Evidence map›Paper›PMID 29243102›Full record

ArticleDigestive diseases and sciences2018

Split-Dose Bowel Preparation Reduces the Need for Early Repeat Colonoscopy Without Improving Adenoma Detection Rate.

Li Wang, Brandon S Sprung, Arthur J DeCross, Danielle Marino

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Article in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Li WangDepartment of Medicine -Internal Medicine Residency Program, University of Massachusetts, 55 North Lake Ave, Worcester, MA, 01655, USA. li.wang@umassmemorial.org.ORCID http://orcid.org/0000-0002-3987-7710
Brandon S SprungDivision of Gastroenterology and Hepatology, University of Rochester Medical Center, University of Rochester, 601 Elmwood Ave, Box 646, Rochester, NY, 14642, USA.
Arthur J DeCrossDivision of Gastroenterology and Hepatology, University of Rochester Medical Center, University of Rochester, 601 Elmwood Ave, Box 646, Rochester, NY, 14642, USA.
Danielle MarinoDivision of Gastroenterology and Hepatology, University of Rochester Medical Center, University of Rochester, 601 Elmwood Ave, Box 646, Rochester, NY, 14642, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsSplit-dose bowel preparation is associated with improved mucosal visualization and patient tolerance, becoming a standard of care. However, quality measures data associated with this preparation are limited. At our academic tertiary-care facility, we aim to study the effect of changing from single- to split-dose preparation on colonoscopy quality measures.

methodsA retrospective cohort study with quality indicators was conducted using electronic medical record data. Cases were identified via ICD9 code V76.51, "Special screening for malignant neoplasms of colon." Single-dose preparation data was collected from 9/1/13 to 8/31/14. Split-dose preparation was implemented 11/2014, and data were collected from 1/1/15 to 8/31/15.

resultsA total of 1602 colonoscopies in the single-dose group and 1061 colonoscopies in the split-dose group were analyzed. The Boston Bowel Preparation Scale was significantly improved in the split-dose group 8.64 ± SD 1.25 versus 8.25 ± SD 1.61, p < 0.001. There was no significant difference in adenoma detection rate 40.7% (95% CI 37.8-43.7%) versus 40.5% (95% CI 38.1-42.9%), p = 0.92; however, the rate for recommending an early repeat examination due to an inadequate bowel preparation was significantly decreased to 3.9% (95% CI 2.7-5.0%) versus 8.9% (95% CI 1.52-2.97%), p < 0.001.

conclusionWhile split-dose preparation significantly improves overall bowel cleanliness, there is no significant adenoma detection rate improvement with high baseline rate, suggesting a threshold which may not improve with enhanced preparations. Split-dose preparation significantly reduces the frequency with which inadequate preparation prompts an early repeat examination, which has important clinical implications on performance, costs, and patient experience, providing further evidence supporting split-dose preparation use.

Indexed as

ColonoscopyAdenomaAdultAgedAged, 80 and overCatharticsColonic NeoplasmsFemaleHumansLogistic ModelsMaleMiddle AgedQuality Indicators, Health CareRetrospective StudiesCatharticsAdenoma detection rateBoston Bowel Preparation ScaleEarly repeat colonoscopyHigh baseline ADR

Identifiers

PMID29243102

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.