ABSTRACT Background and Aim Computer‐aided detection (CADe) facilitates colorectal lesion detection, but it remains unclear whether CADe affects endoscopist's eye strain by altering gaze patterns. This study aimed to determine whether CADe‐assisted colonoscopy is superior to conventional colonoscopy in reducing endoscopists' gaze‐shift distance. Methods This single‐center randomized controlled trial enrolled participants and randomly assigned them to two groups: first observation with CADe, then second observation without CADe (CADe‐first group) in the ascending colon, or observations in the reverse order (conventional‐first group). The endoscopist's gaze positions were recorded via a dedicated eye‐tracking system. The primary endpoint was the endoscopist's gaze‐shift distance within the first allocated group. The secondary endpoints were the gaze‐shift distance based on CADe experience and eye strain, ascertained using a visual analog scale (VAS) score. Results Among 59 patients that were assigned to two groups (CADe‐first, n = 30; conventional‐first, n = 29), there was no intergroup difference in the gaze‐shift distance (30.7 ± 10.7 pixels/30 ms vs. 32.7 ± 8.7 pixels/30 ms, p = 0.450). Among CADe‐experienced endoscopists, the distance was significantly shorter in the CADe‐first than in the conventional‐first group (25.9 ± 3.4 pixels/30 ms vs. 29.4 ± 3.6 pixels/30 ms, p < 0.01), whereas no difference was observed among CADe‐inexperienced endoscopists (40.3 ± 13.8 pixels/30 ms vs. 45.4 ± 11.1 pixels/30 ms, p = 0.463). The VAS score was significantly lower in the CADe‐first than in the conventional‐first group (3.2 ± 1.2 vs. 4.6 ± 1.5, p < 0.05). Conclusions CADe assistance did not significantly change the gaze‐shift distance overall, but it reduced gaze‐shift distance among CADe‐experienced endoscopists. Thus, CADe may be associated with reduced eye strain, depending on the endoscopist's CADe experience.
Ito et al. (2026) studied this question.