{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:53:10Z","timestamp":1785876790186,"version":"3.56.0"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Fonds de Recherche du Qu\u00e9bec Sant\u00e9"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Artificial intelligence (AI)-based computer-aided diagnosis (CADx) systems are increasingly used to classify colorectal polyps during colonoscopy, but their impact depends on how endoscopists interpret AI predictions. This study aimed to evaluate endoscopists\u2019 decision-making after reviewing CADx outputs, using histopathology diagnosis as ground truth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We performed a secondary analysis of a prospective study (NCT06822816) conducted at our centre between 2022 and 2025. All patients and polyps \u226410\u2009mm with documented CADx output and endoscopist diagnosis were included. Endoscopists either accepted CADx classifications (neoplastic vs hyperplastic) or provided alternatives. Our primary outcome was the accuracy of accepted CADx diagnoses; secondary outcomes assessed reclassification patterns after CADx output rejection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our cohort included 754 polyps &amp;lt;10 mm from 367 patients. Accepted CADx diagnoses were correct for 89.1% of neoplastic and 68.7% of hyperplastic CADx predictions. Endoscopists accepted incorrect CADx classifications more frequently when these were neoplastic compared to hyperplastic (64.9% vs 26.5%). Upon rejecting correct CADx neoplastic predictions, endoscopists misclassified 23.4% as sessile serrated lesions (SSLs). Similarly, 29.5% of rejected correct CADx hyperplastic predictions were incorrectly reassigned as SSLs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endoscopists exhibit a diagnostic bias toward neoplasia, particularly misclassifying hyperplastic polyps as SSLs. While this may enhance safety, it may risk unnecessary surveillance colonoscopies and increase costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jcag\/gwag016","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:50:49Z","timestamp":1776430249000},"page":"204-209","source":"Crossref","is-referenced-by-count":0,"title":["Human\u2013machine interaction in optical polyp diagnosis: decision-making after CADx polyp diagnosis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5538-5435","authenticated-orcid":false,"given":"Delphine","family":"Dubois","sequence":"first","affiliation":[{"name":"University of Montreal Hospital Research Center (CRCHUM) , Montreal, Quebec, H2X0A9,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousr","family":"Jalal","sequence":"additional","affiliation":[{"name":"University of Montreal Hospital Research Center (CRCHUM) , Montreal, Quebec, H2X0A9,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Pohl","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Medical Center, White River Junction, VT and The Geisel School of Medicine at Dartmouth , Hanover, NH 05009,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas K","family":"Rex","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology\/Hepatology, IN University School of Medicine , Indianapolis, IN 46202,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Gastroenterology, Endoscopy Unit, IRCCS Humanitas Research Hospital , Rozzano, 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