{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:18:18Z","timestamp":1789089498497,"version":"build-2803163510"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"09","funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["TRIANGLE Award"],"award-info":[{"award-number":["TRIANGLE Award"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"crossref","award":["Career Development Award"],"award-info":[{"award-number":["Career Development Award"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000149","name":"Canadian Association of Gastroenterology","doi-asserted-by":"crossref","award":["TRIANGLE Award"],"award-info":[{"award-number":["TRIANGLE Award"]}],"id":[{"id":"10.13039\/501100000149","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Computer-aided diagnosis (CADx) may support optical diagnosis of diminutive (\u22645 mm) colorectal polyps, replacing histopathology. We described CADx usage and diagnostic performance under real-life, discretionary adoption.<\/jats:p>\n                  <jats:p>This prospective implementation study enrolled patients undergoing colonoscopy at our tertiary center (2021\u20132025). Patients aged &lt;40 years, with inflammatory bowel disease, polyposis syndromes, or no diminutive polyp were excluded. CADx use was at the endoscopists\u2019 discretion. Endoscopists\u2019 optical diagnoses with and without CADx assistance, and the CADx output were documented. Main outcomes were CADx usage and sensitivity for adenomas of CADx-assisted and CADx-unassisted optical diagnosis, using histopathology as reference.<\/jats:p>\n                  <jats:p>868 patients (age 66.1 years, 47.0% female) with 1660 diminutive polyps (62.0% adenomas) were included. Endoscopists recorded CADx-assisted and CADx-unassisted optical diagnoses for 657 and 864 polyps, respectively, showing sensitivity of 85.1% (95%CI 78.3\u201390.1) and 85.1% (81.2\u201388.4), specificity 55.2% (45.8\u201364.3) and 61.1% (54.5\u201367.3), positive predictive value 76.2% (69.1\u201382.1) and 79.3% (75.5\u201382.9), negative predictive value (NPV) 60.8% (52.6\u201368.5) and 67.1% (60.7\u201373.0), and accuracy 62.7% (56.5\u201368.4) and 66.4% (63.0\u201369.7), respectively. In a simulated resect-and-discard strategy, CADx assistance marginally increased the proportion of polyps that could avoid histopathology (84.9% vs. 81.1%). For high-confidence rectosigmoid diagnoses, NPV for adenomas was 95.5% (86.9\u201398.5) for CADx-assisted and 93.8% (85.9\u201397.4) for CADx-unassisted predictions.<\/jats:p>\n                  <jats:p>Both CADx-assisted and CADx-unassisted optical diagnoses showed good diagnostic performance in real-world practice. Assessment of the relationship between CADx use and optical diagnosis was limited by unavoidable selection bias relating to discretionary use and variable endoscopist behavior.<\/jats:p>","DOI":"10.1055\/a-2882-7665","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T22:54:09Z","timestamp":1779490449000},"page":"1017-1025","source":"Crossref","is-referenced-by-count":1,"title":["Computer-assisted and unassisted optical diagnosis of colorectal polyps: results from a prospective pragmatic implementation study"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0688-4869","authenticated-orcid":false,"given":"Edgard","family":"Medawar","sequence":"first","affiliation":[{"name":"University of Montreal Hospital Centre Research Centre, Canada","place":["Montreal"],"department":["Division of 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