title: Comprehensive validation of the Boston Bowel Preparation Scale.
abstract: BACKGROUND
  The Boston Bowel Preparation Scale (BBPS) is a novel bowel cleanliness rating scale that has undergone partial validation previously.
  
  
  OBJECTIVE
  To fully validate the BBPS and assess the ease of its dissemination.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Various endoscopy units worldwide.
  
  
  METHODS
  Endoscopists.
  
  
  METHODS
  Video recordings of colonoscopies with varying degrees of cleanliness were viewed twice by gastroenterologists at 1 medical center. For each video, participants assigned segment and total BBPS scores. Endoscopists worldwide were also surveyed about their experience with the BBPS after viewing an instructional video.
  
  
  METHODS
  Intraclass correlation coefficients and weighted κ values assessed inter- and intrarater reliability, respectively. The BBPS was used among 983 patients undergoing screening colonoscopy.
  
  
  RESULTS
  The BBPS demonstrated near-perfect interrater reliability (intraclass correlation coefficient = 0.91) and substantial intrarater reliability (weighted κ = 0.78; 95% CI, 0.73-0.84). Among 983 colonoscopies, right and left colon segment scores of 2 or 3 had a multivariate odds ratio of 1.60 (95% CI, 1.01-2.55) and 2.58 (95% CI, 1.34-4.98), respectively, for polyp detection compared with segment scores of 0 or 1. Endoscopists from a variety of settings worldwide found the BBPS easy to implement and applicable to their patient population.
  
  
  CONCLUSIONS
  Single-center reliability testing.
  
  
  CONCLUSIONS
  The BBPS is a valid and reliable instrument for assessing bowel cleanliness during colonoscopy. Segment scores may represent a standardized way to determine bowel preparation adequacy. The BBPS can be easily disseminated through the use of a brief instructional video.
authors.affiliation: Section of Gastroenterology, Boston University Medical Center, 85 East Concord Street, 7th Floor, Boston, MA 02118, USA. audrey.calderwood@bmc.org
authors.forename: Audrey H
authors.initials: AH
authors.lastname: Calderwood
authors.forename: Brian C
authors.initials: BC
authors.lastname: Jacobson
mesh_terms: D002400:Cathartics; D003111:Colonic Polyps / Q000175:diagnosis; D003113:Colonoscopy / Q000592:standards; D006801:Humans; D011300:Preoperative Care / Q000592:standards; D015203:Reproducibility of Results
chemical_list: D002400:Cathartics