Çocuklarda İki Bağırsak Hazırlık İlacının Etkinlik ve Kullanılabilirliğinin Karşılaştırılması: Polietilen Glikol ve Sodyum Fosfat
Bibliographic record
Abstract
Adequate bowel cleansing with a good patient tolerability is important for high-quality and safe colonoscopy. We aimed to compare the efficacy and tolerability of an osmotic agent, polyethylene glycol (PEG) and a less frequently used stimulant agent, sodium phosphate (NP) for pediatric patients. We analyzed the records of pediatric patients who underwent colonoscopy and used either PEG or NP for bowel cleansing between January 2016 and December 2019. The patient tolerability of bowel preparation was assessed using a patient questionnaire that consisted of acceptance and adverse events, recording abdominal pain, nausea, vomiting, dizziness and severity of these symptoms. The quality of bowel preparation was assessed according to the Ottawa scale, including cleanliness and fluid quantity. The colonoscopic video records were retrospectively and blindly evaluated for Ottawa scale. There were a total of 145 patients (65 boys, 44.8%) with a mean age of 12.3±4.2 years. PEG was used in 93 patients (64.1%), while NP was used in 52 patients (35.9%). The mean age of the patients was significantly lower in PEG group (11.2±4.6 years) when compared to NP group (14.2±2.7 years) (p<0.0001). The patients who used PEG had significantly better tolerance without any complaints when compared to the patients who used NP (49/93 patients (52.7%) vs 14/52 patients (26.9%), respectively, p=0.003). Regarding the severity of symptoms in patients who had adverse events, the NP group had significantly more frequent moderate-severe side effects when compared to PEG group (15/52 patients (28.8%) vs 15/93 patients (16.1%), respectively, p=0.014). One of the children in NP group had severe hyperphosphatemia, which required fluid resuscitation. Regarding the efficacy of the preparations, 39/93 (41.9%) of the patients in PEG group had required wash and suctioning in any segments of the colon, this ratio was significantly lower in NP group (12/52 (23%)), (p=0.029). The Ottawa bowel preparation quality score in right colon and total Ottawa scale rating was significantly better in NP group when compared to PEG group (p=0.009 and 0.034, respectively). The Ottawa scores in mid and rectosigmoid colons were not significantly different between two groups. As conclusion, NP is more efficient in bowel cleansing when compared to PEG. But PEG had less frequent moderate-severe side effects compared to NP. Additionally, NP should be carefully used in selected cases where other bowel cleansing methods cannot be used, because of the severe side effects like hyperphosphatemia in children.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".