Response to Hassan et al.

When focusing on screening colonoscopies, the difference between the groups was no longer significant;however, ADR and polyp detection rate were still numerically lower in the AIAC group. Nonetheless, we also compared our patient mix at 2019 (before the pandemic) with that of 2020 and 2021 and did not find a difference either in total number of procedures or in the proportion of screening procedures of the total number of procedures. [...]we do not believe that the different ADR between the 2 periods can be attributed to a referral bias related to the COVID-19 pandemic;nonetheless, some concealed bias that was not identified by our analysis can never be completely ruled out. [...]the impact of the Hawthorne effect on physician performance (the constant scrutiny and measurement under study settings) remains to be better studied. [...]the potential direction of AI-assisted devices development should probably be pointed through quality enhancement—in this case, this could be an interactive timer that facilitates proper withdrawal time or an indicator of proper mucosal exposure.