Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy

Matthew A. Kluge, J. Lucas Williams, Connie K. Wu, Brian C. Jacobson, Paul C. Schroy, David Lieberman, Audrey H. Calderwood

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background and Aims: The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed by using the Boston Bowel Preparation Scale (BBPS). Methods: In this observational study of prospectively collected data within a large, national, endoscopic consortium, we identified patients aged 50 to 75 years who underwent average-risk screening colonoscopy (C1) followed by a second colonoscopy for any indication within 3 years (C2). We determined the polyp detection rates (PDRs) and advanced PDRs during C2 stratified by C1 BBPS scores. Results: Among segment pairs without polyps at C1 (N = 601), those with inadequate C1 BBPS segment scores had a higher PDR at C2 (10%) compared with those with adequate bowel preparation at C1 (5%; P =.04). Among segment pairs with polyps at C1 (N = 154), segments with inadequate bowel preparation scores at C1 had higher advanced PDRs at C2 (20%) compared with those with adequate bowel preparation scores at C1 (4%; P =.03). In multivariable analysis, the presence of advanced polyps at C1 (adjusted odds ratio [OR] 3.5; 95% confidence intervals [CIs], 1.1-10.8) but not inadequate BBPS scores at C1 (adjusted OR 1.8; 95% CI, 0.6-5.1) was associated with a significantly increased risk of advanced polyps at C2. Conclusions: Inadequate BBPS segment scores generally are associated with higher rates of polyps and advanced polyps at subsequent colonoscopy within a short timeframe. The presence of advanced polyps as well as inadequate BBPS segment scores can inform the risk of missed polyps and help triage which patients warrant a timely repeat colonoscopy.

Original languageEnglish (US)
Pages (from-to)744-751
Number of pages8
JournalGastrointestinal Endoscopy
Volume87
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Colonoscopy
Polyps
Neoplasms
Odds Ratio
Confidence Intervals
Triage
Observational Studies

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy. / Kluge, Matthew A.; Williams, J. Lucas; Wu, Connie K.; Jacobson, Brian C.; Schroy, Paul C.; Lieberman, David; Calderwood, Audrey H.

In: Gastrointestinal Endoscopy, Vol. 87, No. 3, 01.03.2018, p. 744-751.

Research output: Contribution to journalArticle

Kluge, Matthew A. ; Williams, J. Lucas ; Wu, Connie K. ; Jacobson, Brian C. ; Schroy, Paul C. ; Lieberman, David ; Calderwood, Audrey H. / Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy. In: Gastrointestinal Endoscopy. 2018 ; Vol. 87, No. 3. pp. 744-751.
@article{2d5ab932aa2c4d48b0b94773e07426c1,
title = "Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy",
abstract = "Background and Aims: The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed by using the Boston Bowel Preparation Scale (BBPS). Methods: In this observational study of prospectively collected data within a large, national, endoscopic consortium, we identified patients aged 50 to 75 years who underwent average-risk screening colonoscopy (C1) followed by a second colonoscopy for any indication within 3 years (C2). We determined the polyp detection rates (PDRs) and advanced PDRs during C2 stratified by C1 BBPS scores. Results: Among segment pairs without polyps at C1 (N = 601), those with inadequate C1 BBPS segment scores had a higher PDR at C2 (10{\%}) compared with those with adequate bowel preparation at C1 (5{\%}; P =.04). Among segment pairs with polyps at C1 (N = 154), segments with inadequate bowel preparation scores at C1 had higher advanced PDRs at C2 (20{\%}) compared with those with adequate bowel preparation scores at C1 (4{\%}; P =.03). In multivariable analysis, the presence of advanced polyps at C1 (adjusted odds ratio [OR] 3.5; 95{\%} confidence intervals [CIs], 1.1-10.8) but not inadequate BBPS scores at C1 (adjusted OR 1.8; 95{\%} CI, 0.6-5.1) was associated with a significantly increased risk of advanced polyps at C2. Conclusions: Inadequate BBPS segment scores generally are associated with higher rates of polyps and advanced polyps at subsequent colonoscopy within a short timeframe. The presence of advanced polyps as well as inadequate BBPS segment scores can inform the risk of missed polyps and help triage which patients warrant a timely repeat colonoscopy.",
author = "Kluge, {Matthew A.} and Williams, {J. Lucas} and Wu, {Connie K.} and Jacobson, {Brian C.} and Schroy, {Paul C.} and David Lieberman and Calderwood, {Audrey H.}",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.gie.2017.06.012",
language = "English (US)",
volume = "87",
pages = "744--751",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Inadequate Boston Bowel Preparation Scale scores predict the risk of missed neoplasia on the next colonoscopy

AU - Kluge, Matthew A.

