title: Impact of colonoscopy preparation quality on detection of suspected colonic neoplasia.
abstract: BACKGROUND
  Suboptimal bowel preparation for colonoscopy can lead to missed colonic lesions. The aim of this study was to describe the impact of preparation quality on detection of suspected colonic neoplasia.
  
  
  METHODS
  Data from the Clinical Outcomes Research Initiative national endoscopic database for the period January 1, 2000 to December 31, 2001, were analyzed. Patient demographics, quality of preparation, and colonoscopy findings were abstracted from the database.
  
  
  RESULTS
  Overall, 93,004 colonoscopies with adequate documentation were reviewed. Preparation was adequate for 71,501 (76.9%) of these procedures. On multivariate analysis, preparation adequacy was associated with colonic lesion detection, odds ratio (OR) 1.21: 95% CI [1.16, 1.25]. Adequate preparation demonstrated a closer association with identification of "nonsignificant" lesions (polyps <or=9 mm), OR 1.23: 95% CI [1.19, 1.28], compared with "significant" lesion detection (mass lesion, polyps >9 mm), OR 1.05: 95% CI [0.98, 1.11].
  
  
  CONCLUSIONS
  Bowel preparation is inadequate for almost a quarter of patients undergoing colonoscopy. These results suggest that inadequate preparation quality only hinders detection of smaller lesions, while having negligible impact on detection of larger lesions. These results should be confirmed in prospective studies.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Gavin C
authors.initials: GC
authors.lastname: Harewood
authors.forename: Virender K
authors.initials: VK
authors.lastname: Sharma
authors.forename: Pat
authors.initials: P
authors.lastname: de Garmo
mesh_terms: D003113:Colonoscopy / Q000379:methods* / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D016001:Confidence Intervals; D003902:Detergents / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012042:Registries; D012106:Research; D012680:Sensitivity and Specificity; D007507:Therapeutic Irrigation / Q000592:standards* / Q000639:trends; D017749:Total Quality Management; D014481:United States
chemical_list: D003902:Detergents