title: Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness.
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.
  
  
  METHODS
  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.
  
  
  METHODS
  The Clinical Outcomes Research Initiative.
  
  
  METHODS
  Average-risk patients attending screening colonoscopy.
  
  
  METHODS
  Colonoscopy.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Retrospective study.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA.
authors.forename: Audrey H
authors.initials: AH
authors.lastname: Calderwood
authors.affiliation: Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Schroy
authors.affiliation: Division of Gastroenterology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Lieberman
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Judith R
authors.initials: JR
authors.lastname: Logan
authors.affiliation: Division of Gastroenterology, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Zurfluh
authors.affiliation: Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Jacobson
mesh_terms: D002400:Cathartics; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy / Q000592:standards*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011300:Preoperative Care / Q000592:standards*; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D013997:Time Factors; D014741:Video Recording
chemical_list: D002400:Cathartics