{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:49:42Z","timestamp":1791362982211,"version":"4.3.1"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Endoscopic biopsy is fundamental for diagnosing gastrointestinal lesions, yet the effectiveness of AI assistance on endoscopists' biopsy strategies and efficiency for detecting gastric neoplasms remains unclear. This study aims to investigate this effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This study is a secondary analysis of a randomized controlled trial (AI group:\n n<\/jats:italic>\n \u2009=\u200913,440; control:\n n<\/jats:italic>\n \u2009=\u200912,561) compared AI\u2010assisted versus standard screening. The AI system marked high\u2010risk and low\u2010risk lesions with red and blue boxes, respectively. The AI group was stratified into red\u2010box and non\u2010red\u2010box subgroups. Outcomes included neoplasm biopsy efficiency and proportion of non\u2010biopsied documented lesions. The patient\u2010level correlation between false\u2010positive alerts and biopsy counts was examined. All analyses were based on the pathological results after centralized pathology review.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The non\u2010biopsy rate was significantly lower in the red\u2010box group than in the non\u2010red box group and the control group (18.00% vs. 43.26%, 18.00% vs. 45.60%, both\n p<\/jats:italic>\n \u2009<\u20090.001), suggesting that lesions were biopsied more frequently in the red\u2010box group. Neoplasm biopsy efficiency was higher in the red\u2010box group (8.19% vs. 0.36%, 8.19% vs. 1.77%, both\n p<\/jats:italic>\n \u2009<\u20090.001). In negative binomial regression, red\u2010box classification remained associated with a lower non\u2010biopsy rate (IRR 0.393, 95% CI 0.360\u20130.429,\n p<\/jats:italic>\n \u2009<\u20090.001). False\u2010positive alerts showed a weak inverse correlation with biopsy counts (\n \u03c1<\/jats:italic>\n \u2009=\u2009\u22120.182,\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Red\u2010box classification was associated with more targeted biopsy sampling, while false\u2010positive prompts were not associated with indiscriminate biopsies.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/den.70302","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:55:57Z","timestamp":1791359757000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Computer\u2010Aided Device on Endoscopists' Biopsy Practice for Gastric Neoplasms: A Secondary Analysis of a Randomized Controlled Trial"],"prefix":"10.1111","volume":"38","author":[{"given":"Hongliu","family":"Du","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuzhe","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyi","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinran","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehua","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiamin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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 Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"},{"name":"Taikang Center for Life and Medical Sciences Wuhan University Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Renmin Hospital of Wuhan University Wuhan China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision Renmin Hospital of Wuhan University Wuhan China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease Renmin Hospital of Wuhan University Wuhan China"},{"name":"Engineering Research Center for Artificial Intelligence Endoscopy Interventional Treatment of Hubei Province Wuhan China"},{"name":"Taikang Center for Life and Medical Sciences Wuhan University Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"11","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1055\/a-1611-5091","article-title":"Endoscopic Tissue Sampling \u2010 Part 1: Upper Gastrointestinal and Hepatopancreatobiliary Tracts. European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"53","author":"Pouw R. E.","year":"2021","journal-title":"Endoscopy"},{"issue":"1","key":"e_1_2_7_3_1","doi-asserted-by":"crossref","first-page":"14909","DOI":"10.1038\/s41598-019-51487-0","article-title":"Biopsy Strategies for Endoscopic Screening of Pre\u2010Malignant Gastric Lesions","volume":"9","author":"Zhang M.","year":"2019","journal-title":"Scientific Reports"},{"issue":"3","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.gie.2019.04.216","article-title":"Anatomic Location of Barrett's Esophagus Recurrence After Endoscopic Eradication Therapy: Development of a Simplified Surveillance Biopsy Strategy","volume":"90","author":"Omar M.","year":"2019","journal-title":"Gastrointestinal Endoscopy"},{"issue":"6","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.gie.2024.02.003","article-title":"Diagnostic Yield of Endoscopic and EUS\u2010Guided Biopsy Techniques in Subepithelial Lesions of the Upper GI Tract: A Systematic Review","volume":"99","author":"Verloop C. A.","year":"2024","journal-title":"Gastrointestinal