Rachel Martin

Colorectal cancer is the third most common cancer and a leading cause of cancer death in the United States. Colonoscopy, recommended for all adults aged 45 or older, is a crucial screening tool where gastroenterologists remove polyps to prevent them from becoming cancerous. Recognizing the importance of detecting these polyps, the FDA authorized the first AI-assisted device for colonoscopies in 2021.

Dr. Gyanprakash Ketwaroo at the West Haven VA emphasizes the value of AI in providing a "second set of eyes" during colonoscopies. This technology, known as computer-aided detection (CADe), has shown promise in increasing adenoma detection rates, according to a meta-analysis led by Dr. Dennis Shung. The analysis, which reviewed 44 studies, found that CADe systems improved adenoma detection compared to standard colonoscopies, although the increase in advanced colorectal neoplasia detection was slight.

Shung's meta-analysis suggests further research is needed to assess AI's impact on interval colorectal cancer rates and recommends that future studies should randomize colonoscopists to understand better where CADe can be most effective. Yale has implemented this AI technology at the West Haven VA campus, providing additional support for endoscopists and trainees during procedures.

The American Gastroenterological Association (AGA) is also preparing new clinical guidelines for using AI in colonoscopies, for which Dr. Shung is the co-first author. These draft guidelines conditionally recommend CADe for polyp detection in adults, considering the technology's safety and efficiency. The AGA is gathering feedback from both providers and patients on AI use in screening, aiming to publish the final guideline in March 2025, with regular updates as the technology evolves.

Overall, AI-assisted colonoscopies represent a significant advancement in colorectal cancer screening, with the potential to enhance detection rates and outcomes for patients. Clinicians are advised to stay informed on evolving guidelines and technological developments to offer the best care possible.

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Colorectal cancer ranks as the third most prevalent cancer and a major cause of cancer mortality in the U.S. Colonoscopy is vital for early detection, with AI-assisted devices enhancing polyp detection. The FDA approved the first AI device for colonoscopies in 2021, and studies show improved adenoma detection rates with AI. Further research is needed to evaluate AI's impact on interval cancer rates. The American Gastroenterological Association is developing guidelines for AI use in colonoscopies, with final recommendations expected in March 2025, emphasizing the importance of staying updated on advancements.

Computer-aided detection during colonoscopies with AI may help increase adenoma detection rates.

AI-Assisted Colonoscopy: New Research and Guidelines for Clinical Use

Hypertension is a prevalent condition in the U.S. that can lead to severe health complications, particularly among Black or Hispanic adults, as well as rural, uninsured, and low-income populations. Regular screening is crucial, as high blood pressure often presents no symptoms. Dr. Erica Spatz at Yale School of Medicine, along with Dr. Rafael Pérez-Escamilla, is spearheading the Pressure Check study to address disparities in blood pressure management, supported by a substantial PCORI funding award.

The study involves a partnership with community-based organizations (CBOs) across four diverse health sites. It aims to compare three strategies for blood pressure control: education and wireless monitoring with a referral to a primary care provider, the addition of biweekly telehealth support, and the integration of a community health worker to assist with social barriers to health.

To date, CBOs have screened nearly 2,000 individuals and enrolled over 330 in the study, which will monitor participants over 18 months to evaluate the most effective control method. The approach emphasizes community engagement and trust-building, acknowledging past research mistrust. The study uses cellular-enabled blood pressure cuffs provided by Stel, which allow secure data transfer without the need for smartphones or Wi-Fi, addressing technology barriers.

Participants also manually record their blood pressure readings to observe trends. The goal is to highlight the importance of controlling blood pressure by delivering care that meets individuals where they are. The study is embedded within Yale's Department of Internal Medicine, recognized for its excellence in integrating clinical care, research, and education. For more information, readers are encouraged to visit the Internal Medicine page of the Yale School of Medicine website.

Hypertension is a significant health issue in the U.S., disproportionately affecting Black, Hispanic, rural, uninsured, and low-income populations. The Pressure Check study, led by Dr. Erica Spatz and Dr. Rafael Pérez-Escamilla, aims to address disparities in blood pressure management through community-based partnerships. The study evaluates three strategies: education with wireless monitoring, biweekly telehealth support, and community health worker integration. Nearly 2,000 individuals have been screened, with over 330 enrolled. The study emphasizes community engagement, trust-building, and overcoming technology barriers using cellular-enabled blood pressure cuffs.

The Pressure Check study at Yale aims to address disparities in blood pressure management.