Publications by authors named "Tyler M Berzin"
Article Synopsis
- The study focuses on the need for an objective method to evaluate and compare different computer-aided detection (CADe) algorithms used in colorectal cancer screening, as their performance varies and no standard exists.
- A modified Delphi approach was employed, where 25 experts generated and prioritized scoring criteria over eight months, ultimately identifying six key metrics, including sensitivity and adenoma detection rate.
- The resulting criteria aim to guide the development and improvement of CADe software, with future research suggested to validate these metrics on benchmark video datasets.
Article Synopsis
- The study focuses on developing guidelines for the safe use of fluoroscopy in gastrointestinal endoscopy, balancing its benefits with concerns about radiation exposure to patients and healthcare workers.
- A modified Delphi method was used, involving three rounds of surveys with 46 experts, resulting in 43 proposed statements, of which 31 achieved consensus and were prioritized across various categories such as Patient Safety and Staff Safety.
- The final consensus statements highlight the importance of education and safety measures, with a significant majority rated as high priority, aiming to enhance safety culture in healthcare settings while utilizing fluoroscopy.
Recent advancements in artificial intelligence (AI) have significantly impacted the field of gastrointestinal (GI) endoscopy, with applications spanning a wide range of clinical indications. The central goals for AI in GI endoscopy are to improve endoscopic procedural performance and quality assessment, optimize patient outcomes, and reduce administrative burden. Despite early progress, such as Food and Drug Administration approval of the first computer-aided polyp detection system in 2021, there are numerous important challenges to be faced on the path toward broader adoption of AI algorithms in clinical endoscopic practice.
View Article and Find Full Text PDFGenerative Artificial Intelligence Tools in Gastroenterology Training.
Clin Gastroenterol Hepatol
October 2024
Article Synopsis
- EUS-FNA is a technique used for assessing pancreatic cysts, with an emphasis on determining the risk of pancreatitis, a common complication, to improve clinical decision-making.
- A systematic review analyzed 64 studies involving over 8,000 patients, finding that the risk of pancreatitis from EUS-FNA is low at about 1.4% and typically mild.
- Recent trends suggest that certain factors, like the type of needle used and the method of biopsy, might influence the risk, indicating a need for more research in this area.
Article Synopsis
- A significant increase in nonaccredited advanced endoscopy fellowship programs (AEFPs) has led to a need for defining "high-quality" standards due to the rising complexity of interventional endoscopy procedures.
- A consensus process, using the RAND UCLA appropriateness method, was employed to establish quality indicators for AEFPs across six categories related to training and practice.
- After thorough reviews and expert feedback, 37 out of 89 proposed quality indicators were identified as appropriate, setting a foundation for improved accreditation standards in AEFPs.
Background And Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is the standard of care for the management of choledocholithiasis but carries risk of complications which may result in significant morbidity and mortality. While currently available guidelines endorse the use of ERCP for the management of symptomatic common bile duct stones, the need for ERCP in incidentally found asymptomatic choledocholithiasis is more controversial, and practice varies on a geographic and institutional level. This systematic review and meta-analysis is conducted to compare post-ERCP adverse events between asymptomatic and symptomatic choledocholithiasis patients.
View Article and Find Full Text PDFArticle Synopsis
- A 4-mm injector needle was used to deliver a lifting agent to a mass found in the esophagus, followed by a mucosal incision with an electrocautery knife to facilitate dissection.
- The dissection aimed to keep the submucosal area clean while identifying a smooth, oval mass originating from the muscularis propria layer, which was extended 2 cm distally before resection.
- The mass was completely removed using precise cutting techniques, with continuous irrigation for visibility, and the site was closed using hemostatic clips without any signs of perforation or bleeding afterward.
Endoscopic ultrasound (EUS)-guided liver biopsy is gaining popularity for liver parenchymal sampling due to its detailed visualization of liver anatomy, precision in sampling, and the ability to combine liver biopsy with other endoscopic goals. In this study, we present a case involving an anatomically complex, immunocompromised patient who underwent EUS-guided liver biopsy. While the samples were sufficient and progressed the management of her autoimmune hepatitis, her course was complicated by a multiloculated liver abscess.
