{"id":"AIBD-0645","title":"Veterans Health Administration cluster-randomized rollout of GI Genius: adenoma detection rises from 50.7% to 54.9% at equipped facilities","summary":"At 42 VA facilities chosen at random to receive GI Genius, adenoma detection rose from 50.7% to 54.9%, while it fell from 51.8% to 51.1% at 97 control facilities.","date_observed":"2022-10-01","date_basis":"event","date_precision":"month","benefit_status":"reported","source_collection":null,"source_entry":null,"account":"The National Gastroenterology and Hepatology Program of the Veterans Health Administration ran a pragmatic cluster-randomized quality improvement study of computer-aided polyp detection in the United States. Between October 2022 and February 2023 the program equipped randomly selected VA facilities with the devices; the trial registry names the device as the GI Genius Intelligent Endoscopy Module from Medtronic. Control facilities were given a random deployment date for comparison. The analysis covered 269 endoscopists at 42 equipped facilities, who performed 71,594 colonoscopies before deployment and 35,399 after, and 547 endoscopists at 97 control facilities, who performed 151,792 before and 75,415 after. At the equipped facilities the adenoma detection rate rose from 50.7% to 54.9%, an absolute increase of 4.2 percentage points. At the control facilities it fell from 51.8% to 51.1%. In a regression model, availability of the device was associated with 22% higher odds of adenoma detection. The device did not change the detection of other lesions or the withdrawal time. The authors state that the effect on cancer outcomes and the risk that endoscopists lose skill remain unknown.","category":"general benefit","unexpected":false,"purpose":"GI Genius was built to flag possible polyps on the colonoscopy video in real time. The higher adenoma detection was that purpose.","system":"GI Genius Intelligent Endoscopy Module","model_version":null,"developer":"Medtronic","deployer":"Veterans Health Administration, National Gastroenterology and Hepatology Program","location":"42 VA medical facilities, United States","domain":"Healthcare","segment":null,"benefit_type":"Improved Task Accuracy","taxonomy_note":null,"registry_ids":{},"ratings":[{"group":"personal","depth":3,"reason":"More veterans had precancerous adenomas found and removed: detection rose from 50.7% to 54.9% of colonoscopies at equipped facilities."},{"group":"organizational","depth":2,"reason":"The VA raised a core colonoscopy quality measure by 4.2 percentage points without a change in withdrawal time."}],"ai_role":{"status":"assessed","statement":"Facilities were assigned at random to receive the device, and the authors compare the change in adenoma detection at equipped facilities with the change at control facilities over the same period."},"evidence":[{"kind":"peer-reviewed study","citation":"Saridakis G, Mavroudis D, Souglakos J. Bridging the precancerous gap in colorectal cancer through AI-enhanced liquid biopsy, endoscopy, and digital pathology. Cancers (Basel). 2026;18(18):2940. doi:10.3390/cancers18182940","title":"Bridging the Precancerous Gap in Colorectal Cancer Through AI-Enhanced Liquid Biopsy, Endoscopy, and Digital Pathology","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13604928/","date":"2026-09-10","written_by":"independent","quote":"Routine-practice studies have sometimes reported smaller benefits than conventional randomized trials, although a large pragmatic cluster-randomized study found that an ADR benefit could be retained at scale"},{"kind":"peer-reviewed study","citation":"Dominitz JA, Gawron AJ, McKee GB, Hoggatt KJ, Kaltenbach T. Impact of Availability of Computer-Aided Detection Devices on Adenoma Detection During Colonoscopy: A Cluster Randomized Study. Gastroenterology. 2026;171(5):870-884. doi:10.1053/j.gastro.2026.05.018","title":"Impact of Availability of Computer-Aided Detection Devices on Adenoma Detection During Colonoscopy: A Cluster Randomized Study","url":"https://pubmed.ncbi.nlm.nih.gov/42250891/","date":"2026-06-05","written_by":"deployer","quote":"Comparing post- with predeployment colonoscopies, the absolute increase in ADR was 4.2 percentage points (95% CI, 3.48 to 4.74 percentage points), from 50.7% to 54.9%, at CADe sites and ADR decreased by 0.7 percentage points (95% CI, -1.16 to -0.28 percentage points), from 51.8% to 51.1%, at control sites."}],"replication":{"produced_by":["The VA installed the devices at facilities chosen at random.","Endoscopists used the device during routine colonoscopy.","Baseline adenoma detection at the facilities was already about 51%."],"must_hold":["Endoscopists must keep using the device once it is installed.","The gain must not fade as endoscopists grow used to the alerts."],"echoes":[{"date":"2025-04-01","setting":"Randomized trial at two tertiary hospitals in Seoul, South Korea (ENAD-DET-01)","model_version":null,"outcome":"recurred","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12800677/"},{"date":"2023-08-01","setting":"Randomized trial at a Japanese community hospital","model_version":null,"outcome":"did not recur","source":"https://pubmed.ncbi.nlm.nih.gov/40611562/"}]},"paired_incident":null,"headline":"*GI Genius* lifts adenoma detection in VA colonoscopy units","metric":"adenoma detection rose from 50.7% to 54.9%","comparator":{"against":"VA facilities without the device over the same period","before":"Adenoma detection rate of 50.7% at equipped facilities before deployment","after":"Adenoma detection rate of 54.9% after deployment, against 51.1% at control facilities","basis":"measured","quote":"CADe availability was associated with a significantly increased odds of adenoma detection (odds ratio, 1.22; 95% CI, 1.15 to 1.28)","url":"https://pubmed.ncbi.nlm.nih.gov/42250891/"},"later":null,"value":null,"developer_country":"Ireland","deployer_country":"United States","unrated_because":null,"brief_notes":null,"brief":null,"revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13604928/","editor":"AIBD"}],"confidence":"studied","shade":"high","claim_status":"Independently studied","claim_basis":"Sources: one independent peer-reviewed study and the deployer's peer-reviewed study. 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