Endoscopy"},{"issue":"3","key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1159\/000511867","article-title":"Biopsy Sampling in Upper Gastrointestinal Endoscopy: A Survey From 10 Tertiary Referral Centres Across Europe","volume":"39","author":"Bornschein J.","year":"2021","journal-title":"Digestive Diseases"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.1008537","article-title":"Two\u2010Step Artificial Intelligence System for Endoscopic Gastric Biopsy Improves the Diagnostic Accuracy of Pathologists","volume":"12","author":"Zhu Y.","year":"2022","journal-title":"Frontiers in Oncology"},{"issue":"4","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1007\/s10620-018-4947-1","article-title":"Adenoma Detection Rate Falls at the End of the Day in a Large Multi\u2010Site Sample","volume":"63","author":"Marcondes F. O.","year":"2018","journal-title":"Digestive Diseases and Sciences"},{"issue":"1","key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1186\/s12876-025-04255-6","article-title":"Histopathologic Discrepancies Between Endoscopic Forceps Biopsy and Resection Specimens in Duodenal Papillary Lesions: A Retrospective Study","volume":"25","author":"Zheng Z.","year":"2025","journal-title":"BMC Gastroenterology"},{"issue":"4","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1136\/gutjnl-2019-319460","article-title":"Real\u2010Time Use of Artificial Intelligence in the Evaluation of Cancer in Barrett's Oesophagus","volume":"69","author":"Ebigbo A.","year":"2020","journal-title":"Gut"},{"issue":"6","key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.gie.2019.12.049","article-title":"Artificial Intelligence Using Convolutional Neural Networks for Real\u2010Time Detection of Early Esophageal Neoplasia in Barrett's Esophagus (With Video)","volume":"91","author":"Hashimoto R.","year":"2020","journal-title":"Gastrointestinal Endoscopy"},{"issue":"6","key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1016\/j.gie.2019.12.048","article-title":"Deep Learning Algorithm Detection of Barrett's Neoplasia With High Accuracy During Live Endoscopic Procedures: A Pilot Study (With Video)","volume":"91","author":"Groof A. J.","year":"2020","journal-title":"Gastrointestinal Endoscopy"},{"issue":"5","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1007\/s10120-020-01071-7","article-title":"A Deep Learning Method for Delineating Early Gastric Cancer Resection Margin Under Chromoendoscopy and White Light Endoscopy","volume":"23","author":"An P.","year":"2020","journal-title":"Gastric Cancer"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanwpc.2024.101308","article-title":"Effectiveness of an Intelligent Endoscopic Assistant Device for Detecting Gastric Neoplasms and Its Application Conditions: A Multi\u2010Center, Randomized, Controlled Trial","volume":"55","author":"Dong Z.","year":"2025","journal-title":"Lancet Regional Health \u2013 Western Pacific"},{"issue":"1","key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1186\/s13063-023-07346-5","article-title":"The Effectiveness of a Computer\u2010Aided System in Improving the Detection Rate of Gastric Neoplasm and Early Gastric Cancer: Study Protocol for a Multi\u2010Centre, Randomized Controlled Trial","volume":"24","author":"Dong Z.","year":"2023","journal-title":"Trials"},{"issue":"2","key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.cgh.2022.07.006","article-title":"Artificial Intelligence\u2010Assisted Colonoscopy for Colorectal Cancer Screening: A Multicenter Randomized Controlled Trial","volume":"21","author":"Xu H.","year":"2023","journal-title":"Clinical Gastroenterology and Hepatology"},{"issue":"12","key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1055\/a-1350-5583","article-title":"Evaluation of the Effects of an Artificial Intelligence System on Endoscopy Quality and Preliminary Testing of Its Performance in Detecting Early Gastric Cancer: A Randomized Controlled Trial","volume":"53","author":"Wu L.","year":"2021","journal-title":"Endoscopy"},{"issue":"12","key":"e_1_2_7_18_1","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1055\/a-1950-5694","article-title":"Expected Value of Artificial Intelligence in Gastrointestinal Endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement","volume":"54","author":"Messmann H.","year":"2022","journal-title":"Endoscopy"}],"container-title":["Digestive Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.70302","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/den.70302","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/den.70302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:55:59Z","timestamp":1791359759000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/den.70302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/den.70302"],"URL":"https:\/\/doi.org\/10.1111\/den.70302","archive":["Portico"],"relation":{},"ISSN":["0915-5635","1443-1661"],"issn-type":[{"value":"0915-5635","type":"print"},{"value":"1443-1661","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70302"}}