The Feasibility Study Of Polish Young Endoscopists Group For Upper Gastrointestinal Preparation Scale Validation – The Polprep Scale

Aims Mucosal cleanliness is crucial for detection of abnormalities of mucosa during endoscopic examinations. Although numerous preparation scales for colonoscopy have been worked-out, no validated scale for upper gastrointestinal tract has been developed so far. The aim of our study was to develop and validate easy to use upper gastrointestinal scale estimating quality of mucosal visibility.

Methods We have developed four-point scale (0-3) assessing mucosal visibility in the esophagus, stomach and duodenum.This scale was used twice by 12 endoscopists (7 trainees and 5 consultants) to assess 18 photographs of esophagus, stomach and duodenum (second time after two weeks). Inter- and intra-observer reproducibility was calculated. Photo documentation obtained according to ESGE guidelines and endoscopy report of 443 patients who underwent complete diagnostic esophagogastroduodenoscopy (EGD) in 6 endoscopic centers were retrospectively analyzed. Photographs were assessed according to POLPREP scale by two independent clinicians. Endoscopic data: reflux esophagitis, endoscopic suspicion of esophageal metaplasia, esophageal tumors, cervical inlet patch, gastric tumors, gastric polyps and ulcers, duodenal ulcers, duodenal polyps, post-ulcer duodenal bulb deformation and duodenal tumor was recorded.

Results The inter-observer reproducibility in use of POLPREP was 0.8 (0.85 for trainees and 0.79 for consultants). The Fleiss Kappa value estimating intra-observer reproducibility was 0.64 (the value was equal in whole assessed group, trainees and consultants). The inter-observer reproducibility values for esophagus, stomach and duodenum were: 0.74, 0.83 and 0.82, respectively. The difference in detection rate of endoscopic findings for inadequate preparation (points 1) and adequate preparation (points 2 and 3) among assessed segments was statistically significant (7.7 % and 19.7 % respectively; p= 0.049). The odds ratio for the detection of abnormalities was 3.2 for point 3 in comparison to point 1 (95 %CI 1.1-9; p=0.03).

Conclusions The POLPREP scale might be a potential tool to inform about mucosal visibility in EGD.

Citation: Romańczyk M, Ostrowski B, Kozłowska-Petriczko K et al. OP202 THE FEASIBILITY STUDY OF POLISH YOUNG ENDOSCOPISTS GROUP FOR UPPER GASTROINTESTINAL PREPARATION SCALE VALIDATION – THE POLPREP SCALE. Endoscopy 2021; 53: S83.

Publication History

Article published online:
19 March 2021