Validation of the St. Paul’s Endoscopy Comfort Scale (SPECS) for Colonoscopy

Abstract

Aims Patient comfort during colonoscopy is an important measure of quality, which can improve patient satisfaction and compliance with future procedures. Our aim was to develop and validate a pain assessment tool based on objective behavioural cues tailored to outpatients undergoing colonoscopy: St. Paul’s endoscopy comfort score (SPECS). Methods A single-centre, prospective study was conducted in consecutive adults undergoing planned outpatient colonoscopy. Patient comfort was independently assessed by the physician, nurse and a research assistant (observer) using the SPECS and the Gloucester scale (GS). In addition, the nurse-assessed patient comfort score (NAPCOMS), nonverbal pain Assessment tool (NPAT) and Richmond agitation sedation scale (RASS) were completed by the observer. Data on subject demographics, sedation dose and duration of the procedure were collected. Following the procedure, patients completed a patient satisfaction questionnaire, including a visual analogue scale (VAS) to measure their overall perceived pain during the procedure. Results The study enrolled 350 subjects. The SPECS showed excellent inter-rater reliability among all three raters with an intra-class coefficient (ICC) of 0.81 (95% CI, 0.78–0.84), while the GS showed good reliability with an ICC of 0.77 (95% CI, 0.73–0.80). The SPECS demonstrated moderate agreement with the patient-reported VAS ratings. Conclusions The St. Paul’s endoscopy comfort score was successfully validated, demonstrating excellent inter-rater reliability.

Patient-Reported Experience Measures for Colonoscopy: A Systematic Review and Meta-Ethnography

“…Another limitation may be the inclusion criteria for the existing instruments, since they may have led to missed colonoscopy-specific PREMs due to the fact that only instruments with more than two dimensions were included in this study. Despite patients evidently experiencing more than two dimensions when they undergo a colonoscopy, there are several instruments measuring only one or two dimensions, which may succeed in capturing parts of colonoscopy-specific experiences, but not the whole process [ 60 , 61 , 62 , 63 , 64 ].…”

Comparing Colon Capsule Endoscopy to colonoscopy; a symptomatic patient’s perspective

“…This study also highlights the disconnect between the level of comfort patients experienced compared to endoscopy reported Modified-Gloucester-Comfort-Scores. The GCS, although not formally validated, is used to assess patient comfort during colonoscopy in all Irish endoscopy units, forms part of quality indicators of colonoscopy and is regularly audited by NQAIS [ 22 – 24 ]. Similar discordances have also been reported in other studies [ 25 , 26 ].…”

“…Poor comfort outcomes may cause patients to refrain from engaging with similar diagnostic tools in the future. Development and implementation of comfort scores that includes patient’s perspective such as the Patient-Reported Scale for Tolerability of Endoscopic Procedures (PRO-STEP) [ 27 ] or scores that have shown correlation with patient reported outcomes such as the St. Paul's endoscopy comfort score (SPECS) [ 22 ] should be considered. Although these scores are validated their use are not yet common.…”

Novel Negative Pressure Protective Box in Upper Digestive Endoscopy: A Prospective Case Series

“…More importantly, there were no adverse events or premature removal of TRACEY. One of TRACEY's major advantage compared with other existing devices (7,8) is its ability to protect against aerosolized particles as confirmed through NIOSHapproved N95-100 aerosol barrier testing. In addition, unlike traditional PPEs such as the N95 respirator, TRACEY prevents contamination of the endoscopy suite obviating the need for negative pressure rooms or room turnover downtime for aerosol elimination.…”