needs to be removed or not.

COLO-DETECT is a 2-arm, prospective, randomised controlled trial to assess whether GI Genius is able to detect more polyps (specifically, adenomas) during colonoscopy than standard colonoscopy without GI Genius. The primary outcome will be the mean number of adenomas per procedure (MAP) and the key secondary outcome will be the proportion of colonoscopies in which one or more adenomas is detected (Adenoma Detection Rate - ADR). These are both important quality markers for colonoscopy; the study will be powered to detect a clinically meaningful difference in ADR, which will by default detect a meaningful difference in MAP as the sample size required for ADR is larger.

In addition to measuring the effect of GI Genius on polyp detection, COLO-DETECT will provide a health economics analysis concerning the use of GI Genius, perform long-term passive follow-up to examine for future outcomes related to colorectal polyps and colorectal cancer, and perform additional nested studies (subject to ethical approval) that examine the effect upon users (for example through a visual scanning study) and their experience of using the GI Genius.

Conditions

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Colonic Polyp Colorectal Polyp Colorectal Adenoma Colorectal Adenomatous Polyp Colorectal SSA Sessile Serrated Adenoma Sessile Colonic Polyp

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
The patient and colonoscopist (care provider) cannot be blinded to the allocation. The investigator and statistician will remain blinded to the allocation until analysis has been conducted.

Study Groups

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GI Genius-assisted colonoscopy (GGC)

In the GGC arm, participants will undergo colonoscopy as per standard care for the unit where they are having their procedure, except that at some point prior to commencing withdrawal of the colonoscope, a member of the endoscopy staff will turn on the GI Genius machine. This will remain operational from the time it is switched on until the end of the procedure.

Group Type EXPERIMENTAL

GI Genius-assisted diagnostic colonoscopy

Intervention Type DEVICE

Participants will undergo diagnostic colonoscopy, which will be identical to the normal standard of care at the unit where they are undergoing their procedure, except that GI Genius will be turned on during the procedure.

Standard Colonoscopy (SC)

In the SC arm, participants will undergo colonoscopy as per standard care for the unit where they are having their procedure.

Group Type ACTIVE_COMPARATOR

Diagnostic Colonoscopy

Intervention Type DIAGNOSTIC_TEST

Diagnostic colonoscopy will be performed as per the standard of care for the unit where the patient is having their procedure.

Interventions

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GI Genius-assisted diagnostic colonoscopy

Participants will undergo diagnostic colonoscopy, which will be identical to the normal standard of care at the unit where they are undergoing their procedure, except that GI Genius will be turned on during the procedure.

Intervention Type DEVICE

Diagnostic Colonoscopy

Diagnostic colonoscopy will be performed as per the standard of care for the unit where the patient is having their procedure.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Able to give informed consent
* Patients attending for colonoscopy

* Through standard National Health Service (NHS) care (most commonly due to iron deficiency anaemia, altered bowel habit, weight loss, rectal bleeding, positive FIT (faecal immunohistochemical test) based on symptoms, those referred on basis of family history, abnormal cross- sectional imaging, polyp surveillance or post CRC surveillance)
* Through Bowel Cancer Screening Programme (FIT positive, surveillance)
* Colonoscopy to be performed by colonoscopist trained to perform GGC as part of the study

Exclusion Criteria

* Absolute contraindications to colonoscopy
* Patients lacking capacity to give informed consent
* Confirmed or expected pregnancy
* Established or suspected large bowel obstruction or pseudo-obstruction
* Known presence of colorectal cancer or polyposis syndromes
* Known colonic strictures (meaning that the colonoscopy maybe incomplete)
* Known active colitis (ulcerative colitis, Crohn's colitis, diverticulitis, infective colitis)
* Inflammatory Bowel Disease (IBD) surveillance procedures
* Patients who are on clopidogrel, warfarin, or other antiplatelet agents or anticoagulants who have not stopped this for the procedure (as polyps cannot be removed and thus histology cannot be confirmed)
* Patients who are attending for a planned therapeutic procedure or assessment of a known lesion
* Patients referred with polyps identified on Bowel Scope procedure
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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North Wales Organisation for Randomised Trials in Health

OTHER

Sponsor Role collaborator

Newcastle University

OTHER

Sponsor Role collaborator

Medtronic

INDUSTRY

Sponsor Role collaborator

South Tyneside and Sunderland NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Colin J Rees, MBBS

Role: STUDY_DIRECTOR

Newcastle University, South Tyneside and Sunderland NHS Foundation Trust

Locations

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North Tees and Hartlepool NHS Foundation Trust

Hartlepool, County Durham, United Kingdom

Site Status

University Hospitals of Morecambe Bay NHS Foundation Trust

Kendal, Cumbria, United Kingdom

Site Status

Northumbria Healthcare NHS Foundation Trust

North Shields, North Tyneside, United Kingdom

Site Status

Kettering General Hospital NHS Foundation Trust

Kettering, Northamptonshire, United Kingdom

Site Status

University Hospitals Sussex NHS Foundation Trust

Worthing, Sussex, United Kingdom

Site Status

South Tees Hospitals NHS Foundation Trust

Middlesbrough, Teesside, United Kingdom

Site Status

The Newcastle-upon-Tyne Hospitals NHS Trust

Newcastle upon Tyne, Tyne & Wear, United Kingdom

Site Status

South Tyneside and Sunderland NHS Foundation Trust

Sunderland, Tyne and Wear, United Kingdom

Site Status

The Royal Wolverhampton NHS Trust

Wolverhampton, West Midlands, United Kingdom

Site Status

Bolton NHS Foundation Trust

Bolton, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Seager A, Sharp L, Neilson LJ, Brand A, Hampton JS, Lee TJW, Evans R, Vale L, Whelpton J, Bestwick N, Rees CJ; COLO-DETECT trial team. Polyp detection with colonoscopy assisted by the GI Genius artificial intelligence endoscopy module compared with standard colonoscopy in routine colonoscopy practice (COLO-DETECT): a multicentre, open-label, parallel-arm, pragmatic randomised controlled trial. Lancet Gastroenterol Hepatol. 2024 Oct;9(10):911-923. doi: 10.1016/S2468-1253(24)00161-4. Epub 2024 Aug 14.

Reference Type DERIVED
PMID: 39153491 (View on PubMed)

Seager A, Sharp L, Hampton JS, Neilson LJ, Lee TJW, Brand A, Evans R, Vale L, Whelpton J, Rees CJ. Trial protocol for COLO-DETECT: A randomized controlled trial of lesion detection comparing colonoscopy assisted by the GI Genius artificial intelligence endoscopy module with standard colonoscopy. Colorectal Dis. 2022 Oct;24(10):1227-1237. doi: 10.1111/codi.16219. Epub 2022 Jun 28.

Reference Type DERIVED
PMID: 35680613 (View on PubMed)

Other Identifiers

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286426

Identifier Type: OTHER

Identifier Source: secondary_id

21-WS-003

Identifier Type: OTHER

Identifier Source: secondary_id

10451355

Identifier Type: OTHER

Identifier Source: secondary_id

COLO-DETECT

Identifier Type: -

Identifier Source: org_study_id