Validation of the Saint Paul’s Endoscopy Comfort Scale (SPECS) for upper gastrointestinal endoscopy
Bibliographic record
Abstract
Introduction: Patient comfort is an important predictor of patient satisfaction and a quality indicator in endoscopy. The St. Paul's Endoscopy Comfort Score (SPECS), previously validated for colonoscopy, was assessed for measuring patient comfort during esophagogastroduodenoscopy (EGD). Methods: In this prospective cohort study, 3 groups of assessors (gastroenterologists, nurses, and observers) used SPECS and the modified Gloucester Comfort Scale (GS) to measure patients' comfort during outpatient EGD. Patient-reported outcomes were measured using a visual analogue scale (VAS) and satisfaction survey. Descriptive statistics and inter-rater reliability were calculated across the 3 groups for both tools. The correlation between SPECS, GS, and VAS was calculated. Results: =267) of subjects received conscious sedation with intravenous midazolam and fentanyl at a mean dose of 3.3 mg (SD 1.6 mg) and 51.4 mcg (SD 29.7 mcg), respectively. The mean total SPECS for physicians, nurses, and observers were 1.3 (SD 1.6), 1.4 (SD 1.7), and 1.7 (SD 1.9), respectively. Amongst the 3 assessors (9 physicians, 5 nurses, and 4 observers), SPECS and GS demonstrated good inter-rater reliability with an intraclass coefficient of 0.71 (95% CI, 0.66-0.76) and 0.64 (95% CI, 0.58-0.69), respectively. SPECS and GS had a mild correlation with VAS. Conclusions: SPECS is a reliable assessment tool to measure patient comfort during EGD. SPECS may be used to audit patient comfort at a facility and physician level.
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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 | 0.007 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".