Meta-Analysis
Copyright ©The Author(s) 2018.
World J Gastrointest Endosc. Dec 16, 2018; 10(12): 422-441
Published online Dec 16, 2018. doi: 10.4253/wjge.v10.i12.422
Table 1 Studies characteristics
STUDYSITEPOPULATIONINTERVENTION (ITT/PP)COMPARISON (ITT/PP)OUTCOMES
Regev et al[34]129 to 86 yPico-Salax (1+1+1)/0 sachetsNew-Meroken® 3/0 LBowel cleansing quality
Israel+ (200/h for 16h)/0 mL of waterCecal intubation
ITT: 68+ clear liquid diet+ clear liquid dietGeneral discomfort
PP: 6839/3929/29Medication Intake
Adverse events
Lawrance et al[35]118 to 75 yPico® (1+1)/0 sachets for morning procedure orColonLytely® 4/0 L for morning procedure orBowel cleansing quality
Australia
Pico 1/1 sachets for afternoon procedureColonLytely® 4/0 L for afternoon procedure
+ liquid+ clear liquid 2/0
ITT: 634+ low residue diet284/279Medication Intake
PP: 625171/169
CB fleet® (45+45)/0 mL
+ (750+750)/0 mL of water for morning procedure orMucosal inflammation
CB fleet® 45/45 mL
+ 750/750 mL of water for afternoon procedure
+ low residue diet
179/177
Kao et al[36]118 to 75 ySPMC (1+1+MC)/0 sachets for morning procedure orPEG 4/0 L for morning procedure orBowel cleansing quality
Canada
SPMC (1+1)/MC sachets for afternoon procedurePEG 2/2 L for afternoon procedureBowel cleansing quality according to the procedure time
ITT: 834+ liquid+ liquidTolerability
PP: 790+ clear liquid diet+ clear liquid diet
194/194218/210Adherence
NaP 45/45/0 mL for morning procedure orPEG 2/0 L + bisacodyl 20/0 mg for morning procedure orSleeping hours
NaP 0/45/45 mL for afternoon procedurePEG 0/2 L + bisacodyl 20/0 mg for afternoon procedureWillingness to reuse
+ liquid+ liquidSafety
+ clear liquid diet+ clear liquid diet
164/164214/210Ischemic colitis
Katz et al[15]1218 to 80 yPrepopik® (1+1)/0 sachetsHalf-Lytely e bisacodyl Tablets® 2/0 LBowel cleansing quality
USA
+ (1200+720)/0 mL of liquid+ 10/0 mg bisacodylAcceptability
Tolerability
ITT: 603+ clear liquid diet+ clear liquid dietMedication Intake
PP: 598Ease to use medication
300/296303/302General experience
Taste
Willingness to reuse
Adverse events
Manes et al[37]318 to 85 yCitraFleet® (1+1)/0 sachetsMoviprep® 2/0 LBowel cleansing quality
Italy
+ 3/0 L of liquid for morning procedure or+ 1/0 L of liquid for morning procedure orBowel cleansing quality of right colon
ITT: 293CitraFleet® 1/1 sachetsMoviprep® 1/1 LPolyps detected
PP: 285+ 1.5/1.5 L of liquid for afternoon procedure+ 500/500 mL of liquid for afternoon procedureAcceptance
+ low-fiber diet+ low-fiber dietTolerability
145/140148/145Adherence
Adverse events
Rex et al[15]1018 to 80 yPrepopik® 1/1 sachetsHalf-Lytely e bisacodyl Tablets® 2/0 LBowel cleansing quality
USA
+ 1200/720 mL of liquid+ bisacodyl 10/0 mgAcceptability
+ clear liquid dietTolerability
ITT: 608+ clear liquid dietEase to use medication
PP: 601Medication Intake
Taste
NA/305NA/298Willingness to reuse medication
Adverse events
Colonoscopy before
Jeon et al[38]120 to 80 yPicolight powder® (1+1)/1 sachetCoolprep powder® 1/1 LBowel cleansing quality
South Korea
+ (1+1)/1 L of water+ 500/500 mL of waterCecal intubation
+ low-fiber diet+ low-fiber dietWithdrawal time
ITT: 430ADR
PP: 388PDR
Tolerability
215/195215/193Satisfaction
Adverse events
Kang et al[39]118 to ou maisPicolight® 0/(1+1)Colyte® 2/2 LBowel cleansing quality
South Korea
+ 0/≥ 1 L of water+ low-fiber dietTolerability
ITT: 197+ low-fiber diet99/99Adverse events
PP: 19798/98Sleep time quantity
PDR
ADR
Kim et al[40]118 to 75 ySPMC 1/1 sachetsPEG 0/4 LBowel cleansing quality
South Korea
+ 1/1 L of liquidAdherence
+ low-fiber diet+ low-fiber dietMedication Intake
ITT: 20050/5050/50
PP: 200SPMC (1+1)/1 sachetsPEG 2/2 LTolerability
+ (1+1)/1 L of liquidTaste
+ low-fiber diet+ low-fiber dietBiochemical changes
50/5050/50Adverse events
Kim et al[41]118 to 80 yPicolight (1+1)/0 sachetsStandard PEG 4/0 LAcceptability
South Korea+ 2L of waterAdherence to instructions
ITT: 194+ bisacodyl 10/0 mg+ bisacodyl 10/0 mgBowel cleansing quality
PP: 184+ low-fiber diet (ZeroCol)+ semi-fluid dietAdverse events
97/9497/90Willingness to reuse medication
Leitao et al[28]318 to 80 yCitraFleet® 1/1 sachetsEnddealk® 2/1LBowel cleansing quality
Norway