AU - Williams, J. Lucas

AU - Wu, Connie K.

AU - Jacobson, Brian C.

AU - Schroy, Paul C.

AU - Lieberman, David

AU - Calderwood, Audrey H.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background and Aims: The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed by using the Boston Bowel Preparation Scale (BBPS). Methods: In this observational study of prospectively collected data within a large, national, endoscopic consortium, we identified patients aged 50 to 75 years who underwent average-risk screening colonoscopy (C1) followed by a second colonoscopy for any indication within 3 years (C2). We determined the polyp detection rates (PDRs) and advanced PDRs during C2 stratified by C1 BBPS scores. Results: Among segment pairs without polyps at C1 (N = 601), those with inadequate C1 BBPS segment scores had a higher PDR at C2 (10%) compared with those with adequate bowel preparation at C1 (5%; P =.04). Among segment pairs with polyps at C1 (N = 154), segments with inadequate bowel preparation scores at C1 had higher advanced PDRs at C2 (20%) compared with those with adequate bowel preparation scores at C1 (4%; P =.03). In multivariable analysis, the presence of advanced polyps at C1 (adjusted odds ratio [OR] 3.5; 95% confidence intervals [CIs], 1.1-10.8) but not inadequate BBPS scores at C1 (adjusted OR 1.8; 95% CI, 0.6-5.1) was associated with a significantly increased risk of advanced polyps at C2. Conclusions: Inadequate BBPS segment scores generally are associated with higher rates of polyps and advanced polyps at subsequent colonoscopy within a short timeframe. The presence of advanced polyps as well as inadequate BBPS segment scores can inform the risk of missed polyps and help triage which patients warrant a timely repeat colonoscopy.

AB - Background and Aims: The risks of missed findings after inadequate bowel preparation are not fully characterized in a diverse cohort. We aimed to evaluate the likelihood of missed polyps after an inadequate preparation as assessed by using the Boston Bowel Preparation Scale (BBPS). Methods: In this observational study of prospectively collected data within a large, national, endoscopic consortium, we identified patients aged 50 to 75 years who underwent average-risk screening colonoscopy (C1) followed by a second colonoscopy for any indication within 3 years (C2). We determined the polyp detection rates (PDRs) and advanced PDRs during C2 stratified by C1 BBPS scores. Results: Among segment pairs without polyps at C1 (N = 601), those with inadequate C1 BBPS segment scores had a higher PDR at C2 (10%) compared with those with adequate bowel preparation at C1 (5%; P =.04). Among segment pairs with polyps at C1 (N = 154), segments with inadequate bowel preparation scores at C1 had higher advanced PDRs at C2 (20%) compared with those with adequate bowel preparation scores at C1 (4%; P =.03). In multivariable analysis, the presence of advanced polyps at C1 (adjusted odds ratio [OR] 3.5; 95% confidence intervals [CIs], 1.1-10.8) but not inadequate BBPS scores at C1 (adjusted OR 1.8; 95% CI, 0.6-5.1) was associated with a significantly increased risk of advanced polyps at C2. Conclusions: Inadequate BBPS segment scores generally are associated with higher rates of polyps and advanced polyps at subsequent colonoscopy within a short timeframe. The presence of advanced polyps as well as inadequate BBPS segment scores can inform the risk of missed polyps and help triage which patients warrant a timely repeat colonoscopy.

UR - http://www.scopus.com/inward/record.url?scp=85058199968&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058199968&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2017.06.012

DO - 10.1016/j.gie.2017.06.012

M3 - Article

C2 - 28648575

AN - SCOPUS:85026815964

VL - 87

SP - 744

EP - 751

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 3

ER -