A double-blind randomized trial in China has assessed the effect of operational bias in the use of computer-aided detection (CAD) systems for polyp detection. A total of 962 patients presenting for diagnostic and screening colonoscopy were randomly allocated to colonoscopy with a CAD or a sham system; both patient and operator were unaware of the assigned group. The adenoma detection rate was significantly greater in the CAD group than the sham group (P = 0.03). Polyps detected by the CAD system but not the endoscopist had difficult-to-recognise characteristics (small, flat, isochromatic and unclear boundaries).
Wan, P. et al. Effect of a deep-learning computer-aided detection system on adenoma detection during colonoscopy (CADe-DB trial): a double-blind randomised study. Lancet Gastroenterol. Hepatol. https://doi.org/10.1016/S2468-1253(19)30411-X (2020)
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Dickson, I. A trial of deep-learning detection in colonoscopy. Nat Rev Gastroenterol Hepatol 17, 194 (2020). https://doi.org/10.1038/s41575-020-0279-7