A Randomized Trial of Standard vs. Split-dose Polyethylene Glycol Electrolyte (PEG-E) Bowel Preparation for Inpatient Colonoscopy
Bibliographic record
Abstract
Purpose: Several studies, conducted in outpatient settings, have shown that split-dose administration of PEG-E solution offers better quality colon cleansing, improved patient adherence, comfort, and satisfaction when compared to the standard dosing regimen. We plan to evaluate the efficacy and tolerability of split-dose PEG-E solution in a prospective, randomized, single-blind study of inpatients undergoing colonoscopy at a tertiary care center. Methods: Inpatients requiring colonoscopy were randomly assigned to receive either split-dose (Group A) or standard (Group B) regimen PEG-E. Group A patients ingested PEG-E solution in split doses: 2 liters beginning at 5 PM the evening before the procedure, and the remaining 2 liters beginning at 5 AM the morning of the procedure. They were permitted to have a regular breakfast and lunch, and clear liquids for dinner the day before procedure. Group B patients ingested all 4 liters of PEG-E solution beginning at 5 PM on the evening before the procedure. They were permitted only clear liquids the day before colonoscopy. Demographic data and indication for colonoscopy were recorded for each patient. Before sedation, each patient completed a questionnaire to evaluate symptoms experienced during the prep, and to rate (on a 5-point scale) tolerance of the prep. The quality of bowel cleansing was graded by the endoscopist, who was blinded to the patient's prep regimen, using the Ottawa Preparation Quality Scale. Results: Of 43 patients enrolled thus far, 21 patients were randomized to split-dose regimen (Group A), and 22 patients to standard regimen (Group B). Mean age, gender, and BMI were not significantly different between the groups. Indications for colonoscopy included GI bleeding, abdominal pain, anemia, diarrhea, and abnormal imaging study. Adherence to prep was not significantly different between the groups. Abdominal pain occurred less often in Group A (4.8% vs. 45%, p=0.002). Group A patients tolerated the prep volume better (score: 2.7 vs. 1.8, p=0.002) and were more willing to repeat colonoscopy (score: 3.4 vs. 2.3, p=0.002). There was a trend toward greater overall satisfaction in Group A (3.3 vs. 2.8, p=0.089). Group A had better quality cleansing in the right colon (0.63 vs. 1.70, p=0.004) and mid-colon (0.60 vs. 1.45, p=0.016). Rectosigmoid cleansing was also better, with a trend toward significance (0.67 vs. 1.36, p=0.055). The overall Ottawa score was lower (superior) in Group A (2.35 vs. 4.54, p=0.039). Conclusion: Split-dose administration of PEG-E solution for inpatient colonoscopy led to better overall quality of bowel preparation. Furthermore, patients experienced less abdominal pain, tolerated prep volume better, and were more willing to repeat the procedure in the future.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".