That the endoscopist must be the only visual observer capable of flagging a lesion during withdrawal.
Collections: Human still decides · Regulated autonomy
Executive brief
The model changed the attention workflow rather than the clinical decision right; value came from watching every frame without slowing the procedure.
AI value · Adenomas detected per colonoscopy
Verified1.07 in the CADe group; incidence-rate ratio 1.46, with no increase in withdrawal time
Randomized detection endpoint; the trial did not establish reduced colorectal-cancer mortality, and much of the uplift was in small lesions.
Before
Inspect the live colonoscopy feed and visually identify suspected lesions. → Determine whether removed tissue is neoplastic.
After
Processes the live video and superimposes a green box over a suspected lesion. → Inspects the highlighted area and decides whether to remove tissue.
Human boundary
The AI draws attention; the endoscopist decides whether a finding is real and whether to resect.
Why it matters
That the endoscopist must be the only visual observer capable of flagging a lesion during withdrawal.
Before
How the work ran before the change.
Endoscopist
Inspect the live colonoscopy feed and visually identify suspected lesions.
ControlClinical judgment and minimum withdrawal time
Pathologist
Determine whether removed tissue is neoplastic.
ControlHistopathology reference standard
What changed
That the endoscopist must be the only visual observer capable of flagging a lesion during withdrawal.
Decision rightHuman moves from creator to judge
After
How the same work runs now.
GI Genius CADe
Processes the live video and superimposes a green box over a suspected lesion.
ControlReal-time computer-aided detection
Endoscopist
Inspects the highlighted area and decides whether to remove tissue.
ControlPhysician retains procedural decision rights
Exception path
The physician ignores false alerts, inspects missed or ambiguous tissue directly, and relies on histopathology for final classification.
Decision authority
The AI draws attention; the endoscopist decides whether a finding is real and whether to resect.
| # | Actor | Action | Control |
|---|---|---|---|
| 01 | Endoscopist | Inspect the live colonoscopy feed and visually identify suspected lesions. | Clinical judgment and minimum withdrawal time |
| 02 | Pathologist | Determine whether removed tissue is neoplastic. | Histopathology reference standard |
| # | Actor | Action | Control |
|---|---|---|---|
| 01 | GI Genius CADe | Processes the live video and superimposes a green box over a suspected lesion. | Real-time computer-aided detection |
| 02 | Endoscopist | Inspects the highlighted area and decides whether to remove tissue. | Physician retains procedural decision rights |
Work that left the path
Human role before
The endoscopist acted as the sole real-time visual detector.
Human role after
The endoscopist remains the procedural decision maker but works with an always-on secondary observer.
AI role
Deep-learning computer vision that flags suspected colorectal lesions on the live display.
0.71 mean adenomas per colonoscopy in the standard-colonoscopy control group1.07 in the CADe group; incidence-rate ratio 1.46, with no increase in withdrawal time
September-November 2019 randomized trial · 685 subjects at three Italian centers
Randomized detection endpoint; the trial did not establish reduced colorectal-cancer mortality, and much of the uplift was in small lesions.
Anti-pattern
Calling every AI box a diagnosis or extrapolating detection uplift to mortality.
Questions
Portability conditions
Reputation risk
low