Abstract
OBJECTIVES: Computer-aided diagnosis (CADx) is anticipated to enhance the prediction of colorectal polyp histology. This study aims to compare the diagnostic accuracy of CADx in the optical diagnosis of colorectal polyps, evaluating its performance against that of both experienced and inexperienced endoscopists. METHODS: The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42024585097). Three electronic databases including MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched in September 2024. A bivariate random effects model was employed. The primary outcome was the comparison of sensitivity and specificity between CADx and experienced endoscopists; the secondary outcome was the comparison between CADx and inexperienced endoscopists. RESULTS: Twenty-one studies involving 5477 polyps were included. The pooled sensitivities of CADx and experienced endoscopists were 0.87 (95% confidence interval [CI] 0.82-0.91) and 0.88 (95% CI 0.83-0.91), respectively (P = 0.93). The pooled specificities of CADx and experienced endoscopists were 0.85 (95% CI 0.78-0.90) and 0.87 (95% CI 0.82-0.92), respectively (P = 0.53). In nine studies comparing CADx with inexperienced endoscopists, the pooled sensitivities were 0.88 (95% CI 0.82-0.92) for CADx and 0.85 (95% CI 0.78-0.90) for inexperienced endoscopists (P = 0.46). The pooled specificities were 0.84 (95% CI 0.78-0.88) for CADx and 0.77 (95% CI 0.70-0.83) for inexperienced endoscopists (P = 0.16). CONCLUSION: Computer-aided diagnosis does not demonstrate superior diagnostic accuracy in optical diagnosis of colorectal polyps compared to endoscopists, regardless of their experience level.