title: Importance of reporting segmental bowel preparation scores during colonoscopy in clinical practice.
abstract: OBJECTIVE
  To evaluate the impact of reporting bowel preparation using Boston Bowel Preparation Scale (BBPS) in clinical practice.
  
  
  METHODS
  The study was a prospective observational cohort study which enrolled subjects reporting for screening colonoscopy. All subjects received a gallon of polyethylene glycol as bowel preparation regimen. After colonoscopy the endoscopists determined quality of bowel preparation using BBPS. Segmental scores were combined to calculate composite BBPS. Site and size of the polyps detected was recorded. Pathology reports were reviewed to determine advanced adenoma detection rates (AADR). Segmental AADR's were calculated and categorized based on the segmental BBPS to determine the differential impact of bowel prep on AADR.
  
  
  RESULTS
  Three hundred and sixty subjects were enrolled in the study with a mean age of 59.2 years, 36.3% males and 63.8% females. Four subjects with incomplete colonoscopy due BBPS of 0 in any segment were excluded. Based on composite BBPS subjects were divided into 3 groups; Group-0 (poor bowel prep, BBPS 0-3) n = 26 (7.3%), Group-1 (Suboptimal bowel prep, BBPS 4-6) n = 121 (34%) and Group-2 (Adequate bowel prep, BBPS 7-9) n = 209 (58.7%). AADR showed a linear trend through Group-1 to 3; with an AADR of 3.8%, 14.8% and 16.7% respectively. Also seen was a linear increasing trend in segmental AADR with improvement in segmental BBPS. There was statistical significant difference between AADR among Group 0 and 2 (3.8% vs 16.7%, P < 0.05), Group 1 and 2 (14.8% vs 16.7%, P < 0.05) and Group 0 and 1 (3.8% vs 14.8%, P < 0.05). χ(2) method was used to compute P value for determining statistical significance.
  
  
  CONCLUSIONS
  Segmental AADRs correlate with segmental BBPS. It is thus valuable to report segmental BBPS in colonoscopy reports in clinical practice.
authors: Deepanshu Jain, Internal Medicine Department, Albert Einstein Medical Centre, PH 19141, United States.
authors: Deepanshu
authors: D
authors: Jain
authors: Deepanshu Jain, Internal Medicine Department, Albert Einstein Medical Centre, PH 19141, United States.
authors: Mojdeh
authors: M
authors: Momeni
authors: Deepanshu Jain, Internal Medicine Department, Albert Einstein Medical Centre, PH 19141, United States.
authors: Mahesh
authors: M
authors: Krishnaiah
authors: Deepanshu Jain, Internal Medicine Department, Albert Einstein Medical Centre, PH 19141, United States.
authors: Sury
authors: S
authors: Anand
authors: Deepanshu Jain, Internal Medicine Department, Albert Einstein Medical Centre, PH 19141, United States.
authors: Shashideep
authors: S
authors: Singhal
mesh_terms: D018256:Adenomatous Polyps / Q000473:pathology*; D002400:Cathartics / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D003110:Colonic Neoplasms / Q000473:pathology*; D003111:Colonic Polyps / Q000473:pathology*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D002400:Cathartics; D011092:Polyethylene Glycols
keywords: Adenomas; Boston Bowel Preparation Score; Colorectal cancer screening; Polyps