{"id":"AIBD-0623","title":"FDA De Novo review of GI Genius: randomized trial finds more adenomas with AI-aided colonoscopy","summary":"In the randomized Italian trial that FDA reviewed, colonoscopy with GI Genius found adenomas in 55.1% of low-risk patients, against 42.0% with standard colonoscopy.","date_observed":"2019-11-01","date_basis":"event","date_precision":"month","benefit_status":"reported","source_collection":null,"source_entry":null,"account":"Cosmo Artificial Intelligence of Dublin, Ireland, makes GI Genius, a program that marks suspected polyps with a box on the screen during colonoscopy. In the AID trial at three hospitals in Milan, Rome and Como, 700 patients were randomly assigned between September and November 2019 to colonoscopy with or without the program, performed by six endoscopists. FDA asked for an analysis of the 263 patients at low risk of colorectal cancer. In that group, FDA reviewers report an adenoma detection rate of 55.1% with GI Genius against 42.0% with standard colonoscopy, and 0.81 adenomas per colonoscopy against 0.57. The program caused no added adverse events. FDA granted the De Novo request on 9 April 2021. The reviewers note that race was not recorded, that most patients were presumed to be white, and that only six endoscopists in Italy took part. They write that a reduction in cancer risk would need confirmation in further trials.","category":"general benefit","unexpected":false,"purpose":"GI Genius was built to help endoscopists detect colonic lesions such as polyps and adenomas in real time. Higher adenoma detection is that purpose.","system":"GI Genius","model_version":null,"developer":"Cosmo Artificial Intelligence - AI, Ltd.","deployer":"Humanitas Research Hospital, Nuovo Regina Margherita Hospital and Valduce Hospital (AID trial)","location":"Milan, Rome and Como, Italy","domain":"Healthcare","segment":null,"benefit_type":"Improved Task Accuracy","taxonomy_note":null,"registry_ids":{},"ratings":[{"group":"personal","depth":2,"reason":"Patients in the GI Genius arm had at least one adenoma found in 55.1% of procedures against 42.0% in the standard arm."},{"group":"organizational","depth":2,"reason":"Endoscopists found 0.81 adenomas per colonoscopy with the program against 0.57 without it."}],"ai_role":{"status":"assessed","statement":"Patients were randomized to colonoscopy with or without GI Genius, performed by the same endoscopists, so the trial isolates the contribution of the program."},"evidence":[{"kind":"regulatory document","citation":"U.S. Food and Drug Administration, Center for Devices and Radiological Health. De Novo classification request for GI Genius (DEN200055): decision summary. Granted 2021-04-09.","title":"De Novo classification request for GI Genius (DEN200055)","url":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf","date":"2021-04-09","written_by":"independent","quote":"The GI Genius procedures had an ADR* of 55.1% and the standard colonoscopy procedures had an ADR* of 42.0%."},{"kind":"peer-reviewed study","citation":"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(2):512-520.e7.","title":"Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial","url":"https://pubmed.ncbi.nlm.nih.gov/32371116","date":"2020-05-01","written_by":"unknown","quote":"The ADR was significantly higher in the CADe group (54.8%) than in the control group (40.4%) (relative risk [RR], 1.30; 95% confidence interval [CI], 1.14-1.45)."}],"replication":{"produced_by":["Endoscopists with an adenoma detection rate of 25 to 40% used the program during white-light colonoscopy.","A minimum withdrawal time of six minutes was required.","Histology confirmed each lesion."],"must_hold":["The program runs with standard white-light endoscopy.","Endoscopists use the marks as an aid and keep inspecting the whole colon."],"echoes":[]},"paired_incident":null,"headline":"*GI Genius* helped endoscopists find more adenomas in a randomized trial","metric":"an adenoma detection rate of 55.1% with GI Genius against 42.0% with standard colonoscopy","comparator":{"against":"Standard white-light colonoscopy in the same trial","before":"42.0% adenoma detection rate","after":"55.1% adenoma detection rate","basis":"measured","quote":"The GI Genius procedures had an ADR* of 55.1% and the standard colonoscopy procedures had an ADR* of 42.0%.","url":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf"},"later":null,"value":null,"developer_country":"Ireland","deployer_country":"Italy","unrated_because":null,"brief_notes":null,"brief":null,"revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf","editor":"AIBD"}],"confidence":"found","shade":"high","claim_status":"Found by a regulator","claim_basis":"Sources: one independent regulatory document and one peer-reviewed study with authorship relationship unassessed. The cited evidence includes no independent study or report.","case_jurisdictions":["Italy"],"profile":{"case_id":"AIBD-0623","catalog_version":"1.0.0","source_fingerprint":"1e6792d94f0c1a0af3e2061fcae8d3607e09bc1de4bc217a5fcbcf4612d692bd","collection_refs":[{"collection_id":"aibd","version":"2026-10-29"},{"collection_id":"querist","version":"2026-10-25"},{"collection_id":"viator","version":"2026-10-25"}],"source_ids":["AIBD-0623-source-0001","AIBD-0623-source-0002"],"families":{"strategic assessments":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"Editorial assignment.","review_state":"not_assessed","coverage":"partial","record_ids":[]},"evaluations":{"state":"value_present","value":{"kind":"identifiers","identifiers":["AIBD-0623-evaluation-1"],"role":"Evaluations of the benefit"},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":[],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"partial","record_ids":["AIBD-0623-evaluation-1"]},"monetary observations":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"Editorial