TY - JOUR
T1 - Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness
AU - Calderwood, Audrey H.
AU - Schroy, Paul C.
AU - Lieberman, David A.
AU - Logan, Judith (Judy)
AU - Zurfluh, Michael
AU - Jacobson, Brian C.
N1 - Funding Information:
DISCLOSURE: D. Lieberman is a consultant for Exact Science, Given, and Roche and is the executive director of the Clinical Outcomes Research Initiative (CORI), a nonprofit organization supporting this study. This potential conflict of interest has been reviewed and managed by the Oregon Health & Science University and Veterans Affairs Conflict of Interest in Research Committee. This work was funded by National Institutes of Health (NIH) NIDDK, grant K08-DK090150-02 (A. Calderwood). D. Lieberman and CORI are supported with funding from NIH NIDDK U01 DK057132, R33-DK61778-01, and R21-CA131626. Funding from NIDDK supports the collection, management, analysis, and interpretation of this and all CORI research. In addition, the practice network (CORI) has received support for the infrastructure of the practice-based network from AstraZeneca, Bard International, Pentax USA, ProVation, Endosoft, Given Imaging, and Ethicon. The commercial entities had no involvement in this research. No other financial relationships relevant to this publication were disclosed.
PY - 2014/8
Y1 - 2014/8
N2 - Background Establishing a threshold of bowel cleanliness below which colonoscopies should be repeated at accelerated intervals is important, yet there are no standardized definitions for an adequate preparation. Objective To determine whether Boston Bowel Preparation Scale (BBPS) scores could serve as a standard definition of adequacy. Design Cross-sectional observational analysis of colonoscopy data from 36 adult GI endoscopy practices and prospective survey showing 4 standardized colonoscopy videos with varying degrees of bowel cleanliness. Setting The Clinical Outcomes Research Initiative. Patients Average-risk patients attending screening colonoscopy. Interventions Colonoscopy. Main Outcome Measurements Recommended follow-up intervals among average-risk, screening colonoscopies without polyps stratified by BBPS scores. Results We evaluated 2516 negative screening colonoscopies performed by 74 endoscopists. If the BBPS score was ≥2 in all 3 segments (N = 2295), follow-up was recommended in 10 years in 90% of cases. Examinations with total BBPS scores of 3 to 5 (N = 167) had variable recommendations. Follow-up within 1 year was recommended for 96% of examinations with total BBPS scores of 0 to 2 (N = 26). Similar results were noted among 167 participants in a video survey with pre-established BBPS scores. Limitations Retrospective study. Conclusion BBPS scores correlate with endoscopist behavior regarding follow-up intervals for colonoscopy. A total BBPS score ≥6 and/or all segment scores ≥2 provides a standardized definition of adequate for 10-year follow-up, whereas total scores ≤2 indicate that a procedure should be repeated within 1 year. Future work should focus on finding consensus for management of examinations with total scores of 3 to 5.
AB - Background Establishing a threshold of bowel cleanliness below which colonoscopies should be repeated at accelerated intervals is important, yet there are no standardized definitions for an adequate preparation. Objective To determine whether Boston Bowel Preparation Scale (BBPS) scores could serve as a standard definition of adequacy. Design Cross-sectional observational analysis of colonoscopy data from 36 adult GI endoscopy practices and prospective survey showing 4 standardized colonoscopy videos with varying degrees of bowel cleanliness. Setting The Clinical Outcomes Research Initiative. Patients Average-risk patients attending screening colonoscopy. Interventions Colonoscopy. Main Outcome Measurements Recommended follow-up intervals among average-risk, screening colonoscopies without polyps stratified by BBPS scores. Results We evaluated 2516 negative screening colonoscopies performed by 74 endoscopists. If the BBPS score was ≥2 in all 3 segments (N = 2295), follow-up was recommended in 10 years in 90% of cases. Examinations with total BBPS scores of 3 to 5 (N = 167) had variable recommendations. Follow-up within 1 year was recommended for 96% of examinations with total BBPS scores of 0 to 2 (N = 26). Similar results were noted among 167 participants in a video survey with pre-established BBPS scores. Limitations Retrospective study. Conclusion BBPS scores correlate with endoscopist behavior regarding follow-up intervals for colonoscopy. A total BBPS score ≥6 and/or all segment scores ≥2 provides a standardized definition of adequate for 10-year follow-up, whereas total scores ≤2 indicate that a procedure should be repeated within 1 year. Future work should focus on finding consensus for management of examinations with total scores of 3 to 5.
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U2 - 10.1016/j.gie.2014.01.031
DO - 10.1016/j.gie.2014.01.031
M3 - Article
C2 - 24629422
AN - SCOPUS:84904745632
SN - 0016-5107
VL - 80
SP - 269
EP - 276
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 2
ER -