{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:55:53Z","timestamp":1792032953353,"version":"4.4.0"},"reference-count":38,"publisher":"Georg Thieme Verlag KG","issue":"09","funder":[{"DOI":"10.13039\/100008794","name":"Research Manitoba","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008794","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:p>\n            Background\u2002We compared the effectiveness of optional split-dose bowel preparation (SDBP) with mandatory SDBP for morning colonoscopies in usual clinical practice.<\/jats:p><jats:p>\n            Methods\u2002Adult patients undergoing outpatient early morning (8:00\u200aAM\u201310:30\u200aPM) and late morning (10:30\u200aAM\u201312:00\u200aPM) colonoscopies were included. Written bowel preparation instructions were provided based on randomization: one group were instructed to take their bowel preparation (4\u200aL polyethylene glycol solution) as a split dose (mandatory), while the comparator group was allowed the choice of SDBP or single-dose bowel preparation administered entirely on the day before (optional). The primary end point, using noninferiority hypothesis testing with a 5\u200a% margin, was adequate bowel cleanliness measured by the Boston Bowel Preparation Scale (BBPS) and defined by a BBPS score \u2265\u200a6.<\/jats:p><jats:p>\n            Results\u2002Among 770 randomized patients with complete data, there were 267 mandatory SDBP and 265 optional SDBP patients for early morning colonoscopies, and 120 mandatory SDBP and 118 optional SDBP patients for late morning colonoscopies. Optional SDBP was inferior to mandatory SDBP, with a lower proportion of adequate BBPS cleanliness for early morning colonoscopies (78.9\u200a% vs. 89.9\u200a%; absolute risk difference [aRD] 11.0\u200a%, 95\u200a%CI 5.9\u200a% to 16.1\u200a%), but was not statistically different for late morning colonoscopies (76.3\u200a% vs. 83.3\u200a%; aRD 7.1\u200a%, 95\u200a%CI \u22121.5\u200a% to 15.5\u200a%).<\/jats:p><jats:p>\n            Conclusions\u2002Optional SDBP is inferior to mandatory SDBP in providing adequate bowel preparation quality for early morning colonoscopies (8:00\u200aAM\u201310:30\u200aAM), and probably inferior for late morning colonoscopies (10:30\u200aAM\u201312:00\u200aPM).<\/jats:p>","DOI":"10.1055\/a-2070-5561","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T22:55:46Z","timestamp":1680821746000},"page":"822-835","source":"Crossref","is-referenced-by-count":4,"title":["Mandatory vs. optional split-dose bowel preparation for morning colonoscopies: a pragmatic noninferiority randomized controlled trial"],"prefix":"10.1055","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct03650725","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Casandra","family":"Dolovich","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Unruh","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana C.","family":"Moffatt","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Loewen","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brennan","family":"Kaita","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan N.","family":"Barkun","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada"},{"name":"Department of Clinical Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Martel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, McGill University Health Center, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9354-2356","authenticated-orcid":false,"given":"Harminder","family":"Singh","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1158\/1940-6207.CAPR-19-0202","article-title":"Colonoscopy and sigmoidoscopy use among the average-risk population for colorectal cancer: a systematic review and trend analysis","volume":"12","author":"R Cardoso","year":"2019","journal-title":"Cancer Prev Res (Phila)"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.gie.2013.01.002","article-title":"Screening and surveillance 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A comparison of colonoscopy cleansing effectiveness in clinical practice versus efficacy from selected prospective trials","volume":"3","author":"C Wang","year":"2020","journal-title":"J Can Assoc Gastroenterol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1007\/s10620-014-3262-8","article-title":"Nationwide variability of colonoscopy preparation instructions","volume":"59","author":"L Ton","year":"2014","journal-title":"Dig Dis Sci"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.gie.2014.01.024","article-title":"Patient compliance and suboptimal bowel preparation with split-dose bowel regimen in average-risk screening colonoscopy","volume":"79","author":"S B Menees","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"ref16","first-page":"274","article-title":"Internet-based patient education prior to colonoscopy: prospective, observational study of a single center\u2019s implementation, with objective assessment 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Radaelli","year":"2017","journal-title":"Gut"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"e000736","DOI":"10.1136\/bmjgast-2021-000736","article-title":"Is it time we split bowel preparation for all colonoscopies? Outcomes from a national survey of bowel preparation practice in the UK","volume":"8","author":"T Archer","year":"2021","journal-title":"BMJ Open Gastroenterol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"E706","DOI":"10.1055\/s-0044-102298","article-title":"Predictors of patient reluctance to wake early in the morning for bowel preparation for colonoscopy: a precolonoscopy survey in city-wide practice","volume":"6","author":"L Shafer","year":"2018","journal-title":"Endosc Int Open"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1093\/jcag\/gwab047","article-title":"Improving colonoscopy bowel preparation and reducing patient anxiety through recently developed online information resource: a cross-sectional study","volume":"5","author":"A Jain","year":"2022","journal-title":"J Can Assoc Gastroenterol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1007\/s10620-009-1092-x","article-title":"Willingness to undergo split-dose bowel preparation for colonoscopy and compliance with split-dose instructions","volume":"55","author":"R Z Unger","year":"2010","journal-title":"Dig Dis Sci"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1177\/2050640617717157","article-title":"Educational strategies for colonoscopy bowel prep overcome barriers against split-dosing: A randomized controlled trial","volume":"6","author":"A Andrealli","year":"2018","journal-title":"United European Gastroenterol J"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s10742-018-0192-5","article-title":"Pragmatic randomized clinical trials: best practices and statistical guidance","volume":"19","author":"V Gamerman","year":"2019","journal-title":"Health Serv Outcomes Res Methodol"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"e2034553","DOI":"10.1001\/jamanetworkopen.2020.34553","article-title":"Effect of text messaging on bowel preparation and appointment attendance for outpatient colonoscopy: a randomized clinical trial","volume":"4","author":"N Mahmud","year":"2021","journal-title":"JAMA Netw Open"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1159\/000511767","article-title":"Patient engagement with interactive text message system improves successful colonoscopy rates in an outpatient endoscopy center","volume":"39","author":"B D Rogers","year":"2021","journal-title":"Dig Dis"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"E401","DOI":"10.1055\/a-1072-4556","article-title":"Colonoscopy education delivered via the patient portal does not improve adherence to scheduled first-time screening colonoscopy","volume":"8","author":"R N Keswani","year":"2020","journal-title":"Endosc Int Open"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2070-5561.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T01:10:38Z","timestamp":1693357838000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2070-5561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,6]]},"references-count":38,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2023,8,29]]},"published-print":{"date-parts":[[2023,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2070-5561","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4,6]]},"published":{"date-parts":[[2023,4,6]]}}}