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Endoscopy
Original article
Randomised controlled trial of WISENSE, a real-time quality improving system for monitoring blind spots during esophagogastroduodenoscopy
  1. Lianlian Wu1,2,3,
  2. Jun Zhang1,2,3,
  3. Wei Zhou1,2,3,
  4. Ping An1,2,3,
  5. Lei Shen1,2,3,
  6. Jun Liu1,3,
  7. Xiaoda Jiang1,2,3,
  8. Xu Huang1,2,3,
  9. Ganggang Mu1,2,3,
  10. Xinyue Wan1,2,3,
  11. Xiaoguang Lv1,2,3,
  12. Juan Gao1,3,
  13. Ning Cui1,2,3,
  14. Shan Hu4,
  15. Yiyun Chen4,
  16. Xiao Hu4,
  17. Jiangjie Li4,
  18. Di Chen1,2,3,
  19. Dexin Gong1,2,3,
  20. Xinqi He1,2,3,
  21. Qianshan Ding1,2,3,
  22. Xiaoyun Zhu1,2,3,
  23. Suqin Li1,2,3,
  24. Xiao Wei1,2,3,
  25. Xia Li1,2,3,
  26. Xuemei Wang1,2,3,
  27. Jie Zhou1,2,3,
  28. Mengjiao Zhang1,2,3,
  29. Hong Gang Yu1,2,3
  1. 1 Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
  2. 2 Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China
  3. 3 Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Wuhan University Renmin Hospital, Wuhan, China
  4. 4 School of Resources and Environmental Sciences of Wuhan University, Wuhan, China
  1. Correspondence to Professor Hong Gang Yu, Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan 430060, China; yuhonggang1968{at}163.com

Abstract

Objective Esophagogastroduodenoscopy (EGD) is the pivotal procedure in the diagnosis of upper gastrointestinal lesions. However, there are significant variations in EGD performance among endoscopists, impairing the discovery rate of gastric cancers and precursor lesions. The aim of this study was to construct a real-time quality improving system, WISENSE, to monitor blind spots, time the procedure and automatically generate photodocumentation during EGD and thus raise the quality of everyday endoscopy.

Design WISENSE system was developed using the methods of deep convolutional neural networks and deep reinforcement learning. Patients referred because of health examination, symptoms, surveillance were recruited from Renmin hospital of Wuhan University. Enrolled patients were randomly assigned to groups that underwent EGD with or without the assistance of WISENSE. The primary end point was to ascertain if there was a difference in the rate of blind spots between WISENSE-assisted group and the control group.

Results WISENSE monitored blind spots with an accuracy of 90.40% in real EGD videos. A total of 324 patients were recruited and randomised. 153 and 150 patients were analysed in the WISENSE and control group, respectively. Blind spot rate was lower in WISENSE group compared with the control (5.86% vs 22.46%, p<0.001), and the mean difference was −15.39% (95% CI −19.23 to −11.54). There was no significant adverse event.

Conclusions WISENSE significantly reduced blind spot rate of EGD procedure and could be used to improve the quality of everyday endoscopy.

Trial registration number ChiCTR1800014809; Results.

  • endoscopy

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/gutjnl-2018-317366

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    Footnotes

    • LW, JZ and WZ contributed equally.

    • Contributors HGY conceived and supervised the overall study. LLW designed and conducted the experiments. JZ, WZ, PA, LS and XJ labelled image or video data. JL supervised the experiments. XH, GM, XinW, XL, JG and NC performed endoscopy in the clinical trial. SH, YC, XH and JL developed the system. DC, DG, XH and QD analysed the data. XZ, SL, XiaW, LX, XuW, JZ and MZ were involved in data collection. LLW wrote the manuscript. HGY is responsible for the overall content as guarantor. All authors approved the final version of the manuscript.

    • Funding This work was partly supported by the grant from the Research Funds for Key Laboratory of Hubei Province (No 2016CFA066), the National Natural Science Foundation of China (grant nos 81672387 [to HGY]) and the China Youth Development Foundation (grant no 81703030 [to QD]).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.