View Article and Find Full Text PDFArticle Synopsis
- - The Bethesda ERCP Skill Assessment Tool (BESAT) is a validated video-based tool designed to evaluate skills in endoscopic retrograde cholangiopancreatography (ERCP) by assessing video performances of practitioners.
- - In a study, 12 experienced ERCP practitioners rated 43 videos of various skill levels, revealing that the BESAT effectively discriminates between novice and expert practitioners, with higher scores for more experienced endoscopists.
- - Results showed strong reliability and validity, with inter-rater reliability scores ranging from 0.86 to 0.93, indicating consistent ratings across different reviewers, which suggests the BESAT could enhance training and improve patient outcomes in the future.
Physician perceptions on the current and future impact of artificial intelligence to the field of gastroenterology.
Gastrointest Endosc
April 2024
Background And Aims: The use of artificial intelligence (AI) has transformative implications to the practice of gastroenterology and endoscopy. The aims of this study were to understand the perceptions of the gastroenterology community toward AI and to identify potential barriers for adoption.
Methods: A 16-question online survey exploring perceptions on the current and future implications of AI to the field of gastroenterology was developed by the American Society for Gastrointestinal Endoscopy AI Task Force and distributed to national and international society members.
Background And Aims: The application of endoscopic suturing has revolutionized defect closures. Conventional over-the-scope suturing necessitates removal of the scope, placement of the device, and reinsertion. A single channel, single sequence, through-the-scope suturing device has been developed to improve this process.
View Article and Find Full Text PDFKaposi sarcoma (KS) is a pathological endothelial growth associated with human herpes virus-8 which primarily affects the skin. In HIV-negative men who have sex with men, the clinical presentation of KS resembles the classic form limited to cutaneous or multifocal disease. In this report, we present a unique case of a healthy 61-year-old man who has sex with men with an isolated gastrointestinal KS who does not meet criteria for any of the typical KS clinical variants.
View Article and Find Full Text PDFPyloric gland adenomas (PGAs) are rare neoplasms found not only in the gastrointestinal tract but also in other extragastrointestinal organs. They have potential for malignant conversion, and early detection and removal is imperative to prevent invasive disease. PGAs prove difficult in management and surveillance given their rarity.
View Article and Find Full Text PDFDescription: The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update (CPU) is to review the available evidence and provide expert commentary on the current landscape of artificial intelligence in the evaluation and management of colorectal polyps.
Methods: This CPU was commissioned and approved by the AGA Institute Clinical Practice Updates Committee (CPUC) and the AGA Governing Board to provide timely guidance on a topic of high clinical importance to the AGA membership and underwent internal peer review by the CPUC and external peer review through standard procedures of Gastroenterology. This Expert Commentary incorporates important as well as recently published studies in this field, and it reflects the experiences of the authors who are experienced endoscopists with expertise in the field of artificial intelligence and colorectal polyps.
Video 1Endoscopic treatment of a Bouveret syndrome showing and describing the techniques and procedures involved.
View Article and Find Full Text PDFAmerican Society of Gastrointestinal Endoscopy (ASGE) and European Society of Gastrointestinal Endoscopy (ESGE) guidelines recommend categorizing patients by risk for choledocholithiasis to determine management. The goal of our study was to compare the accuracy of criteria proposed in these guidelines. All patients with suspected choledocholithiasis at our institution were prospectively identified.
View Article and Find Full Text PDFVideo 1Natural orifice transendoscopic surgery as a rescue for a dislodged lumen-apposing metal stent after EUS-directed transgastric ERCP.
View Article and Find Full Text PDFVideo 1Enhanced suction for removal of esophageal food impaction.
View Article and Find Full Text PDFVideo 1Deploying automated machine learning for computer vision projects: a brief introduction for endoscopists.
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