SAN DIEGO — Researchers have developed a novel system that provides real-time feedback during colonoscopy and can be readily implemented into existing practices without adversely affecting screening procedures, according to data presented at the 2012 Digestive Disease Week Annual Meeting.
The software infrastructure, called Semi-Automated Parallel Programming Heterogeneous Intelligent Reconfigurable Environment (SAPPHIRE), has been implemented on Windows XP and Windows 7 workstations. It allows for simultaneous execution of video capturing, annotation and feedback modules that communicate with one another, and each incorporates results from the other modules. Feedback appears within two-tenths of a second and can be text-based or incorporate images with location and time information. The system provides an overall score for the procedure, as well as for preparation, cleansing and thoroughness.
“Rather than give an average performance report over a year or half-year of endoscopies, we would like to give a report on quality at the end of each procedure,” Piet C. de Groen, MD, professor of medicine at the Mayo Clinic in Rochester, Minn., told Healio.com. “We have a system that can actually tell you, independently and objectively, how well you perform an endoscopy. Patients will have the empowerment to see the score for their endoscopy, rather than [relying on] somebody saying, ‘We think we did a good exam.’ I think that patients will like this, I think insurance companies will like this, and I think doctors who really do a good job will like this.”
In a related study, researchers evaluated whether the SAPPHIRE system can be readily implemented into existing practices, and whether it will lengthen overall procedure time. Systems were installed in two facilities already using video capture systems, and endoscopy RNs activated the systems during the withdrawal phase of colonoscopies and turned them off at the end of the procedure. Investigators collected 22 random video files (11 including and 11 not including use of the feedback system) to determine the effect of its use on procedure time.
The average total procedure time was 33 minutes in the videos incorporating the system compared with 32 minutes in the group without it (P=.39). The mean insertion time was slightly greater in the feedback group (15 minutes vs. 12.5 minutes, P=.06), and the mean withdrawal time was slightly shorter (17.9 minutes vs. 19.6 minutes, P=.33); neither was considered statistically significant. Mucosal visualization scores were similar: 85.3% in the feedback group compared with 86.6% in the non-feedback group (P=.33). The average rating on the Boston Bowel Preparation Scale was 6.8 of 9 in both groups (P=.43).
Investigators concluded that the system can be readily installed and does not adversely impact procedure time. “This is a very small pilot study, but you don’t see any big difference,” researcher Nandakumar Srinivasan, MD, told Healio.com. “It is feasible, and it doesn’t increase [procedure] time; we want to see if [real-time feedback] will make a difference in terms of the quality of the inspection by itself.” Srinivasan added that a clinical trial on the subject is under way and scheduled for completion later this year.
For more information:
De Groen PC. #Sa1855: A Novel System Able to Provide Real-Time Feedback During Colonoscopy. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, San Diego.
Srinivasan N. #Sa1110: Will Real-Time Feedback Systems Adversely Affect Colonoscopy Practice? Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, San Diego.