568 Polyp Detection and Histology by Colon Cleansing Quality With a Ready-to-Drink Low Volume Bowel Preparation: Subgroup Analysis From a Randomized, Assessor-Blinded, Multicenter Study
Bibliographic record
Abstract
INTRODUCTION: High-quality bowel preparations are essential for polyp detection. In a recent meta-analysis, patients with adequate bowel preparation by the Aronchick Scale (AS) (defined as those with “excellent,” “good,” or “fair” ratings) had sufficient adenoma detection rate (ADR) for follow-up at guideline-recommended intervals. Here, we examine polyp and adenoma detection, grouped by AS rating, from a study of a ready-to-drink preparation of sodium picosulfate, magnesium oxide, and citric acid (SPMC oral solution). METHODS: A phase 3, randomized, assessor-blinded, multicenter study compared the efficacy and safety of low volume, split-dose SPMC oral solution to a powder formulation for colon cleansing in adults undergoing elective colonoscopy for screening, surveillance, or diagnosis. The study protocol was approved by Schulman IRB (protocol #000253). The primary efficacy endpoint assessed overall colon cleansing quality using a modified AS. Any polyps found during the colonoscopy were removed, recorded as AEs, and all polyps were sent for histological analysis. A post-hoc analysis examined polyp detection and histology by AS rating group. Polyp detection rate (PDR) and ADR in this study were defined as the percentage of any participants who had ≥1 polyp or adenoma, respectively (NCT03017235). RESULTS: A total of 448 patients received SPMC oral solution. For patients with an “excellent” rating by AS (n = 241), the mean (standard deviation, SD) age was 56.5 (12.2) years. In this group, PDR was 46.1% (111/241), and ADR was 30.3% (73/241), with a total of 122 adenomas identified across all participants (Figure 1, Table 1). For patients with a “good” rating by AS (n = 152), the mean (SD) age was 57.3 (9.4) years. In this group, PDR was 46.7% (71/152), and ADR was 33.6% (51/152), with a total of 104 adenomas identified in the group. For patients with a “fair” rating by AS (n = 43), the mean (SD) age was 60.8 (9.5) years. In this group, PDR was 41.9% (18/43), and ADR was 34.9% (15/43), with a total of 23 adenomas identified across all participants in this group. There were 4 (0.9%) patients who received an “inadequate” rating by AS, with a mean (SD) age of 51.0 (10.7) years. CONCLUSION: In patients receiving SPMC oral solution who had “excellent”, “good”, or “fair” ratings by AS, PDR and ADR were above guideline-recommended levels. Detection of sessile polyps was higher for those with “excellent” or “good” ratings by AS, compared to those with “fair” ratings.
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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 | 0.011 | 0.014 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.016 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
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".