Reliability of the Boston Bowel Preparation Scale in the Endoscopy Nurse Population

Schindler, Amy E.; Chan, Walter W.; Laborde, Cregan J.; Obstein, Keith L.

doi:10.1016/j.cgh.2014.11.011

Cited by 7 publications

(8 citation statements)

References 6 publications

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“…All three commonly used contemporary scales studied 9 10 11 12 13 14 15 have been partially validated, though head-to-head comparisons are lacking, which justifies this new assessment 16 .…”

Section: Discussionmentioning

confidence: 99%

“…We selected three previously validated bowel preparation scales that do not specifically require a fluid score, in order to allow the inclusion of videos after optimal washing. The BBPS evaluates three colonic segments (right, transverse, left) on a scale of 0 to 3 with a total score out of 9, 9 being the cleanest 10 11 12 13 . The CBPS scores each of these same segments on a scale of 0 to 12 for a total score out of 36, with higher scores representing cleaner preparations 15 .…”

Section: Methodsmentioning

confidence: 99%

“…Over the years, several scales have been developed in order to better quantify for clinical or research purposes the adequacy of cleansing attributable to a bowel preparation 8 9 10 11 12 13 14 15 16 . However, few of these have been formally validated to guide clinical management.…”

Section: Introductionmentioning

confidence: 99%

“…We have therefore chosen to compare three of the most commonly used scales: the Boston Bowel Preparation Scale (BBPS) 10 11 12 13 , the Chicago Bowel Preparation Scale (CBPS) 15 , and the Harefield Cleansing Scale (HCS) 14 . For each of these scales, intra-rater and inter-rater reliability were assessed using a standardized set of colonoscopy video clips, as well as predictive abilities for clinical outcomes (adenoma detection and ability to detect lesions ≥ 5 mm).…”

Section: Introductionmentioning

confidence: 99%

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Validating bowel preparation scales

et al. 2017

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Background and study aim Few scales assessing bowel preparation quality have been validated, and direct between-scale comparisons remain scarce. The aim of the study was to compare inter- and intra-rater reliability, predictive abilities for clinical outcomes, and ease of use for each scale. Methods Colonoscopy video recordings highlighting five colonic segments after washing were viewed independently by three physicians, and cleanliness was evaluated using the Boston Bowel Preparation Scale (BBPS), the Chicago Bowel Preparation Scale (CBPS), and the Harefield Cleansing Scale (HCS) in randomized order. Kappa or intraclass correlations quantified intra- and inter-rater reliability. Ease of use was evaluated (1 – 10 scale, 1 = easy), as were associations between scores, adenoma detection, and adequacy of preparation to exclude lesions ≥ 5 mm. Results Among 83 colonoscopy videos, indications included screening or surveillance in 72.3 %. Mean (± SD) scores of the respective three raters were 5.17 ± 1.57, 6.49 ± 1.48, and 5.12 ± 1.21 for BBPS, and 23.73 ± 6.01, 28.39 ± 5.47, and 24.75 ± 5.83 for CBPS, while successful HCS scores (grade A or B) were given for 76 %, 89 %, and 63 % of examinations. Intra-rater reliability ranges were 0.88 – 1.00, 0.83 – 1.00, and 0.62 – 1.00 for BBPS, CBPS, and HCS, respectively. Similarly, inter-rater reliability ranges were 0.50 – 0.79, 0.64 – 0.83, and 0.28 – 0.52, respectively. Sources of disagreement included varying rater strictness, which was possibly most marked for preparations rated as intermediate. Overall, associations between preparation scores and adenoma detection lacked statistical significance. Conclusion The BBPS and CBPS showed the best inter- and intra-rater reliability, and the BBPS was considered the easiest to use. Further studies are needed to determine an optimal adequacy threshold for these scales, with the goal of predicting clinical outcomes and determining the appropriate interval to the next colonoscopy.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validating bowel preparation scales

et al. 2017

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“…The most well established and commonly used validated bowel preparation quality scales in clinical trials include the Aronchick Scale[ 41 , 42 ], the Boston Bowel Preparation Scale (BBPS)[ 43 - 49 ], and the Ottawa Bowel Preparation Scale (OBPS)[ 50 ] (Table 1 ). Other instruments that have been validated, but are less commonly used, include the Harefield Cleansing Scale (HCS)[ 51 ] and the Chicago Bowel Preparation Scale (CBPS)[ 52 ] (Table 1 ).…”

Section: Validated Bowel Preparation Scalesmentioning

confidence: 99%

Bowel preparation quality scales for colonoscopy

Kastenberg

Bertiger

Brogadir

2018

WJG

157

144

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Colorectal cancer (CRC) is the third most common cancer and second leading cause of cancer-related death in the United States. Colonoscopy is widely preferred for CRC screening and is the most commonly used method in the United States. Adequate bowel preparation is essential for successful colonoscopy CRC screening. However, up to one-quarter of colonoscopies are associated with inadequate bowel preparation, which may result in reduced polyp and adenoma detection rates, unsuccessful screens, and an increased likelihood of repeat procedure. In addition, standardized criteria and assessment scales for bowel preparation quality are lacking. While several bowel preparation quality scales are referred to in the literature, these differ greatly in grading methodology and categorization criteria. Published reliability and validity data are available for five bowel preparation quality assessment scales, which vary in several key attributes. However, clinicians and researchers continue to use a variety of bowel preparation quality measures, including nonvalidated scales, leading to potential confusion and difficulty when comparing quality results among clinicians and across clinical trials. Optimal clinical criteria for bowel preparation quality remain controversial. The use of validated bowel preparation quality scales with stringent but simple scoring criteria would help clarify clinical trial data as well as the performance of colonoscopy in clinical practice related to quality measurements.

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