Assessment of patients' perceptions of bowel preparation quality at colonoscopy.
OBJECTIVE
There is little published literature evaluating the accuracy of patients' perceptions of the quality of their own bowel preparation for colonoscopy. The aim of this article was to compare patients' perceptions of the adequacy of their bowel preparation with the endoscopists' rating at colonoscopy.


METHODS
Outpatients undergoing elective colonoscopy completed surveys assessing bowel preparation. Patient responses regarding quality of bowel preparation were compared with endoscopists' assessment of colonic preparation. A residual stool score was also calculated for each subject based on the amount of stool, consistency of residual stool, and percentage of bowel visualized.


RESULTS
A total of 474 patients were enrolled. Patients' perceptions of the quality of their bowel preparation were inaccurate when compared to the endoscopists' rating (sensitivity, 75%; specificity, 34%; accuracy, 50%). Overall correlation with endoscopists' rating was low, r = 0.08. Young patient age (<61 yr) was an independent predictor of both adequate bowel preparation ( p= 0.009) and agreement of patient/endoscopist ratings ( p= 0.003).


CONCLUSIONS
Patients are unreliable judges of the quality of their own bowel preparation, tending to overestimate the cleanliness of their colon. Conversely, a patient's fear that their preparation is suboptimal is also inaccurate. A colonoscopy should not be canceled on the basis of a patient's perception that the quality of their preparation is poor.
Harewood
Gavin C
GC
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Wright
Curtis A
CA
Baron
Todd H
TH
D000368:Aged; D002400:Cathartics / Q000008:administration & dosage*; D003113:Colonoscopy / Q000592:standards* / Q000639:trends; D015179:Colorectal Neoplasms / Q000175:diagnosis; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010817:Physician-Patient Relations; D011336:Probability; D011786:Quality Control; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods*; D014481:United States
D002400:Cathartics