A218 SODIUM PHOSPHATE IS SUPERIOR TO POLYETHYLENE GLYCOL IN CONSTIPATED PATIENTS UNDERGOING COLONOSCOPY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Notice bibliographique
Résumé
We performed a systematic review and meta-analysis to determine the optimal bowel preparation in constipated patients undergoing colonoscopy. Constipation is an important and highly prevalent predictor of inadequate bowel preparation during colonoscopy. In North America, between 2% and 28% of the general population suffer from constipation. Despite the high prevalence of constipation, to our knowledge, no meta-analysis on optimal bowel preparations for constipated patients has been performed. Furthermore, while the literature recognizes constipation as a predictor for poor bowel preparation, specific recommendations regarding the preparation of these patients for colonoscopy remain scarce. 1. Determine the optimal bowel preparation in chronically constipated patients A comprehensive search of electronic databases (MEDLINE, EMBASE, SCOPUS, and Web of Science) was performed. Studies were assessed using the following inclusion criteria: adult patients (age ≥ 18 years), randomized controlled trial study design, studies comparing two or more different bowel preparations, studies that included constipated patients, and studies that assessed the effectiveness of the bowel preparation. The primary outcome of interest was the quality of the bowel preparation measured with either validated or non-validated scales. Studies varied in the criteria used to distinguish patients as constipated, therefore, for this review patients were considered constipated based on the method the study authors used to define constipation. Where possible, meta-analysis was performed to compare the percentage of successful bowel preparations amongst constipated patients receiving Polyethylene Glycol (PEG) versus constipated patients receiving Sodium Phosphate (NaP). Preliminary database search yielded 1581 articles after duplicates were removed. After screening of the titles and abstracts using the exclusion criteria, 358 full-text articles were retained. Full text articles were reviewed and eight studies meeting the inclusion criteria were included for qualitative synthesis. Three randomized controlled trials identified a total of 1636 constipated patients, of whom 225 were eligible for meta-analysis. Of those, 107 (47.6%) received NaP and 118 (52.4%) received PEG. The weighted mean age was 57.6 years and weighted sex was 53.5% female. When compared to the PEG cohort, the NaP cohort had a higher likelihood of having a successful bowel preparation (odds ratio [OR] 1.87, CI 1.06 to 3.32, P= 0.003). In chronically constipated patients undergoing colonoscopy, the use of NaP resulted in superior colonic cleanliness when compared to PEG. Barring contraindications, NaP should be used over PEG in constipated patients to improve the quality of bowel preparation. Figure 1. Successful bowel preparation rates comparing PEG versus NaP None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,018 | 0,043 |
| Bibliométrie | 0,006 | 0,006 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».