+ 2/2 L of water+ 0/1 L of liquidTolerability
ITT: 368+ no-grains diet+ diet without cropsAdherence
PP: 368PDR
179/179189/189Cecal intubation time
Cecal intubation
Kim et al[29]1320 to 75 ysachetsStandard PEG 2/2 LBowel cleansing quality
South Korea
+ 2/2 L of waterno bisacodylSatisfaction
+ bisacodyl 10/0 mg+ low-fiber dietTolerability
+ low-fiber dietMedication Intake
ITT: 387193/181194 / 184Ease to use
PP: 365Taste
Willingness to reuse
Adverse events
Munsterman et al[30]118 to 80 yPicoprep® 1/1 sachets for morning procedure orKleanprep® 3/1 L for morning procedure orBowel cleansing quality
Netherlands
ITT: 173Picoprep® 1/1 sachets for afternoon procedureKleanprep® 2/2 L for afternoon procedure
PP: 172+ 2/2 L of water+ additional liquidTolerability
+ low-fiber diet+ low-fiber diet
88/8785/85
Pohl et al[31]1740 to 80 yCitraFleet® (1+1)/0 sachetsMoviprep® 1/1 LPatients with at least one polyp or flat lesion
Germany
ITT: 399+ 250mL/h of water after sachet+ 500/500 mL of liquidPatients with at least one adenoma
PP: 398Cancer detection rate
+ fibers restriction diet+ fibers restriction dietFlat lesion detection rate
NA/197NA/201Advanced lesions detection rate
Yoo et al[32]118 to 80 yPicolight® 1/1 sachetsCoolprep® 1/1 LBowel cleansing quality
South Korea
+ 1/1 L of water+ 500/500 mL of waterBubble score
ITT: 200+ low-fiber diet+ low-fiber dietTolerability
PP: 200
100/100100/100Satisfaction
Kojecky et al[33]318 to 99 yPicoprep® 2/0 sachetsFortrans™ 4/0 LLength of preparation
Czech Republic+ 2L of water94/102
ITT: 61292/102Fortrans™ 3/1 LTime to colonoscopy
87/102
PP: 584ORMoviprep™ 2/0 L
+ 1/0 L of fluids
Picoprep® 1/1 sachets96/102Bowel cleansing quality
+ 1/1 L of water
86/102Moviprep™ 1/1
+ 0.5/0.5 L of fluids
93/102Tolerability score
+ low residue diet+ low residue diet
Table 2 Assessment of risk of bias by JADAD scale
#STUDYRandomized? (1 pt)Randomization methodAdequate randomization? (1 pt)Double blind? (1 pt)Masking methodAdequate masking? (1 pt)Loss description? (1 pt)Jadad (0-5 pts)GENERAL QUALITY
1Regev et al[34]YesRandomization per patients' ID (odd or even numbers)NoNoEndoscopist blind for the preparation regimenNoYes2Intermidiate
2Lawrance et al[35]YesRandomized using Generator Pro 1.69 (Segobit software) in ratio 2:1:1 (PEG:NaP:Pico)YesNoEndoscopist blind for the preparation regimenNoYes3High
3Kao et al[36]YesRandomization in blocks of 8 and stratified per AM/PM using a computer-generated tableYesNoEndoscopist blind for the preparation regimenNoYes3High
4Katz et al[15]YesRandomization numbers allocated sequentially by voice systemYesNoEndoscopist blind for the preparation regimenNoYes3High
5Manes et al[37]YesRandomization by computer-generated sequenceYesNoEndoscopist blind for the preparation regimenNoYes3High
6Rex et al[15]YesRandomization numbers allocated sequentially by voice systemYesNoEndoscopist blind for the preparation regimenNoYes3High
7Jeon et al[38]YesRandomization by computer-generated tableYesNoEndoscopist blind for the preparation regimenNoYes3High
8Kang et al[39]YesRandomization in blocks using website randomization.comYesNoEndoscopist blind for the preparation regimenNoYes3High
9Kim et al[40]YesNot describedNoNoEndoscopist blind for the preparation regimenNoNo1Low
10Kim et al[41]YesRandomization by computer-generated sequenceYesNoEndoscopist blind for the preparation regimenNoYes3High
11Leitao et al[28]YesRandomization 1:1 with blocks of 10 by endoscopy-unit secretaryYesNoEndoscopist blind for the preparation regimenNoNo2Intermidiate
12Kim et al[29]YesRandomization by computer-generated tableYesNoNot describedNoNo2Intermidiate
13Munsterman et al[30]YesRandomization by computer-generated 1:1 stratified by age (18-64) or (65-80)YesNoEndoscopist blind for the preparation regimenNoNo2Intermidiate
14Pohl et al[31]YesRandomization 1:1 in blocks of 4 by statistician list-generatedYesNoEndoscopist blind for the preparation regimenNoYes3High
15Yoo et al[32]YesRandomization 1:1 in blocks of 4 by a a computer-generated listYesNoEndoscopist blind for the preparation regimenNoYes3High
16Kojecky et al[33]YesRandomization 1:1 using a software generated random tableYesNoEndoscopist blind for the preparation regimentNoYes3High