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Colorectal NeoplasmsFECAL-AINCT07740122

AI-Based Stool Image Analysis for Colorectal Neoplasia Risk Assessment

An observational study of Colorectal Neoplasms, run by Servicio de Salud Metropolitano Sur Oriente at 1 site in Chile.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This prospective observational substudy evaluates the association between artificial intelligence-derived features from stool images analyzed using the FAEX Health digital platform and fecal immunochemical test results in adults undergoing colorectal cancer screening or diagnostic evaluation. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colorectal Neoplasms
What is being tested?
AI-Based Stool Image Analysis
How many people
250 participants
Where
1 siteChile
Study dates
8 May 2026to Dec 2026
How long will I take part?
1 Day
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Adult, Older adult

Study population: Adults receiving care at Hospital Dr. Sótero del Río who are undergoing colorectal cancer screening or diagnostic evaluation and have a quantitative fecal immunochemical test planned or completed. Eligible participants will prospectively submit stool images through the FAEX Health mobile application. AI-derived image features will be compared primarily with matched quantitative FIT results and FIT positivity. Colonoscopy and histopathology findings will be evaluated as secondary exploratory outcomes when available. AI results will not be returned to participants or clinicians and will not influence clinical management.

Who may be able to join

  • Age 18 years or older.
  • Referred for screening or diagnostic colonoscopy at Hospital Dr. Sótero del Río.
  • Quantitative fecal immunochemical testing planned or completed within 30 days before or after stool image submission.
  • Able to submit at least one stool image using the FAEX Health mobile application, independently or with assistance.
  • Able and willing to provide written informed consent.

Who cannot join

  • Unable or unwilling to provide written informed consent.
  • Previous enrollment in the study.
  • Unable to complete stool-image capture, even with assistance.
  • Study images and clinical data cannot be reliably linked using the assigned study code.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Erik Manriquez Alegria, MD contact

+56988232111

erik.manriquez.alegria@gmail.com

Felipe Quezada Diaz, MD contact

+56934651992

ffquezad@gmail.com

Chile1 site, 1 recruiting
  • Hospital Sotero del Rio

    Santiago, Santiago Metropolitan, 8207257

    Erik Manriquez Alegria, MD, +56988232111, erik.manriquez.alegria@gmail.com

    Felipe Quezada Diaz, MD, +56934651992, ffquezad@gmail.com

    Recruiting

Other trials in Chile

About this study

Official title: FECAL-AI: Prospective Observational Validation of AI-Based Stool Image Analysis Against Quantitative Fecal Immunochemical Testing for Colorectal Neoplasia Risk Assessment

This prospective observational substudy evaluates the association between artificial intelligence-derived features from stool images analyzed using the FAEX Health digital platform and fecal immunochemical test results in adults undergoing colorectal cancer screening or diagnostic evaluation. Participants will capture stool images using a mobile application. The primary analysis will compare AI-derived image outputs with quantitative FIT values and FIT positivity. Secondary exploratory analyses will assess associations with colonoscopy and histopathological findings when these results are available. The platform will be used exclusively for research and will not provide diagnoses, replace clinical evaluation, or influence medical decisions.

Read the detailed description

This is a substudy of the project "Estrategia de prevención secundaria de cáncer colorrectal en personas mayores a 18 años." The substudy evaluates the FAEX Health digital platform, which applies artificial intelligence algorithms to stool images for non-diagnostic research and validation.

Participants will capture images of their stools using the FAEX Health mobile application. The images will be coded and analyzed using computational algorithms designed to identify visual characteristics such as color, consistency, and possible visible blood.

The primary objective is to evaluate the association and discriminatory performance of AI-derived stool image features for quantitative fecal immunochemical test results and FIT positivity. Secondary exploratory objectives are to assess associations between these image features and colonoscopic and histopathological findings among participants for whom these results are available.

The AI-derived results will not be returned to participants or treating clinicians and will not be used to determine whether colonoscopy or any other clinical procedure is performed. The findings may inform future studies evaluating stool image analysis as a potential triage strategy when FIT is unavailable or declined; however, the present study does not evaluate the platform as a replacement for FIT.

Personal identifiers will not be stored together with stool images. Access to coded study information will be restricted to authorized researchers, and study data will be managed according to applicable ethical, legal, and confidentiality requirements.

