Artificial intelligence alert system based on intraluminal view for colonoscopy intubation

Mucosal contact of the tip of colonoscopy causes red-out views, and more pressure may result in perforation. There is still a lack of quantitative analysis methods for red-out views. We aimed to develop an artificial intelligence (AI)-based system to assess red-out views during intubation in colonoscopy. Altogether, 479 colonoscopies performed by 34 colonoscopists were analysed using the proposed semi-supervised AI-based system. We compared the AI-based red-out avoiding scores among novice, intermediate, and experienced colonoscopists. The mean AI-based red-out avoiding scores were compared among groups stratified by expert-rated direct observation of procedure or skill (DOPS)-based tip control assessment results. Both the percentage of actual red-out views (p < 0.001) and AI-based red-out avoiding scores (p < 0.001) were significantly different among the novice, intermediate, and experienced groups. Colonoscopists who scored better on the DOPS-based tip control assessment also performed better on the AI-based red-out avoiding skill assessment. AI-based red-out avoiding score was negatively correlated with actual caecal intubation time and actual red-out percentage. Feedback of red-out avoiding score may help remind endoscopists to perform colonoscopy in an effective and safe manner. This system can be used as an auxiliary tool for colonoscopy training.