ArticleDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society2026
Large Language Model-Driven Analysis and Report Generation of Endoscopy Videos-A Pilot Study.
Article in Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness, Safety, and Workflow Burden of Large Language Model-Based Medical Report Generation: Systematic Review.Journal of medical Internet research · 2026Pooled it
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17 authors.
Funding
Abstract
Multimodal large language models (MLLMs) can automatically analyze clinical video, but evidence from full esophagogastroduodenoscopy (EGD) and the impact of on-screen computer-aided detection/diagnosis (CAD) overlays on MLLM behavior remain unclear. We tested whether an MLLM can produce clinically adequate EGD reports and whether a CAD overlay changes performance. We analyzed five complete EGD videos with Gemini 2.5 Pro in paired versions: (1) clean video and (2) the same video with a CAD overlay. Five blinded endoscopists rated report adequacy in three domains. MLLM accuracy for landmarks/lesions was further assessed by two blinded expert endoscopists using the time-window rule (a model detection counted as correct if it occurred within ±2 s of the expert-annotated timestamp). In this retrospective pilot study, five archived diagnostic EGD procedures from five patients were available as full-length videos. Across five raters, MLLM Completeness was judged adequate in 56.0% (14/25 ratings) with Clean-Video versus 48.0% (12/25 ratings) with Overlay-Video (p = 0.500). Visualization was identical (36.0% [9/25 ratings] for both; p = 1.000). Lesions characteristics were identical (16.0% [4/25] for both; p = 1.00). For the Landmark agreement, the overall accuracy of the MLLM with Clean-Video vs. Overlay-Video was: 0.55 [95% CI 0.43-0.67] vs. 0.33 [0.23-0.46], p = 0.029; sensitivity 0.53 [0.40-0.66] vs. 0.35 [0.24-0.49], p = 0.122; specificity 0.67 [0.35-0.88] vs. 0.22 [0.06-0.55], p = 0.125. In this pilot study, Gemini 2.5 Pro demonstrated inadequate performance for clinical EGD reporting. These hypothesis-generating findings suggest substantial optimization and larger-scale validation are required before deployment.
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