The Boston bowel preparation scale: a valid and reliable instrument for colonoscopy-oriented research - 23/08/11
Reprint requests: Brian C. Jacobson, MD, Section of Gastroenterology, Boston University Medical Center, 85 East Concord St, Rm 7721, Boston, MA 02118.Boston, Massachusetts, USA
Abstract |
Background |
Few bowel-preparation rating scales have been validated. Most scales were intended for comparing oral purgatives and fail to account for washing and/or suctioning by the endoscopist. This limits their utility in studies of colonoscopy outcomes, such as polyp-detection rates.
Objective |
To develop a valid and reliable scale for use in colonoscopy outcomes research.
Setting |
Academic medical center.
Methods |
We developed the Boston bowel preparation scale (BBPS), a 10-point scale that assesses bowel preparation after all cleansing maneuvers are completed by the endoscopist. We assessed interobserver and intraobserver reliability by using video footage of colonoscopies viewed on 2 separate occasions by 22 clinicians. We then applied the BBPS prospectively during screening colonoscopies and compared BBPS scores with clinically meaningful outcomes, including polyp-detection rates and procedure times.
Results |
The intraclass correlation coefficient (a measure of interobserver reliability) for BBPS scores was 0.74. The weighted kappa (a measure of intraobserver reliability) for scores was 0.77 (95% CI, 0.66-0.87). During 633 screening colonoscopies, the mean (SD) BBPS score was 6.0 ± 1.6. Higher BBPS scores (≥5 vs <5) were associated with a higher polyp-detection rate (40% vs 24%, P < .02). BBPS scores were inversely correlated with colonoscope insertion (r = –0.16, P < .003) and withdrawal (r = –0.23, P < .001) times.
Limitations |
Single-center study.
Conclusions |
The BBPS is a valid and reliable measure of bowel preparation. It may be well suited to colonoscopy outcomes research because it reflects the colon’s cleanliness during the inspection phase of the procedure.
Le texte complet de cet article est disponible en PDF.Abbreviations : ASGE, BBPS, DVD, ICC
Plan
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. The study was supported by an ASGE/TAP Endoscopic Research Award (B.C.J.) and National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases award K08-DK070706 (B.C.J.). |
|
| Presented at Digestive Disease Week, May 20-23, 2007, Washington, DC (Gastrointest Endosc 2007;65:AB361). |
|
| If you want to chat with an author of this article, you may contact him at brian.jacobson@bmc.org. |
Vol 69 - N° 3P2
P. 620-625 - mars 2009 Retour au numéro
Article précédent
- Where the dragon truly sleeps
- John I. Allen
- The outcome of a second preparation for colonoscopy after preparation failure in the first procedure
- Shomron Ben-Horin, Simon Bar-Meir, Benjamin Avidan
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?