assignment.","review_state":"not_assessed","coverage":"partial","record_ids":[]},"institutional decisions":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"Editorial assignment.","review_state":"not_assessed","coverage":"partial","record_ids":[]}},"fields":{"actors[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"developer":"Cosmo Artificial Intelligence - AI, Ltd.","deployer":"Humanitas Research Hospital, Nuovo Regina Margherita Hospital and Valduce Hospital (AID trial)"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["developer","deployer"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"actors[].ownership_control":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"ai_contribution":{"state":"value_present","value":{"kind":"record_fields","fields":{"ai_role":{"status":"assessed","statement":"Patients were randomized to colonoscopy with or without GI Genius, performed by the same endoscopists, so the trial isolates the contribution of the program."}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ai_role"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"ai_relationship":{"state":"value_present","value":{"kind":"record_fields","fields":{"category":"general benefit","ai_role":{"status":"assessed","statement":"Patients were randomized to colonoscopy with or without GI Genius, performed by the same endoscopists, so the trial isolates the contribution of the program."}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ai_role","category"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].alternatives":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].assessor_date":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].depth":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"Patients in the GI Genius arm had at least one adenoma found in 55.1% of procedures against 42.0% in the standard arm."},{"group":"organizational","depth":2,"reason":"Endoscopists found 0.81 adenomas per colonoscopy with the program against 0.57 without it."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].display_confidence":{"state":"value_present","value":{"kind":"structured","data":{"confidence":"high","evidence_word":"found","claim_status":"Found by a regulator","basis":"Sources: one independent regulatory document and one peer-reviewed study with authorship relationship unassessed. The cited evidence includes no independent study or report.","interpretation":"Existing display rule preserved; the richer outcome-specific confidence question still needs review."}},"provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].rationale":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"Patients in the GI Genius arm had at least one adenoma found in 55.1% of procedures against 42.0% in the standard arm."},{"group":"organizational","depth":2,"reason":"Endoscopists found 0.81 adenomas per colonoscopy with the program against 0.57 without it."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].rubric_version":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].status_basis":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].target":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"Patients in the GI Genius arm had at least one adenoma found in 55.1% of procedures against 42.0% in the standard arm."},{"group":"organizational","depth":2,"reason":"Endoscopists found 0.81 adenomas per colonoscopy with the program against 0.57 without it."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"availability":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"brief":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"case_kind":{"state":"value_present","value":{"kind":"structured","data":{"classification":"evaluation or study","answer":"The case describes an evaluation or a study. A regulatory review of a randomized controlled trial.","scope":"The period and activity described in the case."}},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["account","evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"The case describes an evaluation or a study. A regulatory review of a randomized controlled trial.","inferred":false}},"case_links[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Compared with the incidents in the AI Incident Database snapshot of 26 October 2026.","record_fields":["paired_incident"],"source_refs":[]},"reason":"No incident in the AI Incident Database snapshot of 26 October 2026 concerns the same kind of system harming the same kind of stakeholder.","review_state":"reviewed","coverage":"partial"},"claims[].evidence_links":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"claims[].evidence_strength":{"state":"value_present","value":{"kind":"structured","data":{"answer":"Found by a regulator. Sources: one independent regulatory document and one peer-reviewed study with authorship relationship unassessed. The cited evidence includes no independent study or report.","evidence_word":"found","claim_status":"Found by a regulator"}},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001","AIBD-0623-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Found by a regulator. Sources: one independent regulatory document and one peer-reviewed study with authorship relationship unassessed. The cited evidence includes no independent study or report.","inferred":false}},"claims[].missingness":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"claims[].proposition":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"cross_border_flows[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"decisions[].action_outcome":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"decisions[].grounds":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"decisions[].institution_task":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"decisions[].success_criterion":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"deployment_stage":{"state":"value_present","value":{"kind":"structured","data":{"classification":"pilot","answer":"The system was used in a pilot. A randomized trial in three hospitals before US authorization.","scope":"The period and activity described in the case."