A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy

Cesare Hassan, Lorenzo Fuccio, Mario Bruno, Nico Pagano, Cristiano Spada, Silvia Carrara, Chiara Giordanino, Emanuele Rondonotti, Gabriele Curcio, Pietro Dulbecco, Carlo Fabbri, Domenico Della Casa, Stefania Maiero, Adriana Simone, Federico Iacopini, Giuseppe Feliciangeli, Gianpiero Manes, Antonio Rinaldi, Angelo Zullo, Francesca RogaiAlessandro Repici

Research output: Contribution to journalArticle

126 Citations (Scopus)

Abstract

Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.

Original languageEnglish
Pages (from-to)501-506
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume10
Issue number5
DOIs
Publication statusPublished - May 2012

Fingerprint

Colonoscopy
Odds Ratio
Colorectal Surgery
Sex Ratio
ROC Curve
Body Mass Index
Fibrosis
Multivariate Analysis
Demography
Prospective Studies
Safety
Sensitivity and Specificity

Keywords

  • Colon Cancer Screening
  • Laxative
  • Polyethylene Glycol
  • Polyp Detection

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy. / Hassan, Cesare; Fuccio, Lorenzo; Bruno, Mario; Pagano, Nico; Spada, Cristiano; Carrara, Silvia; Giordanino, Chiara; Rondonotti, Emanuele; Curcio, Gabriele; Dulbecco, Pietro; Fabbri, Carlo; Della Casa, Domenico; Maiero, Stefania; Simone, Adriana; Iacopini, Federico; Feliciangeli, Giuseppe; Manes, Gianpiero; Rinaldi, Antonio; Zullo, Angelo; Rogai, Francesca; Repici, Alessandro.

In: Clinical Gastroenterology and Hepatology, Vol. 10, No. 5, 05.2012, p. 501-506.

Research output: Contribution to journalArticle

Hassan, C, Fuccio, L, Bruno, M, Pagano, N, Spada, C, Carrara, S, Giordanino, C, Rondonotti, E, Curcio, G, Dulbecco, P, Fabbri, C, Della Casa, D, Maiero, S, Simone, A, Iacopini, F, Feliciangeli, G, Manes, G, Rinaldi, A, Zullo, A, Rogai, F & Repici, A 2012, 'A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy', Clinical Gastroenterology and Hepatology, vol. 10, no. 5, pp. 501-506. https://doi.org/10.1016/j.cgh.2011.12.037
Hassan, Cesare ; Fuccio, Lorenzo ; Bruno, Mario ; Pagano, Nico ; Spada, Cristiano ; Carrara, Silvia ; Giordanino, Chiara ; Rondonotti, Emanuele ; Curcio, Gabriele ; Dulbecco, Pietro ; Fabbri, Carlo ; Della Casa, Domenico ; Maiero, Stefania ; Simone, Adriana ; Iacopini, Federico ; Feliciangeli, Giuseppe ; Manes, Gianpiero ; Rinaldi, Antonio ; Zullo, Angelo ; Rogai, Francesca ; Repici, Alessandro. / A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy. In: Clinical Gastroenterology and Hepatology. 2012 ; Vol. 10, No. 5. pp. 501-506.
@article{42b628f481654d98bd2f20d8cb851911,
title = "A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy",
abstract = "Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33{\%}) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60{\%} sensitivity, 59{\%} specificity, 41{\%} positive predictive value, and 76{\%} negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100{\%} efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33{\%} to 13{\%}. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.",
keywords = "Colon Cancer Screening, Laxative, Polyethylene Glycol, Polyp Detection",
author = "Cesare Hassan and Lorenzo Fuccio and Mario Bruno and Nico Pagano and Cristiano Spada and Silvia Carrara and Chiara Giordanino and Emanuele Rondonotti and Gabriele Curcio and Pietro Dulbecco and Carlo Fabbri and {Della Casa}, Domenico and Stefania Maiero and Adriana Simone and Federico Iacopini and Giuseppe Feliciangeli and Gianpiero Manes and Antonio Rinaldi and Angelo Zullo and Francesca Rogai and Alessandro Repici",
year = "2012",
month = "5",
doi = "10.1016/j.cgh.2011.12.037",
language = "English",
volume = "10",
pages = "501--506",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",
number = "5",

}

TY - JOUR

T1 - A Predictive Model Identifies Patients Most Likely to Have Inadequate Bowel Preparation for Colonoscopy

AU - Hassan, Cesare

AU - Fuccio, Lorenzo

AU - Bruno, Mario

AU - Pagano, Nico

AU - Spada, Cristiano

AU - Carrara, Silvia

AU - Giordanino, Chiara

AU - Rondonotti, Emanuele

AU - Curcio, Gabriele

AU - Dulbecco, Pietro

AU - Fabbri, Carlo

AU - Della Casa, Domenico

AU - Maiero, Stefania

AU - Simone, Adriana

AU - Iacopini, Federico

AU - Feliciangeli, Giuseppe

AU - Manes, Gianpiero

AU - Rinaldi, Antonio

AU - Zullo, Angelo

AU - Rogai, Francesca

AU - Repici, Alessandro

PY - 2012/5

Y1 - 2012/5

N2 - Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.

AB - Background & Aims: An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. Methods: We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. Results: Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. Conclusions: We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.

KW - Colon Cancer Screening

KW - Laxative

KW - Polyethylene Glycol

KW - Polyp Detection

UR - http://www.scopus.com/inward/record.url?scp=84859870168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859870168&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2011.12.037

DO - 10.1016/j.cgh.2011.12.037

M3 - Article

C2 - 22239959

AN - SCOPUS:84859870168

VL - 10

SP - 501

EP - 506

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

IS - 5

ER -