S0531 What Is the Ideal Dietary Regimen for Patients Scheduled for Colonoscopy: Low Residue Diet or Clear Liquid Diet? A Meta-Analysis and Systematic Review of Randomized Controlled Trials
Bibliographic record
Abstract
INTRODUCTION: Colonoscopy screening and early detection of pre-cancerous polyps can significantly reduce both the incidence and mortality of colorectal cancer. The quality of bowel preparation before a colonoscopy is an important predictor of lesion identification. However, patients often cite bowel preparation and associated dietary restrictions as the greatest deterrents to having a colonoscopy. Traditionally, a clear liquid diet (CLD) is required the day before colonoscopy. Recent studies have investigated the use of a low-residue diet (LRD), with varying results. We evaluated various outcomes in patients undergoing colonoscopy who either consumed a CLD versus LRD on the day before colonoscopy. METHODS: A literature search was performed on Scopus, PubMed/MEDLINE, and Cochrane databases (April 2020). Studies included in our meta-analysis involved adult patients undergoing colonoscopy who either consumed a LRD or CLD on the day prior to colonoscopy. Analysis was conducted with the Mantel-Haenszel model using the odds ratio (OR) to assess adequate bowel preparations, tolerability, willingness to repeat diet and preparation, compliance with diet, adenoma and polyp detection rate, and overall adverse effects. RESULTS: 17 studies (4340 patients) were included the analysis. Findings suggest that consuming a LRD demonstrated no differences in terms of adequate bowel preparations (OR 1.31; 95% CI, 0.92–1.86; P = 0.14), compared with a CLD. Subgroup analysis was performed based on the scale used to assess the quality of the bowel preparation (Boston Bowel Preparation Scale, Ottawa Bowel Preparation Scale, and Aronchick Scale) and demonstrated non-inferiority of each. There was higher tolerability (OR 2.21; 95% CI, 1.64–2.98; P < 0.0001) and willingness to repeat preparation (OR 1.90; 95% CI, 1.36–2.67; P = 0.0002) with no differences in compliance with dietary regimen (OR = 1.17; 95% CI, 0.60–2.27; P = 0.64), adenoma detection rate (OR = 1.01; 95% CI, 0.86–1.19; P = 0.92), polyp detection rate (OR = 0.87; 95% CI, 0.87–1.04; P = 0.13), or overall adverse effects (OR 0.90; 95% CI, 0.73–1.13; P = 0 0.37). CONCLUSION: A low residue diet compared to a clear liquid diet prior to colonoscopy resulted in improved patient tolerability and willingness to repeat preparation with no differences in preparation quality. As a less restrictive dietary regimen, the low-residue diet may help improve patient participation in colorectal cancer screening programs.Figure 1.: Forest plot comparing the frequency of adequate bowel preparations while on a low-residue diet compared with a clear liquid diet consumed on the day prior to colonoscopy, performed with a sub-group analysis according to the scale used to determine adequacy of the preparation. BBPS, Boston Bowel Preparation Scale; CI, confidence interval; M-H, Mantel-Haenszel; OBPS, Ottawa Bowel Preparation Scale.
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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 | 0.013 | 0.031 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.033 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 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".