}},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["account","evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"The system was used in a pilot. A randomized trial in three hospitals before US authorization.","inferred":false}},"economics[].amount":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].costs[]":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].counterfactual":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].currency_price_basis":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].gross_net":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].measure_type":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].period_unit":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].realization":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].recipient_payer":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].return_payback":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].valuation_method":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"evaluations[].ai_uplift":{"state":"value_present","value":{"kind":"text","text":"Adjusted ADR difference of 13.1 percentage points."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Adjusted ADR difference of 13.1 percentage points.","inferred":false}},"evaluations[].comparator":{"state":"value_present","value":{"kind":"text","text":"Standard colonoscopy without the program."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Standard colonoscopy without the program.","inferred":false}},"evaluations[].design":{"state":"value_present","value":{"kind":"text","text":"Randomized."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Randomized.","inferred":false}},"evaluations[].effect":{"state":"value_present","value":{"kind":"text","text":"ADR 55.1% against 42.0%; APC 0.81 against 0.57."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"ADR 55.1% against 42.0%; APC 0.81 against 0.57.","inferred":false}},"evaluations[].exposure":{"state":"value_present","value":{"kind":"text","text":"One colonoscopy per patient."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"One colonoscopy per patient.","inferred":false}},"evaluations[].id":{"state":"value_present","value":{"kind":"identifiers","identifiers":["AIBD-0623-evaluation-1"],"role":"Evaluations of the benefit"},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Randomized.","inferred":false}},"evaluations[].measurement_method":{"state":"value_present","value":{"kind":"text","text":"Randomized 1:1 multicenter trial with histology as reference; FDA reanalysis in low-risk patients."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Randomized 1:1 multicenter trial with histology as reference; FDA reanalysis in low-risk patients.","inferred":false}},"evaluations[].metric":{"state":"value_present","value":{"kind":"text","text":"Adenoma detection rate and adenomas per colonoscopy."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Adenoma detection rate and adenomas per colonoscopy.","inferred":false}},"evaluations[].reproduction_materials":{"state":"value_present","value":{"kind":"text","text":"ClinicalTrials.gov NCT04079478."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"ClinicalTrials.gov NCT04079478.","inferred":false}},"evaluations[].setting_sample":{"state":"value_present","value":{"kind":"text","text":"700 patients at three Italian hospitals; 263 low-risk patients in the FDA analysis; six endoscopists."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"700 patients at three Italian hospitals; 263 low-risk patients in the FDA analysis; six endoscopists.","inferred":false}},"evaluations[].uncertainty_limitations":{"state":"value_present","value":{"kind":"text","text":"Limited patient diversity; six endoscopists in Italy; cancer outcomes not measured."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0623-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Limited patient diversity; six endoscopists in Italy; cancer outcomes not measured.","inferred":false}},"external_references[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"follow_up[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"human_oversight":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"id":{"state":"value_present","value":{"kind":"record_fields","fields":{"id":"AIBD-0623"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["id"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"infrastructure_dependencies[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].beneficiaries":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].beneficiary_count":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].benefit_type":{"state":"value_present","value":{"kind":"record_fields","fields":{"benefit_type":"Improved Task Accuracy"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["benefit_type"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].claim":{"state":"value_present","value":{"kind":"record_fields","fields":{"account":"Cosmo Artificial Intelligence of Dublin, Ireland, makes GI Genius, a program that marks suspected polyps with a box on the screen during colonoscopy. In the AID trial at three hospitals in Milan, Rome and Como, 700 patients were randomly assigned between September and November 2019 to colonoscopy with or without the program, performed by six endoscopists. FDA asked for an analysis of the 263 patients at low risk of colorectal cancer. In that group, FDA reviewers report an adenoma detection rate of 55.1% with GI Genius against 42.0% with standard colonoscopy, and 0.81 adenomas per colonoscopy against 0.57. The program caused no added adverse events. FDA granted the De Novo request on 9 April 2021. The reviewers note that race was not recorded, that most patients were presumed to be white, and that only six endoscopists in Italy took part. They write that a reduction in cancer risk would need confirmation in further trials.","benefit_type":"Improved Task Accuracy"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["account","benefit_type"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].distribution":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].duration":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].id":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].stakeholder_group":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"Patients in the GI Genius arm had at least one adenoma found in 55.1% of procedures against 42.0% in the standard arm."