Publication Name	World Journal of Gastroenterology
Manuscript ID	121527
DOI	10.3748/wjg.121527
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Prospective Study
Article Title	Disentangling true inspection time from therapeutic intervals: Validation of effective withdrawal time as a colonoscopy quality metric
Manuscript Source	Unsolicited Manuscript
All Author List	Zi-Ye Peng, Jia-Xin Li, Yue Huang, Xiang-Yu Wang, Qi An, Zhao-Yu Yin, Yan-Ru Li, Jia-Yi Sun, Yu-Wei Wang, Xiao Yang, Qi Zhang, Xi-Mo Wang, Shu-Yi Zhang and Zheng-Cun Pei
Funding Agency and Grant Number	Funding Agency Grant Number the Tianjin Health Science and Technology Project No. TJWJ2025MS017 the Natural Science Foundation of Tianjin No. 24JCQNJC01990
Corresponding Author	Zheng-Cun Pei, PhD, Medical School, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin 300072, China. peizhengcun@tju.edu.cn
Key Words	Colonoscopy; Artificial intelligence; Adenoma detection rate; Withdrawal time; Quality control
Core Tip	Effective withdrawal time (EWT), derived from an artificial intelligence-based system, provides a refined measure of true mucosal inspection by excluding therapeutic and visually obscured phases during colonoscopy. In this study, EWT showed stronger associations with adenoma detection rate and polyp detection rate than standard withdrawal time, along with superior predictive performance. Nonlinear analysis revealed a plateau effect, suggesting that an inspection time of approximately 6-10 minutes may be optimal. EWT may serve as a more precise and clinically actionable quality metric.
Citation	Peng ZY, Li JX, Huang Y, Wang XY, An Q, Yin ZY, Li YR, Sun JY, Wang YW, Yang X, Zhang Q, Wang XM, Zhang SY, Pei ZC. Disentangling true inspection time from therapeutic intervals: Validation of effective withdrawal time as a colonoscopy quality metric. World J Gastroenterol 2026; In press DOI: https://doi.org/10.3748/wjg.121527
PDF	121527-in-press.pdf

Received	2026-03-27 02:39
Peer-Review Started	2026-03-27 02:39
First Decision by Editorial Office Director	2026-04-28 02:29
Return for Revision	2026-04-28 02:29
Revised	2026-05-13 12:40
Publication Fee Transferred	2026-05-14 10:35
Second Decision by Editor	2026-06-17 02:39
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-17 08:11
Articles in Press	2026-06-17 08:11
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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