High-quality Bowel Preparation Is Required for Detection of Sessile Serrated Polyps.

Background & Aims: The effect of bowel preparation quality has been well-characterized for detection of adenomas but not for detection of sessile serrated adenomas/polyps (SSPs). We performed a prospective study to determine proportions of patients in whom SSPs were detected at different levels of bowel preparation quality, using common validated scoring systems.

Methods: Our study enrolled 749 male veterans 50-75 years old undergoing screening or surveillance colonoscopy.

Yield of repeat forward-view examination of the right side of the colon in screening and surveillance colonoscopy.

Background And Aims: Colonoscopy is less protective for cancers of the right side of the colon than for distal colon cancers. Repeat examination of the right side of the colon has been suggested to increase adenoma detection and potentially provide greater protection against the development of cancers of the right side of the colon. Our prospective study assessed the yield of a second forward-view examination of the right side of the colon done immediately after the initial examination.

Quantification of Adequate Bowel Preparation for Screening or Surveillance Colonoscopy in Men.

Background & Aims: Bowel preparation is defined as adequate if it is sufficient for identification of polyps greater than 5 mm. However, adequate preparation has not been quantified. We performed a prospective observational study to provide an objective definition of adequate preparation, based on the Boston Bowel Prep Scale (BBPS, which consists of 0-3 points for each of 3 colon segments).

What level of bowel prep quality requires early repeat colonoscopy: systematic review and meta-analysis of the impact of preparation quality on adenoma detection rate.

Objectives: Current guidelines recommend early repeat colonoscopy when bowel preparation quality is inadequate, defined as inability to detect polyps >5 mm, but no data link specific bowel preparation categories or scores to this definition. Nevertheless, most physicians use a shortened screening/surveillance interval in patients with intermediate-quality preparation. We determined whether different levels of bowel preparation quality are associated with differences in adenoma detection rates (ADRs: proportion of colonoscopies with ≥1 adenoma) to help guide decisions regarding early repeat colonoscopy-with primary focus on intermediate-quality preparation.

Patterns and predictors of treatment initiation and completion in patients with chronic hepatitis C virus infection.

Objectives: Guidelines for hepatitis C (HCV) strongly recommend antiviral treatment for patients with more severe liver disease given their increased risk of developing cirrhosis and other liver-related complications. Despite the proven benefits of therapy, 70%-88% of patients chronically infected with HCV do not undergo treatment. The goal of this paper is to describe patterns of treatment initiation among patients with both mild and severe disease and to assess the factors that are associated with treatment initiation and completion.