STTR Phase II: Real-time Analysis and Feedback during Colonoscopy to improve Quality

This Small Business Technology Transfer (STTR) Phase II project will develop an assistive software tool for endoscopists to have real-time feedback of objective quality for colon and potential polyp region examinations. The technology is aimed to reduce polyp miss rates during colonoscopy. Colonoscopy has contributed to a marked decline in colorectal cancer related deaths. However, recent data suggest that there is a significant miss rate for the detection of even large polyps and cancers. Studies suggest that polyp detection rate may be related to the duration of the withdrawal phase of the procedure and cancer miss rate is related to the identity of the endoscopist performing the procedure. This tool, which will provide video stream analysis and feedback during live colonoscopy, is made up of novel middleware software to ensure high performance execution of video analysis on an affordable workstation, and are generic, reconfigurable with new task allocation that support time-constraint video analysis. Objective metrics for real-time feedback are derived from real time analysis that will address complexities arising from blurry frames, stool, camera movement patterns, and regions of appendiceal orifice and polyps. Technical insights learned from development of this tool for colonoscopy may be applicable to new research on quality control using videos generated in other areas of medicine, such as bronchoscopy, cystoscopy, arthroscopy and laparoscopy. The broader/commercial impact of this project, if successfully implemented in large-scale day-to-day medical settings, will be higher quality of care for patients undergoing colonoscopy procedures with real time objective quality assessment, which is currently not feasible. Over 14 million colonoscopies are performed annually in the US. This assistive tool will stimulate high quality inspection, while documentation is done. That will mean that endoscopists will be able to spend more time on performing the colonoscopy and less time on documentation. Hospital/clinic administrators will be able to run endoscopic facilities more efficiently. Insurance companies may benefit from better documentation and lower costs since fewer patients will require extensive cancer treatment as the frequency of missed polyps and early cancers declines. This assistive tool is also expected to contribute to medical education, research, and practice by providing automated feedback during teaching and training of novice endoscopists or continuing education for experienced endoscopists.