{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T08:19:15Z","timestamp":1765354755321,"version":"3.37.3"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background To date, no scale has been validated to assess bubbles associated with bowel preparation. This study aimed to develop and assess the reliability of a novel scale\u00a0\u2013 the Colon Endoscopic Bubble Scale (CEBuS). <\/jats:p><jats:p>\n          Methods This was a multicenter, prospective, observational study with two online evaluation phases of 45 randomly distributed still colonoscopy images (15 per scale grade). Observers assessed images twice, 2 weeks apart, using CEBuS (CEBuS-0 \u2013 no or minimal bubbles, covering\u200a&lt;\u200a5\u200a% of the surface; CEBuS-1 \u2013 bubbles covering 5\u200a%\u201350\u200a%; CEBuS-2 \u2013 bubbles covering &gt;\u200a50\u200a%) and reporting the clinical action (do nothing; wash with water; wash with simethicone). <\/jats:p><jats:p>\n          Results CEBuS provided high levels of agreement both in evaluation Phase 1 (4 experts) and Phase 2 (6 experts and 13 non-experts), with almost perfect intraobserver reliability: kappa 0.82 (95\u200a% confidence interval 0.75\u20130.88) and 0.86 (0.85\u20130.88); interobserver agreement \u2013 intraclass correlation coefficient (ICC) 0.83 (0.73\u20130.89) and 0.90 (0.86\u20130.94). Previous endoscopic experience had no influence on agreement among experts vs. non-experts: kappa 0.86 (0.80\u20130.91) vs. 0.87 (0.84\u20130.89) and ICC 0.91 (0.87\u20130.94) vs. 0.90 (0.86\u20130.94), respectively. Interobserver agreement on clinical action was ICC 0.63 (0.43\u20130.78) in Phase 1 and 0.77 (0.68\u20130.84) in Phase 2.\u200aAbsolute agreement on clinical action per scale grade was 85\u200a% (82\u201388) for CEBuS-0, 21\u200a% (16\u201326) for CEBuS-1, and 74\u200a% (70\u201378) for CEBuS-2.<\/jats:p><jats:p>\n          Conclusion CEBuS proved to be a reliable instrument to standardize the evaluation of colonic bubbles during colonoscopy. Assessment in daily practice is warranted.<\/jats:p>","DOI":"10.1055\/a-1331-4325","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:56:00Z","timestamp":1607388960000},"page":"45-51","source":"Crossref","is-referenced-by-count":11,"title":["The Colon Endoscopic Bubble Scale (CEBuS): a two-phase evaluation study"],"prefix":"10.1055","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6528-5623","authenticated-orcid":false,"given":"Filipe","family":"Taveira","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Portuguese Oncology Institute of Coimbra, Coimbra, Portugal"}]},{"given":"Cesare","family":"Hassan","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy"}]},{"given":"Michal F.","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland"},{"name":"Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland"},{"name":"Department of Cancer Prevention, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland"},{"name":"Department of Health Management and Health Economics, University of Oslo, Oslo, Norway"}]},{"given":"Thierry","family":"Ponchon","sequence":"additional","affiliation":[{"name":"Department of Hepatogastroenterology, H\u00f4pital Edouard Herriot, Lyon, France"}]},{"given":"Robert","family":"Benamouzig","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie, H\u00f4pital Avicenne (APHP), Bobigny, France"}]},{"given":"Marek","family":"Bugajski","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland"},{"name":"Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland"}]},{"given":"Flore","family":"de Castelbajac","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie, H\u00f4pital Avicenne (APHP), Bobigny, France"}]},{"given":"Paola","family":"Cesaro","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy"}]},{"given":"Hasnae","family":"Chergui","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie, H\u00f4pital Avicenne (APHP), Bobigny, France"}]},{"given":"Loredana","family":"Goran","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital, \u2018Carol Davila\u2019 University Bucharest, Romania"}]},{"given":"Leonardo","family":"Minelli Grazioli","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy"}]},{"given":"Martin","family":"Jani\u010dko","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Pavol Jozef \u0160af\u00e1rik University, Ko\u0161ice, Slovakia"}]},{"given":"Wladyslaw","family":"Januszewicz","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland"},{"name":"Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center for Postgraduate Education, Warsaw, Poland"}]},{"given":"Laura","family":"Lamonaca","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Humanitas Clinical and Research Center \u2013 IRCCS \u2013, Rozzano, Lombardia, Italy"}]},{"given":"Jamila","family":"Lenz","sequence":"additional","affiliation":[{"name":"Department of Hepatogastroenterology, H\u00f4pital Edouard Herriot, Lyon, France"}]},{"given":"Lucian","family":"Negreanu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital, \u2018Carol Davila\u2019 University Bucharest, Romania"}]},{"given":"Alessandro","family":"Repici","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Humanitas Clinical and Research Center \u2013 IRCCS \u2013, Rozzano, Lombardia, Italy"}]},{"given":"Cristiano","family":"Spada","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy"},{"name":"Digestive Endoscopy Unit, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}]},{"given":"Marco","family":"Spadaccini","sequence":"additional","affiliation":[{"name":"Endoscopy Unit, Humanitas Clinical and Research Center \u2013 IRCCS \u2013, Rozzano, Lombardia, Italy"}]},{"given":"Monica","family":"State","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospital, \u2018Carol Davila\u2019 University Bucharest, Romania"}]},{"given":"Jakub","family":"Szlak","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Oncology, The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland"}]},{"given":"Eduard","family":"Veseliny","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, Pavol Jozef \u0160af\u00e1rik University, Ko\u0161ice, Slovakia"}]},{"given":"M\u00e1rio","family":"Dinis-Ribeiro","sequence":"additional","affiliation":[{"name":"Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, Porto, Portugal"},{"name":"Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9787-8175","authenticated-orcid":false,"given":"Miguel","family":"Areia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Portuguese Oncology Institute 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