Being tested
AI-Based Stool Image Analysis
Keywords
Colorectal Cancer Screening, Artificial Intelligence, Stool Image Analysis, Fecal Immunochemical Test, Colonoscopy, Digital Health
Medical subject headings
Colorectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AI-Based Stool Image AnalysisDiagnostic test

    Participants capture stool images using the FAEX Health mobile application. Coded images are analyzed using artificial intelligence algorithms to derive visual features and a prespecified patient-level output or score. The AI-derived output is used exclusively for research and is compared primarily with quantitative FIT results and FIT positivity, with secondary comparisons against colonoscopy and histopathology when available. The output is not used to provide a diagnosis or guide clinical management.

Study groups in NCT07740122
Study groupRoleWhat they receive
Prospective Stool Image, FIT and Colonoscopy CohortAdults participating in colorectal cancer screening or diagnostic evaluation who submit stool images through the FAEX Health mobile application. AI-derived stool image outputs will be compared primarily with quantitative fecal immunochemical test results and FIT positivity. Colonoscopy and histopathology findings will be evaluated as secondary exploratory outcomes when available. AI-derived results will not be returned to participants or clinicians and will not influence clinical decisions.
Receives: Diagnostic Test: AI-Based Stool Image Analysis

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Correlation Between AI-Derived Stool Image Score and Quantitative FIT (faecal immunochemical test) Concentration

    Correlation coefficient between the prespecified patient-level AI-derived stool image score and quantitative fecal immunochemical test concentration among participants with analyzable matched data, reported with a 95% confidence interval.

    Measured: Within 90 days of stool image submission

Secondary outcomes (3)
  1. Area Under the ROC Curve for FIT Positivity

    Area under the receiver operating characteristic curve of the prespecified AI-derived stool image score for classifying participants as FIT positive or FIT negative according to the locally established FIT threshold, reported with a 95% confidence interval.

    Measured: Within 90 days of stool image submission

  2. Sensitivity and Specificity of the AI-Derived Stool Image Score for FIT Positivity/Negativity

    Sensitivity and Specificity of a prespecified AI-derived stool image score threshold for identifying participants with a positive/negative FIT result, reported as a percentage with a 95% confidence interval.

    Measured: Within 90 days of stool image submission

  3. Area Under the ROC Curve for Colonoscopy-Detected Colorectal Neoplasia

    Area under the receiver operating characteristic curve of the AI-derived stool image score for identifying colorectal neoplasia detected at colonoscopy, with histopathological confirmation when available.

    Measured: Within 90 days of stool image submission

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Jul 2026
  2. Study start8 May 2026
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
250 participants (estimated)
Target duration
1 Day
IDs, dates and publications
ClinicalTrials.gov ID
NCT07740122
Sponsor's protocol ID
HSR-FAEX-CRC-FIT-2026
Acronym
FECAL-AI
Status last verified
Jul 2026
First submitted
28 Jul 2026
Last updated
31 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be made publicly available or routinely shared with external researchers. The dataset includes coded clinical information and potentially sensitive stool images, and access is restricted by participant consent, ethics approval, applicable data-protection requirements, and the research data-sharing agreement between Hospital Dr. Sótero del Río and Faex Health. Study findings will be reported in aggregate and de-identified form. Any future external secondary use would require separate institutional, ethical, legal, and data-sharing approvals.

Publications

  • Lee JW, Woo D, Kim KO, Kim ES, Kim SK, Lee HS, Kang B, Lee YJ, Kim J, Jang BI, Kim EY, Jo HH, Chung YJ, Ryu H, Park SK, Park DI, Yu H, Jeong S; IBD Research Group of KASID and Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD). Deep Learning Model Using Stool Pictures for Predicting Endoscopic Mucosal Inflammation in Patients With Ulcerative Colitis. Am J Gastroenterol. 2025 Jan 1;120(1):213-224. doi: 10.14309/ajg.0000000000002978. Epub 2024 Jul 25.

    PubMed 39051648
  • Collins GS, Moons KGM, Dhiman P, Riley RD, Beam AL, Van Calster B, Ghassemi M, Liu X, Reitsma JB, van Smeden M, Boulesteix AL, Camaradou JC, Celi LA, Denaxas S, Denniston AK, Glocker B, Golub RM, Harvey H, Heinze G, Hoffman MM, Kengne AP, Lam E, Lee N, Loder EW, Maier-Hein L, Mateen BA, McCradden MD, Oakden-Rayner L, Ordish J, Parnell R, Rose S, Singh K, Wynants L, Logullo P. TRIPOD+AI statement: updated guidance for reporting clinical prediction models that use regression or machine learning methods. BMJ. 2024 Apr 16;385:e078378. doi: 10.1136/bmj-2023-078378.

