{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T16:52:52Z","timestamp":1770223972663,"version":"3.49.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2002Estimates on miss rates for upper gastrointestinal neoplasia (UGIN) rely on registry data or old studies. Quality assurance programs for upper GI endoscopy are not fully established owing to the lack of infrastructure to measure endoscopists\u2019 competence. We aimed to assess endoscopists\u2019 accuracy for the recognition of UGIN exploiting the framework of artificial intelligence (AI) validation studies.<\/jats:p><jats:p>\n          Methods\u2002Literature searches of databases (PubMed\/MEDLINE, EMBASE, Scopus) up to August 2020 were performed to identify articles evaluating the accuracy of individual endoscopists for the recognition of UGIN within studies validating AI against a histologically verified expert-annotated ground-truth. The main outcomes were endoscopists\u2019 pooled sensitivity, specificity, positive and negative predictive value (PPV\/NPV), and area under the curve (AUC) for all UGIN, for esophageal squamous cell neoplasia (ESCN), Barrett esophagus-related neoplasia (BERN), and gastric adenocarcinoma (GAC).<\/jats:p><jats:p>\n          Results\u2002Seven studies (2 ESCN, 3 BERN, 1 GAC, 1 UGIN overall) with 122 endoscopists were included. The pooled endoscopists\u2019 sensitivity and specificity for UGIN were 82\u200a% (95\u200a% confidence interval [CI] 80\u200a%\u201384\u200a%) and 79\u200a% (95\u200a%CI 76\u200a%\u201381\u200a%), respectively. Endoscopists\u2019 accuracy was higher for GAC detection (AUC 0.95 [95\u200a%CI 0.93\u20130.98]) than for ESCN (AUC 0.90 [95\u200a%CI 0.88\u20130.92]) and BERN detection (AUC 0.86 [95\u200a%CI 0.84\u20130.88]). Sensitivity was higher for Eastern vs. Western endoscopists (87\u200a% [95\u200a%CI 84\u200a%\u201389\u200a%] vs. 75\u200a% [95\u200a%CI 72\u200a%\u201378\u200a%]), and for expert vs. non-expert endoscopists (85\u200a% [95\u200a%CI 83\u200a%\u201387\u200a%] vs. 71\u200a% [95\u200a%CI 67\u200a%\u201375\u200a%]).<\/jats:p><jats:p>\n          Conclusion\u2002We show suboptimal accuracy of endoscopists for the recognition of UGIN even within a framework that included a higher prevalence and disease awareness. Future AI validation studies represent a framework to assess endoscopist competence.<\/jats:p>","DOI":"10.1055\/a-1500-3730","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T23:15:47Z","timestamp":1620256547000},"page":"403-411","source":"Crossref","is-referenced-by-count":20,"title":["Endoscopists\u02bc diagnostic accuracy in detecting upper gastrointestinal neoplasia in the framework of artificial intelligence studies"],"prefix":"10.1055","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7084-6157","authenticated-orcid":false,"given":"Leonardo","family":"Frazzoni","sequence":"first","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy"}]},{"given":"Giulio","family":"Antonelli","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy"},{"name":"Department of Translational and Precision Medicine, \u201cSapienza\u201d University of Rome, Rome, Italy"}]},{"given":"Julia","family":"Arribas","sequence":"additional","affiliation":[{"name":"CIDES\/CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2691-7522","authenticated-orcid":false,"given":"Diogo","family":"Libanio","sequence":"additional","affiliation":[{"name":"CIDES\/CINTESIS, Faculty of Medicine, University of Porto, Porto, Portugal"}]},{"given":"Alanna","family":"Ebigbo","sequence":"additional","affiliation":[{"name":"III Medizinische Klinik, Universitatsklinikum Augsburg, Augsburg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3593-2356","authenticated-orcid":false,"given":"Fons","family":"van der Sommen","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, VCA group, Eindhoven University of Technology, Eindhoven, The Netherlands"}]},{"given":"Albert Jeroen","family":"de Groof","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands"}]},{"given":"Hiromu","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-2377","authenticated-orcid":false,"given":"Masayasu","family":"Ohmori","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan"}]},{"given":"Ryu","family":"Ishihara","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan"}]},{"given":"Lianlian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Institute for Gastroenterology and Hepatology, Wuhan University, Wuhan, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-7060","authenticated-orcid":false,"given":"Honggang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Institute for Gastroenterology and Hepatology, Wuhan University, Wuhan, China"}]},{"given":"Yuichi","family":"Mori","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway"},{"name":"Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit, Humanitas Research Hospital \u2013 IRCCS, Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy"}]},{"given":"Jacques J. G. H. M.","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam, The Netherlands"}]},{"given":"Prateek","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Kansas Medical Center, Kansas City, Kansas, USA"}]},{"given":"Helmut","family":"Messmann","sequence":"additional","affiliation":[{"name":"III Medizinische Klinik, Universitatsklinikum Augsburg, Augsburg, Germany"}]},{"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8618-2447","authenticated-orcid":false,"given":"Lorenzo","family":"Fuccio","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC), University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy"}]},{"given":"M\u00e1rio","family":"Dinis-Ribeiro","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal"}]}],"member":"194","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1053\/j.gastro.2020.02.068","article-title":"Global burden of 5 major types of gastrointestinal cancer","volume":"159","author":"M Arnold","year":"2020","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1055\/a-0859-1883","article-title":"Management of epithelial precancerous conditions and lesions in the stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa de Endoscopia Digestiva (SPED) guideline update 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Endosc"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1500-3730.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T09:54:26Z","timestamp":1660125266000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1500-3730"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,5]]},"references-count":28,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2022,3,29]]},"published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1500-3730","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,5,5]]},"published":{"date-parts":[[2021,5,5]]}}}