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P315. Assessment of bowel preparation for colonoscopy: comparison between different tools and different healthcare professionals

M. Martinato1, I. Frankovic1, R. Caccaro1, M. Scacchi2, R. Cesaro2, F. Marzari2, F. Colombara2, D. Compagno2, S. Judet2, G.C. Sturniolo1, R. D'Incà1, 1Università degli Studi di Padova, Padova, Italy, 2Azienda Ospedaliera di Padova, Padova, Italy

Background

Optimal bowel preparation is essential for an appropriate endoscopic examination of the colon. Few complex and time consuming tools have been proposed to evaluate bowel cleansing and all of them required the endoscopist's assessment. In order to simplify further research on bowel preparation efficacy, it could be useful to identify new tools equally valid and reliable but more user friendly. It may be also interesting to explore the ability of nurses to assess gut cleansing as compared to endoscopists. The aims of the study are: to assess the concordance of the Ottawa Bowel Preparation Scale (OBPS) with a visual analogic scale (VAS) in measuring bowel cleansing; to measure the agreement on the assessment of bowel cleansing performed by nurses and physicians.

Methods

Quality of bowel preparation in consecutive patients scheduled for outpatient colonoscopy was evaluated independently by the physician and by the endoscopy nurse using both the OBPS and VAS. Agreement between healthcare professionals and concordance between tools were assessed by the Pearson correlation coefficient (r).

Results

150 consecutive colonoscopies were analyzed. Concordance between OBPS and VAS was satisfying both in nurses' hands and in physicians' hands: r = 0.8268 (CI −0.8717, −0.7681) and r = 0.8095 (CI −0.8585, −0.7458) respectively, p < 0.0001 in both cases, and with an overall concordance: r = 0.8214 (CI −0.8552, 0.7806), p < 0.0001 (Figure 1).

Agreement between nurses and physicians was r = 0.6010 (95% CI 0.4877, 0.6944), p < 0.0001, using OBPS and r = 0.6196 (95% CI 0.5091, 0.7046), p < 0.0001, using VAS (Figure 2).

Figure 1. Agreement between nurses and physicians using VAS.

Figure 2. Concordance between OBPS and VAS.

Conclusion

VAS assessment of bowel cleansing is significantly correlated with OBPS, a more complex and time consuming tool. It seems plausible that VAS could be employed in the assessment of bowel preparation in future research and clinical activities. A reliable evaluation of bowel cleansing could be also performed by endoscopy nurses.