    PubMed 38626948
  • Sounderajah V, Guni A, Liu X, Collins GS, Karthikesalingam A, Markar SR, Golub RM, Denniston AK, Shetty S, Moher D, Bossuyt PM, Darzi A, Ashrafian H; STARD-AI Steering Committee. The STARD-AI reporting guideline for diagnostic accuracy studies using artificial intelligence. Nat Med. 2025 Oct;31(10):3283-3289. doi: 10.1038/s41591-025-03953-8. Epub 2025 Sep 15.

    PubMed 40954311
  • Zhong H, Hou C, Huang Z, Chen X, Zou Y, Zhang H, Wang T, Wang L, Huang X, Xiang Y, Zhong M, Hu M, Xiong D, Wang L, Zhang Y, Luo Y, Guan Y, Xia M, Liu X, Yang J, Gan T, Wei W, Chen H, Gong H. A clinical pilot trial of an artificial intelligence-driven smart phone application of bowel preparation for colonoscopy: a randomized clinical trial. Scand J Gastroenterol. 2025 Jan;60(1):116-121. doi: 10.1080/00365521.2024.2443520. Epub 2024 Dec 22.

    PubMed 39709551
  • Ramprasad C, Saini D, Del Carmen H, Krasnovsky L, Chandra R, Mcgregor R, Shinohara RT, Eaton E, Gummadi M, Mehta S, Lewis JD. Text Message System for the Prediction of Colonoscopy Bowel Preparation Adequacy Before Colonoscopy: An Artificial Intelligence Image Classification Algorithm Based on Images of Stool Output. Gastro Hep Adv. 2024 Sep 19;4(2):100556. doi: 10.1016/j.gastha.2024.09.011. eCollection 2025.

    PubMed 39866713
  • Katsoula A, Paschos P, Haidich AB, Tsapas A, Giouleme O. Diagnostic Accuracy of Fecal Immunochemical Test in Patients at Increased Risk for Colorectal Cancer: A Meta-analysis. JAMA Intern Med. 2017 Aug 1;177(8):1110-1118. doi: 10.1001/jamainternmed.2017.2309.

    PubMed 28628706
  • Rahman F, Trivedy M, Rao C, Akinlade F, Mansuri A, Aggarwal A, Laskaratos FM, Rajendran N, Banerjee S. Faecal Immunochemical Testing to Detect Colorectal Cancer in Symptomatic Patients: A Diagnostic Accuracy Study. Diagnostics (Basel). 2023 Jul 10;13(14):2332. doi: 10.3390/diagnostics13142332.

    PubMed 37510076
  • Bailey JA, Weller J, Chapman CJ, Ford A, Hardy K, Oliver S, Morling JR, Simpson JA, Humes DJ, Banerjea A. Faecal immunochemical testing and blood tests for prioritization of urgent colorectal cancer referrals in symptomatic patients: a 2-year evaluation. BJS Open. 2021 Mar 5;5(2):zraa056. doi: 10.1093/bjsopen/zraa056.

    PubMed 33693553
  • D'Souza N, Georgiou Delisle T, Chen M, Benton S, Abulafi M; NICE FIT Steering Group. Faecal immunochemical test is superior to symptoms in predicting pathology in patients with suspected colorectal cancer symptoms referred on a 2WW pathway: a diagnostic accuracy study. Gut. 2021 Jun;70(6):1130-1138. doi: 10.1136/gutjnl-2020-321956. Epub 2020 Oct 21.

    PubMed 33087488

Questions about this trial

What is this clinical trial studying?

An observational study of Colorectal Neoplasms, run by Servicio de Salud Metropolitano Sur Oriente at 1 site in Chile.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 31 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Chile. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Erik Manriquez Alegria, MD (+56988232111, erik.manriquez.alegria@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Correlation Between AI-Derived Stool Image Score and Quantitative FIT (faecal immunochemical test) Concentration (time frame: Within 90 days of stool image submission). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07740122, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Jul 2026.

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