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Gastrointest Endosc. 2014 Aug;80(2):269-76. doi: 10.1016/j.gie.2014.01.031. Epub 2014 Mar 12.

Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness.

Author information

1
Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA.
2
Division of Gastroenterology, Oregon Health & Science University, Portland, Oregon, USA.
3
Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.

Abstract

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.

PMID:
24629422
PMCID:
PMC4104141
DOI:
10.1016/j.gie.2014.01.031
[Indexed for MEDLINE]
Free PMC Article

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