Boston Bowel Preparation Scale scores provide a standardized definition of adequate for describing bowel cleanliness
Audrey H Calderwood, Paul C Schroy 3rd, David A Lieberman, Judith R Logan, Michael Zurfluh, Brian C Jacobson, Audrey H Calderwood, Paul C Schroy 3rd, David A Lieberman, Judith R Logan, Michael Zurfluh, Brian C Jacobson
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.
Design: 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.
Setting: The Clinical Outcomes Research Initiative.
Patients: Average-risk patients attending screening colonoscopy.
Interventions: Colonoscopy.
Main outcome measurements: 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.
Limitations: Retrospective study.
Conclusion: 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.
Conflict of interest statement
Conflicts of Interests: D. Lieberman is the executive director of the Clinical Outcomes Research Initiative (CORI), a nonprofit organization supporting this study. This potential conflict of interest has been reviewed and managed by the Oregon Health & Science University and Veterans Affairs Conflict of Interest in Research Committee. The remaining authors have no conflicts of interest to disclose.
Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
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Source: PubMed