External Validation Of A Model For Predicting Inadequate Bowel Preparation

Objective:The adequacy of bowel preparation before colonoscopy has a significant impact on the quality of colonoscopy.We externally validated the established predictive model of inadequate bowel preparation to clarify whether the predictive model is used in clinical practice.Methods::A total of 1221 patients hospitalized in the gastroenterology department of the People’s Hospital of Xinjiang Uygur Autonomous Region from January to June 2022 were collected.According to the Boston bowel preparation scale(BBPS)≥6was classified as adequately prepared,and BBPS ≤5 or any segment of the bowel rating<2 was classified as inadequately prepared,of which 990 cases had adequate bowel preparation and 231 cases had inadequate bowel preparation,and the established prediction model was used to determine whether the prediction model was used in clinical practice by patient gender,age,Ethnicity,history of inadequate bowel preparation,constipation,and alcohol consumption were used to predict the risk of inadequate bowel preparation in patients,and the different degrees of predicted and actual observed results were compared.The discrimination and calibration of the prediction models were validated by the subject’s working characteristic(ROC)curve and Gi Vi TI calibration curve,respectively.Results::The ROC curve under external validation of the prediction model(AUC)= 0.900(95% CI: 0.875～0.926)allows better differentiation of patients with inadequate bowel preparation.The 95% CI region of the Gi Vi TI calibration curve band did not cross the 45% diagonal bisector(P=0.461),and the prediction probability of the prediction model was close to the actual observed probability,with good calibration,and the prediction model is presented as a column line plot.Conclusion : The model predicts the probability of risk of inadequate bowel preparation with high accuracy and is useful for improving early identification and screening of such high-risk patients.