},{"group":"organizational","depth":2,"reason":"Endoscopists found 0.81 adenomas per colonoscopy with the program against 0.57 without it."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].status":{"state":"value_present","value":{"kind":"record_fields","fields":{"benefit_status":"reported"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["benefit_status"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].tradeoffs":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].unexpected":{"state":"value_present","value":{"kind":"record_fields","fields":{"unexpected":false,"purpose":"GI Genius was built to help endoscopists detect colonic lesions such as polyps and adenomas in real time. Higher adenoma detection is that purpose."}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["unexpected","purpose"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"places[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"location":"Milan, Rome and Como, Italy","developer_country":"Ireland","deployer_country":"Italy"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["location","developer_country","deployer_country"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"purpose":{"state":"value_present","value":{"kind":"record_fields","fields":{"purpose":"GI Genius was built to help endoscopists detect colonic lesions such as polyps and adenomas in real time. Higher adenoma detection is that purpose."}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["purpose"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"record_dates":{"state":"value_present","value":{"kind":"record_fields","fields":{"date_observed":"2019-11-01","date_basis":"event","date_precision":"month","revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf","editor":"AIBD"}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["date_observed","date_basis","date_precision","revisions"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"replication.attempts[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"replication.conditions":{"state":"value_present","value":{"kind":"record_fields","fields":{"replication":{"produced_by":["Endoscopists with an adenoma detection rate of 25 to 40% used the program during white-light colonoscopy.","A minimum withdrawal time of six minutes was required.","Histology confirmed each lesion."],"must_hold":["The program runs with standard white-light endoscopy.","Endoscopists use the marks as an aid and keep inspecting the whole colon."],"echoes":[]}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["replication"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"revision_history[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf","editor":"AIBD"}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["revisions"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sector":{"state":"value_present","value":{"kind":"record_fields","fields":{"domain":"Healthcare"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["domain"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].access_version":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"sources[].citation_locator":{"state":"value_present","value":{"kind":"record_fields","fields":{"evidence":[{"kind":"regulatory document","citation":"U.S. Food and Drug Administration, Center for Devices and Radiological Health. De Novo classification request for GI Genius (DEN200055): decision summary. Granted 2021-04-09.","title":"De Novo classification request for GI Genius (DEN200055)","url":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf","date":"2021-04-09","written_by":"independent","quote":"The GI Genius procedures had an ADR* of 55.1% and the standard colonoscopy procedures had an ADR* of 42.0%."},{"kind":"peer-reviewed study","citation":"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(2):512-520.e7.","title":"Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial","url":"https://pubmed.ncbi.nlm.nih.gov/32371116","date":"2020-05-01","written_by":"unknown","quote":"The ADR was significantly higher in the CADe group (54.8%) than in the control group (40.4%) (relative risk [RR], 1.30; 95% confidence interval [CI], 1.14-1.45)."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].id":{"state":"value_present","value":{"kind":"identifiers","identifiers":["AIBD-0623-source-0001","AIBD-0623-source-0002"],"role":"Existing evidence items, in their original order"},"provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"review_state":"record_mapped","coverage":"complete"},"sources[].language":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"sources[].relationship":{"state":"value_present","value":{"kind":"record_fields","fields":{"evidence":[{"kind":"regulatory document","citation":"U.S. Food and Drug Administration, Center for Devices and Radiological Health. De Novo classification request for GI Genius (DEN200055): decision summary. Granted 2021-04-09.","title":"De Novo classification request for GI Genius (DEN200055)","url":"https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN200055.pdf","date":"2021-04-09","written_by":"independent","quote":"The GI Genius procedures had an ADR* of 55.1% and the standard colonoscopy procedures had an ADR* of 42.0%."