CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-18). The draft was written by AI, the existence of all 2 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2843 · Search date 2026-08-18 · Methodology v0.7

Real-time computer-aided detection,
does it really help with Increased adenoma detection rate during colonoscopy?

30-Second Summary
C
Evidence Grade C · 50 · Safety caution
AI found more adenomas during colonoscopy but did not establish fewer cancers or deaths
AI prompts are an adjunct and do not replace bowel preparation, adequate withdrawal, endoscopist judgment, or pathology. Additional detection can cause extra removal, pathology, and surveillance, so downstream benefits and harms matter.
What the
research shows
The grade is C with 50 points. Histology-confirmed adenoma detection was 187/341 (54.8%) with CADe versus 139/344 (40.4%), an absolute increase of 14.4 percentage points and RR 1.30 (95% CI 1.14 to 1.45). ADR is a detection-rate surrogate, not colorectal cancer incidence or mortality, so the grade is capped at C.
What the
ads claim
South Korean hospitals market AI-assisted endoscopy in checkup programs. Detection assistance must not be advertised as proven reduction in colorectal cancer mortality.
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Useful facts when choosing a product

  • Adenomas per colonoscopy were 1.07 versus 0.71, IRR 1.46 (95% CI 1.15 to 1.86).
  • Non-neoplastic resection was 26.0% versus 28.8%, with no difference.
  • Mean withdrawal time was 417 versus 435 seconds, without a clear difference.
Gap Measurement · Verdict 2843 · C 50
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Three Italian centers randomized 700 patients and analyzed 685 (341/344). Endoscopists could not be blinded to real-time prompts, but blinded pathologists confirmed the objective primary endpoint, so an unblinded subjective endpoint does not apply. Limitation: inadequate randomization or allocation concealment. Listed item: inadequate randomization or allocation concealment. Avoidability: possible - the center-specific stratified random lists could have been implemented and reported through secure central release after enrollment. Exclusion was 15/700 (2.1%), below substantial attrition (>=15%). The paper calls the study nonprofit with no cash funding, but acknowledgments and conflicts disclose a Medtronic equipment loan and Medtronic consulting fees to Repici and Hassan, so it is not classified as publicly independent.

02

Why this is classified as C (50)

The primary endpoint is a detection-rate surrogate, capping the grade at C. A 14.4-point absolute ADR gain is balanced against one RCT, Medtronic equipment and author consulting, and unreported concealment, giving C with 50 points.

Counterpoint. Verdict 1716 is C with 52 points, verdict 1473 is A with 92 points, and verdict 2511 is C with 56 points. Those ask whether screening occurs or reduces cancer incidence and death; this verdict asks whether an ongoing colonoscopy detects more.

Rejudgment record. New verdict — Histology-confirmed ADR increase, detection-rate cap, equipment loan and author conflicts, and unreported concealment

Scoring profile behind this grade
EndpointSSurrogate marker - laboratory or imaging measures
ReplicationR1Single confirmatory trial
IndependenceI1Mixed funding sources
Effect sizeE+Meets the clinically important threshold

The scoring table and the verdict agree (C).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Higher adenoma detection rate during colonoscopyCADR increased by 14.4 percentage points.
Reduced colorectal cancer incidence or mortalityDThe trial did not measure long-term patient outcomes.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Open randomized trial at three Italian centers with blinded pathology344Medtronic equipment loan; Medtronic consulting fees to Repici and HassanADR: proportion with at least one histologically proven adenoma or carcinoma54.8% vs 40.4%; absolute difference +14.4 points; RR 1.30 (95% CI 1.14 to 1.45)Pivotal detection-rate surrogate RCT
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Receipt — 2 References

All 2 cited sources were verified for existence at the original page (as of 2026-08-18).

Repici A, Badalamenti M, Maselli R, et al. Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial. Gastroenterology. 2020;159:512-520.e7. PMID: 32371116.
checked
Reference 2
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-18 · Corrections: none

Cite this verdict

Real-Time Computer-Aided Detection During Colonoscopy for Adenoma Detection Rate — Benefit Evidence Grade C card
[Chamgap] Real-Time Computer-Aided Detection During Colonoscopy for Adenoma Detection Rate — Benefit — Evidence Grade C·50. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/gut/real-time-ai-cade-colonoscopy-adenoma-detection/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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