CC-CLEAR (Colon Capsule Cleansing Assessment and Report): the novel scale to evaluate the clinical impact of bowel preparation in capsule colonoscopy – a multicentric validation study
Rui S. Magalhães, Carolina Chálim Rebelo, Bernardo Sousa‐Pinto, José Pereira, Pedro Boal Carvalho, Bruno Rosa, Maria João Moreira, Maria Antónia Duarte, José Cotter
Abstract
Background Colon Capsule Cleansing Assessment and Report (CC-CLEAR) is a novel quantitative bowel preparation scale for colon capsule.Aim The aim of this study is to validate the association between CC-CLEAR’s classification and major CC outcomes: lesion detection rate, surveillance recommendations and post-CC endoscopic treatment.Methods Multicentric cohort of consecutive CCs. An expert’s panel decided post-CC recommendations. Data included CC-CLEAR and Leighton-REX scales. Major CC outcomes were associated with the different cleansing grades.Results From 168 CC’s included, findings were reported in 123 (73.2%), 67 (54.4%) of those being colorectal polyps. CC-CLEAR influenced CC’s lesion detection (OR 1.25 95% IC [1.07–1.46], p-value .004) and polyp detection rate (OR 1.22 95% IC [1.04–1.43], p-value.014). Thirty-two (19%) post-CC colonoscopies were recommended, including 22 (68.75%) with at least one polypectomy. CC-CLEAR was associated with post-CC colonoscopy treatment (OR 1.40 95% IC [1.07–1.84], p-value .015). Regarding surveillance, CC-CLEAR influenced the decision for immediate CC repetition (OR 0.21 95% IC [0.12–0.36], p-value < .001) and the recommendation for CC in 3–5 years’ time (OR 1.47 95% IC [1.50–1.86], p-value < .002). The Leighton–Rex scale was not correlated with major CC outcomes.Conclusion CC-CLEAR impacts major CC outcomes: lesion detection, surveillance recommendations and post-CC endoscopic treatment.