A randomized controlled trial comparing right lateral decubitus and left lateral decubitus starting position on outcomes in colonoscopy
Bibliographic record
Abstract
Patient positioning in colonoscopy has been proposed as a simple and inexpensive technique to increase luminal distention and improve navigation through the large bowel. We sought to determine if right lateral (RL) starting position compared to the standard left lateral (LL) starting position could improve outcomes in colonoscopy. Patients presenting for their scheduled colonoscopy were consented for the trial and randomized to RL or LL starting position. Variables including age, sex, BMI, time to cecal intubation, adenoma detection rate (ADR), NAPCOMs pain score, amount of sedation administered, and quality of bowel preparation were collected during their colonoscopy. The primary outcome was time to cecal intubation. All colonoscopists who had successfully completed upskilling courses were included in the trial. A total of 185 patients were included in the analysis - 94 patients were randomized to RL and 91 patients were randomized to LL. No difference was found in time to cecal intubation comparing the starting position of RL (542.6s) to LL (497.85s) (p=0.354). There was also no difference in cecal intubation rate (RL - 94.9%, LL – 94.8%, p=0.960), ADR (RL – 56.3%, LL – 64.8%, p=0.240), or patient comfort (p=0.078) comparing the starting position. In conclusion, no difference was found for outcomes in colonoscopy comparing the RL and LL starting position.
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 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".