Computer-aided quality assessment of endoscopist competence during colonoscopy: a systematic review

Background and A & Oslash;s: Endoscopists ' competence can vary widely, as shown in the variation in the adenoma detection rate (ADR). Computer-aided quality assessment (CAQ) can automatically assess performance during individual procedures. In this review we identi fi ed and described different CAQ systems for colonoscopy. Methods: A systematic review of the literature was done using MEDLINE, EMBASE, and Scopus based on 3 blocks of terms according to the inclusion criteria: colonoscopy, competence assessment, and automatic evaluation. Articles were systematically reviewed by 2 reviewers, fi rst by abstract and then in full text. The methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Results: Of 12,575 identi fi ed studies, 6831 remained after removal of duplicates and 6806 did not pass the eligibility criteria and were excluded, leaving 25 studies, of which 13 studies were included in the fi nal analysis. Five categories of CAQ systems were identi fi ed: withdrawal speedometer (7 studies), endoscope movement analysis (3 studies), effective withdrawal time (1 study), fold examination quality (1 study), and visual gaze pattern (1 study). The withdrawal speedometer was the only CAQ system that tested its feedback by examining changes in ADR. Three studies observed an improvement in ADR, and 2 studies did not. The methodological quality of the studies was high (mean MERSQI, 15.2 points; maximum, 18 points). Conclusions: Thirteen studies developed or tested CAQ systems, most frequently by correlating it to the ADR. Only 5 studies tested feedback by implementing the CAQ system. A meta-analysis was impossible because of the heterogeneous study designs, and more studies are warranted. (Gastrointest Endosc 2024;100:167-76.)