Clinical Practice Impact of the Boston Bowel Preparation Scale in a European Country

Abstract

Introduction: The diagnostic acuity of colonoscopy requires a careful evaluation of the colonic mucosa, so an adequate bowel cleansing is a key element of the procedure. It is internationally recommended that an evaluation of the quality of the intestinal preparation should be included in the colonoscopy report. The Boston Bowel Preparation Scale (BBPS) is a bowel cleanliness rating scale that has gained some preponderance in this context. However, its application implies some degree of subjective appreciation, and it is important to conduct interobserver reproducibility studies in different contexts. The objective of the present study was to evaluate the reliability of the BBPS in the Portuguese gastroenterological community. Methods: A prospective study involving Portuguese gastroenterologists with clinical practice in several contexts, and using different methods of evaluation of the intestinal preparation. Participants were invited to answer a questionnaire encompassing 93 static images and 12 video segments of colonoscopy examinations, with different levels of intestinal preparation. For each item, the participant gastroenterologist assigned a score of 0-3, according to the BBPS criteria. A statistical analysis was performed with SPSS 20.0 software, using the intraclass correlation coefficient (ICC). Results: From 45 invited gastroenterologists, 36 replied (mean age 39 ± 9 years). Fifteen (41%) had more than 10 years of colonoscopy experience and 20 (56%) performed more than 40 examinations per month. Twenty-seven (77%) usually used the BBPS in their daily practice. Statistical analysis revealed a strong interobserver correlation (ICC = 0.783) in the application of the BBPS, even in those gastroenterologists who did not use the scale in their daily routine (ICC = 0.775) and those with less years of experience (ICC = 0.820). The correlation in the videos was slightly lower than that observed in the static images (ICC = 0.74 vs. ICC = 0.78). Conclusion: The application of the BBPS in the Portuguese gastroenterology community is reproducible and can represent a way to harmonize the colonoscopy reports, contributing to its correct interpretation and subsequent patient orientation.

A Comparative Clinical Study of a Novel Pre-colonoscopy Bowel Capsule Preparation Against Two Commercially Available Liquid Preparations

“…Immediately after completing the colonoscopy, the gastroenterologist and sedationist independently rated the adequacy of the bowel preparations using the validated Boston Bowel Preparation Score (BBPS) score ( 14 ). The BBPS is a 9-point scale assessing the ascending (3-point), transverse (3-point), and descending colon (3-point), where 0 = inadequate (unprepared colon segment with mucosa unable to be visualized because of solid stool that cannot be cleared); and 3 = excellent (entire mucosa of colon segment can be visualized with no residual staining, small fragments of stool or opaque liquid) ( 14 ). Polyp detection rate (PDR) was also recorded by the gastroenterologist by reporting polyp numbers in the ascending, transverse, and descending colon.…”

Correlation of Cleanliness among Different Bowel Segments during Colonoscopy: A Retrospective Study

“…The scale of evaluation of intestinal cleanliness has also emerged continuously, with its advantages, disadvantages, and scope of application [1][2][3][4]. The Boston Bowel Preparation Scale (BBPS) [5] proposed by the Boston University has been proven to have high reliability and validity [6][7][8], and is widely used by digestive endoscopy workers in Europe, Korea, China, etc. It is also an indicator of intestinal cleanliness observed after a retrospective view and is related to the quality of the intestinal examination.…”

No inferioridad entre dos agentes de bajo volumen (Picosulfato de Sodio/Citrato de Magnesio vs. Sulfato de Sodio/Potasio/Magnesio) en la preparación de colon para procedimientos diagnósticos: estudio observacional

“…Una particularidad presente en esta escala es que la valoración se realiza después de un lavado y succión realizado por el operador (29,30). Cada sección (derecho, trasverso e izquierdo) tiene una puntuación de 0 a 3 (0 = colon sin preparar, no valorable por presencia de residuos fecales sólidos no lavables; 1 = algunas áreas son valorables, residuo fecal; 2 = mucosa visible, escaso residuo fecal líquido; 3 = completamente libre de residuos fecales) (31).…”