{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:58:39Z","timestamp":1776286719897,"version":"3.50.1"},"reference-count":6,"publisher":"Pensoft Publishers","issue":"5","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>\n                    <jats:bold>Aim<\/jats:bold>\n                    : Colonoscopy is the gold standard for colorectal cancer screening and prevention. This multicenter study aims to evaluate and compare the effectiveness, cost-efficiency, and patient tolerability of different bowel preparation regimens for colonoscopy using a high-volume polyethylene glycol-based solution.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Materials and methods<\/jats:bold>\n                    : A total number of 746 patients were enrolled from three Bulgarian centers and were randomly assigned to various bowel preparation protocols categorized as previous-day, split-day, and same-day regimens. Effectiveness was assessed using the Boston Bowel Preparation Scale, cost-efficiency was determined by healthcare facility expenses, and patient tolerability was evaluated through patient-reported questionnaires.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : The split-dose regimens achieved the highest bowel cleansing quality, significantly outperforming the other two groups. Furthermore, SPLIT4, one of the split-dose regimens, achieved the highest median Boston Bowel Preparation Scale (BBPS) score of 8, significantly outperforming previous-day and other split-dose protocols (\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt;0.001), while maintaining excellent patient tolerability (mean score 1.25).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion<\/jats:bold>\n                    : Split-dose preparation using a high-volume polyethylene glycol solution demonstrated superior bowel cleansing and favorable patient tolerability, supporting current clinical guidelines. Future research should further investigate comparisons between high-volume and low-volume polyethylene glycol solutions to optimize patient adherence and outcomes.\n                  <\/jats:p>","DOI":"10.3897\/folmed.67.e159151","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T11:57:11Z","timestamp":1761652631000},"source":"Crossref","is-referenced-by-count":1,"title":["The path to successful colonoscopy: a multi-center study on effective preparation regimens"],"prefix":"10.3897","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-362X","authenticated-orcid":true,"given":"Nikola","family":"Boyanov","sequence":"first","affiliation":[{"name":"Pulmed University Hospital, Plovdiv, Bulgaria"},{"name":"Medical University of Plovdiv, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1058-5098","authenticated-orcid":true,"given":"Nikol","family":"Milinich","sequence":"additional","affiliation":[{"name":"Pulmed University Hospital, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandar","family":"Balabanski","sequence":"additional","affiliation":[{"name":"Pulmed University Hospital, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1520-5813","authenticated-orcid":true,"given":"Katina","family":"Shtereva","sequence":"additional","affiliation":[{"name":"Pulmed University Hospital, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katerina","family":"Madzharova","sequence":"additional","affiliation":[{"name":"Pulmed University Hospital, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Tishkov","sequence":"additional","affiliation":[{"name":"Sofiamed University Hospital, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Katzarov","sequence":"additional","affiliation":[{"name":"Military Medical Academy, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Popadiyn","sequence":"additional","affiliation":[{"name":"Military Medical Academy, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galabina","family":"Hinkova","sequence":"additional","affiliation":[{"name":"Military Medical Academy, Sofia, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stoilka","family":"Tufkova","sequence":"additional","affiliation":[{"name":"Medical University of Plovdiv, Plovdiv, Bulgaria"},{"name":"St George University Hospital, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"159151_B1","unstructured":"1. American Cancer Society. Cancer facts and figures, 2019, Atlanta, 2019. Available from: https:\/\/www.cancer.org\/research\/cancer-facts-statistics\/all-cancer-facts-figures\/cancer-facts-figures-2019.html [Accessed: 2019 July 9]."},{"key":"159151_B2","doi-asserted-by":"publisher","DOI":"10.1055\/a-0959-0505"},{"key":"159151_B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2008.05.057"},{"key":"159151_B4","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.04.004"},{"key":"159151_B5","doi-asserted-by":"publisher","DOI":"10.20524\/aog.2018.0254"},{"key":"159151_B6","doi-asserted-by":"publisher","DOI":"10.2174\/1574887117666220908152754"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/159151\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/159151\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=159151&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T11:57:12Z","timestamp":1761652632000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/159151\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":6,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10,30]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.67.e159151","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"article-number":"e159151"}}