},{"kind":"peer-reviewed study","citation":"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(2):512-520.e7.","title":"Efficacy of Real-Time Computer-Aided Detection of Colorectal Neoplasia in a Randomized Trial","url":"https://pubmed.ncbi.nlm.nih.gov/32371116","date":"2020-05-01","written_by":"unknown","quote":"The ADR was significantly higher in the CADe group (54.8%) than in the control group (40.4%) (relative risk [RR], 1.30; 95% confidence interval [CI], 1.14-1.45)."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].upstream_sources":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"strategic_assessments[]":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"strategic assessments"},"summary":{"state":"value_present","value":{"kind":"record_fields","fields":{"summary":"In the randomized Italian trial that FDA reviewed, colonoscopy with GI Genius found adenomas in 55.1% of low-risk patients, against 42.0% with standard colonoscopy.","account":"Cosmo Artificial Intelligence of Dublin, Ireland, makes GI Genius, a program that marks suspected polyps with a box on the screen during colonoscopy. In the AID trial at three hospitals in Milan, Rome and Como, 700 patients were randomly assigned between September and November 2019 to colonoscopy with or without the program, performed by six endoscopists. FDA asked for an analysis of the 263 patients at low risk of colorectal cancer. In that group, FDA reviewers report an adenoma detection rate of 55.1% with GI Genius against 42.0% with standard colonoscopy, and 0.81 adenomas per colonoscopy against 0.57. The program caused no added adverse events. FDA granted the De Novo request on 9 April 2021. The reviewers note that race was not recorded, that most patients were presumed to be white, and that only six endoscopists in Italy took part. They write that a reduction in cancer risk would need confirmation in further trials."}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["summary","account"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"systems[].autonomy_permissions":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].component_role":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].deployment_configuration":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].inputs_outputs":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].model_name":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].model_version":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].product_name":{"state":"value_present","value":{"kind":"record_fields","fields":{"system":"GI Genius"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["system"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"systems[].provider":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"taxonomy_crosswalks[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"title":{"state":"value_present","value":{"kind":"record_fields","fields":{"title":"FDA De Novo review of GI Genius: randomized trial finds more adenomas with AI-aided colonoscopy","headline":"*GI Genius* helped endoscopists find more adenomas in a randomized trial"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["title","headline"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"version":{"state":"value_present","value":{"kind":"identifiers","identifiers":["4595da4a3cdc9c92b325834f243e3d9fa7bedcbd084d60ec2eadd5d294e135bc"],"role":"SHA-256 of the complete public case and its assessments"},"provenance":{"kind":"curatorial","basis":"SHA-256 of the public case, its assessments, and its displayed answers and notes, excluding its own identifier and the derived coverage summary.","record_fields":[],"source_refs":[]},"review_state":"record_mapped","coverage":"complete"},"workflow":{"state":"value_present","value":{"kind":"record_fields","fields":{"account":"Cosmo Artificial Intelligence of Dublin, Ireland, makes GI Genius, a program that marks suspected polyps with a box on the screen during colonoscopy. In the AID trial at three hospitals in Milan, Rome and Como, 700 patients were randomly assigned between September and November 2019 to colonoscopy with or without the program, performed by six endoscopists. FDA asked for an analysis of the 263 patients at low risk of colorectal cancer. In that group, FDA reviewers report an adenoma detection rate of 55.1% with GI Genius against 42.0% with standard colonoscopy, and 0.81 adenomas per colonoscopy against 0.57. The program caused no added adverse events. FDA granted the De Novo request on 9 April 2021. The reviewers note that race was not recorded, that most patients were presumed to be white, and that only six endoscopists in Italy took part. They write that a reduction in cancer risk would need confirmation in further trials.","replication":{"produced_by":["Endoscopists with an adenoma detection rate of 25 to 40% used the program during white-light colonoscopy.","A minimum withdrawal time of six minutes was required.","Histology confirmed each lesion."],"must_hold":["The program runs with standard white-light endoscopy.","Endoscopists use the marks as an aid and keep inspecting the whole colon."],"echoes":[]}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["account","replication"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"}},"summary":{"total":91,"addressed":91,"known":41,"reviewed":15,"reviewed_complete":14,"reviewed_partial":1,"record_mapped":27,"review_not_assessed":49,"not_assessed":0,"complete":false,"by_state":{"value_present":41,"not_reported":0,"unresolved":50,"not_assessed":0,"not_applicable":0,"withheld":0,"source_unavailable":0}}},"presentation_version":"f75f5d019bab8287ee5b276d2d15ceb286fa79574c646408131d275b0cb89285"}
