Colon Neoplasms Clinical Trial
Official title:
Endocuff-assisted vs. Standard Colonoscopy: a Randomized, Back-to-Back Study
The aim of this study is to evaluate Endocuff- assisted colonoscopy in terms of its possible additive contribution in the detection of important lesions, namely polyps and cancers, compared to standard colonoscopy, in a series of patients undergoing back-to-back screening or surveillance colonoscopies in a randomized fashion. Moreover, we aim to assess possible changes regarding post-polypectomy surveillance programs following Endocuff utilization.
Tandem colonoscopies studies results, show that novel endoscopic technologies detect about
20% more adenomas than those conventional colonoscopy does (missed adenomas). Since
Endocuff-assisted colonoscopy cannot be considered as a perfect examination, we hypothesize
that conventional colonoscopy will detect one third of the missed adenomas that
Endocuff-assisted colonoscopy detects in a similar setting. Therefore a sample size of 120
adenomas achieves 80% power to detect an odds ratio of 3.0 using a two-sided McNemar test
with a significance level of 0.05. The odds ratio is equivalent to a difference between two
paired proportions of 14% which occurs when the proportion of detected missed adenomas
during Endocuff-assisted colonoscopy is 21% and the proportion of missed adenomas during
conventional colonoscopy is 7%. During one year period before the study initiation, our
colonoscopy performance quality data show that we detect a mean number of adenomas per
patient equal of 0.7 in a population similar to the one recruited in our study. Therefore,
172 patients overall will be required to detect 120 adenomas. Given the uncertainty of our
estimation and in order to cope with patients exclusions, withdrawals and unexpected
incomplete colonoscopies, we decided to recruit 200 patients.
A more extensive description regarding the investigators study is provided in the following
fields.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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