Prateek Sharma

Kansas City VA Medical Center · Department of Gastroenterology

Background: Computer-aided diagnosis (CADx) allows prediction of polyp histology during colonoscopy, which may reduce unnecessary removal of nonneoplastic polyps. However, the potential benefits and harms of CADx are still unclear. Purpose: To quantify the benefit and harm of using CADx in colonoscopy for the optical diagnosis of small (≤5-mm) r...

There is limited data on the prevalence and risk factors of colonic adenoma from the Indian sub-continent. We aimed at developing a machine-learning model to optimize colonic adenoma detection in a prospective cohort. All consecutive adult patients undergoing diagnostic colonoscopy were enrolled between October 2020 and November 2022. Patients with...

Background and aims: Accurate polyp size estimation during colonoscopy has an impact on clinical decision-making. A laser-based virtual scale endoscope (VSE) is available to allow measuring polyp size using a virtual adaptive scale. This study evaluates video-based polyp size measurement accuracy among expert endoscopists using either VSE or visua...

Introduction Adenoma per colonoscopy (APC) has recently been proposed as a quality measure for colonoscopy. We evaluated the impact of a novel AI system, compared to standard HD colonoscopy, for APC measurement. Methods This was a U.S. based, multi-center, prospective randomized trial examining a novel AI detection system (EW10-EC02) that enables...

Background Cold forceps and snares are each effective for removing polyps of 1–3 mm, while snares are more effective for polyps of 4–10 mm in size. If, in the same patient, polyps of 1–3 mm are removed with forceps and those of 4–10 mm with snares, two devices are used. If cold snares are used to resect all lesions of 1–10 mm (one-device colonoscop...

Background: Artificial intelligence computer-aided detection (CADe) of colorectal neoplasia during colonoscopy may increase adenoma detection rates (ADRs) and reduce adenoma miss rates, but it may increase overdiagnosis and overtreatment of nonneoplastic polyps. Purpose: To quantify the benefits and harms of CADe in randomized trials. Design:...

Background/objective: Increasing infectious rate estimates and low microbiological surveillance affect safety of gastrointestinal endoscopy globally. Single use endoscopes and accessories have been claimed to improve safety, but there is lack of data on their indication and sustainability. We aimed to identify a series of best practice recommendat...

Importance: The Colonoscopy Versus Fecal Immunochemical Test in Reducing Mortality From Colorectal Cancer (CONFIRM) randomized clinical trial sought to recruit 50 000 adults into a study comparing colorectal cancer (CRC) mortality outcomes after randomization to either an annual fecal immunochemical test (FIT) or colonoscopy. Objective: To (1) d...

Background Proton pump inhibitors (PPIs) are highly effective in treating gastroesophageal reflux disease (GERD). However, persistent, troublesome reflux symptoms despite PPI use are common, and a proportion of individuals with these persistent symptoms is considered to have refractory GERD (rGERD). There are limited data on patients’ experience wi...

Over the last two decades, endoscopic eradication therapy has been established as the therapeutic strategy of choice for patients with Barrett’s oesophagus-related dysplasia and early oesophageal adenocarcinoma. With a multimodal approach, ablative therapies have been highly effective in achieving remarkable eradication rates of metaplastic epithel...

Background & aims: Both Computer-aided detection (CADe)- assisted and Endocuff-assisted colonoscopy have shown to increase adenoma detection. We investigated the performance of the combination of the two tools compared to CADe-assisted colonoscopy alone to detect colorectal neoplasias during colonoscopy in a multicenter randomized trial. Methods:...

Colorectal cancer (CRC) is the third most common cancer worldwide, with the highest incidence reported in high-income countries. However, because of the slow progression of neoplastic precursors, along with the opportunity for their endoscopic detection and resection, a well-designed endoscopic screening program is expected to strongly decrease col...

Background and aims: Real-world data on the adverse events and the survival benefit of Barrett's endoscopic therapy (BET) is limited. We aim to examine the safety and effectiveness (survival benefit) of BET in patients with neoplastic Barrett's esophagus (BE). Methods: An electronic health record-based database (TriNetX) was utilized to select p...

The number of artificial intelligence (AI) tools for colonoscopy on the market is increasing with supporting clinical evidence. Nevertheless, their implementation is not going smoothly for a variety of reasons, including lack of data on clinical benefits and cost-effectiveness, lack of trustworthy guidelines, uncertain indications, and cost for imp...

In the past few years, we have seen a surge in the development of relevant artificial intelligence (AI) algorithms addressing a variety of needs in GI endoscopy. To accept AI algorithms into clinical practice, their effectiveness, clinical value, and reliability need to be rigorously assessed. In this article, we provide a guiding framework for all...

Simple Summary Esophageal cancer is not an uncommon malignancy in the world with a relatively high mortality. There has been a dramatic upward trajectory (approximately 400%) in the number of patients diagnosed with the glandular form of esophageal cancer (adenocarcinoma) since the 1970’s. It has been thought that this condition is related to chron...

Background and aims Greenhouse gases (GHGs) that trap heat in the atmosphere are composed of carbon dioxide (CO 2 ), methane, nitrous oxide and fluorinated gases (synthetic hydrofluorocarbons, perfluorocarbons and nitrogen trifluoride). In the USA, the health sector accounts for 8.5% of total GHG emissions. The primary objective of this systematic...

Introduction: Recent randomized controlled trials (RCTs) and meta-analysis have demonstrated improved adenoma detection rate (ADR) for colonoscopy with artificial intelligence (AI) compared with high-definition (HD) colonoscopy without AI. We aimed to perform a systematic review and network meta-analysis of all RCTs to assess the impact of AI comp...

Background Artificial Intelligence (AI) is set to impact several fields within gastroenterology. In gastrointestinal (GI) endoscopy, AI-based tools have translated into clinical practice faster than expected. We aimed to evaluate the status of research for AI in Gastroenterology while predicting its future applications. Methods All studies registe...

Introduction Various endoscopic resection techniques have been proposed for the treatment of nonpedunculated colorectal polyps sized 6–20 mm, however the optimal technique still remains unclear. Methods A comprehensive literature review was conducted for randomized controlled trials (RCTs), investigating the efficacy of endoscopic treatments for t...

This ESGE Position Statement defines the expected value of artificial intelligence (AI) for the diagnosis and management of gastrointestinal neoplasia within the framework of the performance measures already defined by ESGE. This is based on the clinical relevance of the expected task and the preliminary evidence regarding artificial intelligence i...