Review of small-bowel cleansing scales in capsule endoscopy: A panoply of choices

Table 2 Human dependent scales

Ref.	Computer or human dependent	Capsule endoscopy system	Type of preparation	Qualitative/quantitative scale	Correlation coefficient	Parameters evaluated	Entire video, segments of video or consecutive single frames	Time-consuming	Easy to perform1	Global assessment2
Park et al[11]	Human dependent	PillCam	4 L of PEG	Quantitative	ICC = 0.80	Proportion of visualized mucosa and degree of obscuration by bubbles, debris, and bile	Consecutive single frames	Yes	ΔΔ	ΔΔΔ
QI - Brotz et al[5]	Human dependent	PillCam	Clear liquid diet and overnight fast	Quantitative	ICC = 0.47	QI based on percentage of mucosa visualized, fluid and debris, bubbles, bile/chyme staining, and brightness	Entire video	No	ΔΔΔΔ	ΔΔΔΔΔ
Spada et al[13]	Human dependent	PillCam	Clear liquid diet and overnight fast, or 2 L of PEG and simethicone	Quantitative	Kappa = 0.75-0.9	Proportion of mucosa visualized	Entire video	Yes	Δ	ΔΔΔ
Oliva et al[14]	Human dependent	PillCam	Clear liquid diet and overnight fast, or 25 or 50 mL/kg of PEG, and/or 20 mL of simethicone	Quantitative	Kappa = 0.89	Proportion of mucosa visualized	Consecutive single frames	Yes	ΔΔ	ΔΔΔ
van Tuyl et al[15]	Human dependent	PillCam	Clear liquid diet and overnight fast, or 1 L of PEG, or 2 L of PEG	Quantitative	Kappa = 0.78	Proportion of mucosa visualized	Segments of video	No	ΔΔ	ΔΔΔ
Caddy et al[16]	Human dependent	-	250 mL sodium picosulphate plus 500 mL PEG with or without erythromycin	Quantitative	Kappa = 0.3	Proportion of visualized mucosa	Entire video	No	ΔΔΔΔ	ΔΔ
Viazis et al[19]	Human dependent	PillCam	Clear liquid diet and overnight fast or 2 L PEG	Quantitative	-	Proportion of unclean mucosa due to intestinal debris	Entire video	Yes	ΔΔΔ	ΔΔ
Kantianis et al[22]	Human dependent	PillCam	2 and 4 L of PEG	Quantitative	-	Proportion of mucosa visualized	Consecutive single frames	Yes	Δ	Δ
Chen et al[23]	Human dependent	OMOM	Clear liquid diet and overnight fast, or 250 mL mannitol with or without simethicone	Quantitative	-	Proportion of mucosa visualized	Consecutive single frames	Yes	Δ	Δ
Rosa et al[25]	Human dependent	PillCam	Clear liquid diet and overnight fast, or 2 L of PEG with or without simethicone	Quantitative	-	Proportion of visualized mucosa	Entire video	Yes	ΔΔ	ΔΔ
Niv et al[26]	Human dependent	PillCam	Clear liquid diet and overnight fast, or NaP	Quantitative	-	Proportion of SBTT with invisible mucosa	Entire video	No	ΔΔΔ	ΔΔΔ
OAA - Brotz et al[5]	Human dependent	PillCam	Clear liquid diet and overnight fast	Qualitative	Kappa = 0.41	Overall assessment of small-bowel cleansing	Entire video	No	ΔΔΔΔΔ	ΔΔΔ
QE - Brotz et al[5]	Human dependent	PillCam	Clear liquid diet and overnight fast	Qualitative	Kappa = 0.20	QE based on percentage of mucosa visualized, fluid and debris, bubbles, bile/chyme staining, and brightness	Entire video	No	ΔΔΔΔ	ΔΔΔ
Albert et al[28]	Human dependent	PillCam	Overnight fast or simethicone	Qualitative	r = 0.89 (segment A)	Mucosal invisibility due to intraluminal bubbles	Segments of video	No	ΔΔΔ	ΔΔΔ
					and r = 0.79 (segment B)
Pons Beltrán et al[29]	Human dependent	PillCam	Clear liquid diet, or 90 mL NaP, or 4 L of PEG	Qualitative	Kappa = 0.38	Amounts of enteric residues	Entire video	No	ΔΔΔΔ	ΔΔΔ
Ninomiya et al[30]	Human dependent	PillCam	Clear liquid diet and overnight fast, or citrate magnesium	Qualitative	-	Bubbles, food residues and intestinal juice color	Consecutive single frames	Yes	ΔΔ	ΔΔ
Esaki et al[31]	Human dependent	PillCam	Simethicone or magnesium citrate	Quantitative and Qualitative	r = 0.77-0.88	Fluid transparency and proportion of non-visualized mucosa	Entire video	Yes	ΔΔΔ	ΔΔΔΔ
Dai et al[32]	Human dependent	PillCam	4 L of PEG or overnight fast	Quantitative and qualitative	Kappa = 0.56	Proportion of visualized mucosa and overall visibility	Segments of video	Yes	ΔΔ	ΔΔΔ
Lapalus et al[33]	Human dependent	PillCam	Clear liquid diet and overnight fast, or NaP	Quantitative and qualitative	r = 0.55-0.8	Proportion of visualized mucosa and amounts of enteric liquid and bubbles	Segments of video	No	ΔΔΔ	ΔΔΔ
Hooks et al[34]	Human dependent	PillCam	Clear liquid diet and overnight fast, with or without lubiprostone	Quantitative and qualitative	-	Proportion of mucosa visualized and amounts of enteric debris	Entire video and segments of video	No	ΔΔΔ	ΔΔΔΔ

¹Graduation from Δ to ΔΔΔΔΔ, with higher classifications corresponding to easier scales;

²Graduation from Δ to ΔΔΔΔΔ, with higher classifications corresponding to better scales. PEG: Polyethylene glycol; QI: Quantitative index; QE: Qualitative evaluation; OAA: Overall adequacy assessment; ICC: Intraclass correlation coefficient.