Computer‐Aided Detection‐Assisted Colonoscopy Teaches Gaze to Improve Adenoma Detection in First‐Year Gastroenterology Fellows

ABSTRACT Background and Aims The impact of computer‐aided detection (CADe)‐assisted colonoscopy on gastroenterology fellow trainees remains incompletely defined. In this study, adenoma detection rates (ADR) with and without CADe were assessed among gastroenterology fellows. Methods This quality improvement study compared 1580 colonoscopies performed with and without CADe. The primary outcome was the ADR in fellow‐assisted colonoscopies, with and without CADe, stratified by fellowship year. ADRs were compared among procedures assisted by first‐year fellows; those assisted by second‐ and third‐year fellows (combined); and those performed by faculty without a fellow. Results Age, birth sex, race, body mass index, procedure indication, non‐neoplastic resection rate, and withdrawal time were similar. CADe‐assisted colonoscopy significantly improved the ADR for first‐year fellows (66.2% vs. 48.6%, p < 0.001). However, for colonoscopies assisted by second‐ and third‐year fellows, the ADR was not significantly different (61.5% vs. 58.7%, p = 0.39). Although there was an upward trend in ADR for CADe‐assisted colonoscopies performed by faculty without fellow participation (61% vs. 50%), it was not statistically significant ( p = 0.24). Conclusion CADe‐assisted colonoscopy improved ADR in first‐year fellow‐assisted procedures. The bounding box created by the system's artificial intelligence may enhance polyp detection by improving peripheral gaze patterns in novice endoscopists. Further studies are needed to validate this hypothesis.