Bowel preparations as quality indicators for colonoscopy

Table 1 Quality indicators that can be impacted by bowel preparation in colonoscopy

Indicator	Definition	Acceptable level
Bowel preparation	Proportion of procedures in which colon cleansing is considered excellent or good	> 90%
Adenoma detection rate	Proportion of colonoscopies performed in asymptomatic individuals over 50 in which at least one adenoma has been detected	> 20%
		(men > 25% and women > 15%)
Withdrawal time	Mean time from cecal intubation to colonoscopy extraction through the anus	> 6 min
Cecal intubation rate	Proportion of procedures in which cecal intubation is achieved	> 95%

Table 2 Summary of studies demonstrates an association between bowel preparation and procedural success

Study	Subjects (n)	Perspective	Outcomes	Results
Bowles et al[17]	9223	Prospective	Cecal intubation rate	Poor bowel preparation (19.6%)
Bernstein et al[18]	693	Prospective	Predictor of cecal intubation time (≥ 20 min)	Poor bowel preparation (P = 0.0077)
Kim et al[19]	909	Prospective	Prolonged insertion time (> 10 min)	Inadequate bowel cleaning
				(OR = 2.8, 95%CI: 1.41-5.56, P = 0.003)
Nelson et al[20]	3196	Prospective	Predictor of incomplete colonoscopy	Poor bowel preparation
				(failure rate = 19.3%, P = 0.001)
Aslinia et al[21]	5477	Retrospective	Cecal intubation rate	Inadequate bowel preparation
				(OR = 0.17, 95%CI: 0.14-0.21, P < 0.001)

OR: Odd ratio.