Development and validation of a gut motility based model for predicting bowel preparation quality

Abstract Inadequate bowel preparation negatively impacts the quality of colonoscopy, potentially resulting in missed lesions and the need for repeat procedures. Although gut motility plays a key role in bowel cleansing, it is often neglected in risk prediction. This study developed and validated a p...

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Main Authors: Hongjiao Wu, Rui Wu, Yunyun Zhang, Xinyi Lu, Wei Zhao, Biyun Xu, Jun Liu, Nina Zhang
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13739-0
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author Hongjiao Wu
Rui Wu
Yunyun Zhang
Xinyi Lu
Wei Zhao
Biyun Xu
Jun Liu
Nina Zhang
author_facet Hongjiao Wu
Rui Wu
Yunyun Zhang
Xinyi Lu
Wei Zhao
Biyun Xu
Jun Liu
Nina Zhang
author_sort Hongjiao Wu
collection DOAJ
description Abstract Inadequate bowel preparation negatively impacts the quality of colonoscopy, potentially resulting in missed lesions and the need for repeat procedures. Although gut motility plays a key role in bowel cleansing, it is often neglected in risk prediction. This study developed and validated a predictive model and simplified scoring system that integrates gut motility parameters to identify individuals at risk of inadequate bowel preparation. A total of 1,165 patients from two hospitals were enrolled, with 815 forming the training set and 350 forming the external validation cohort. The overall rate of inadequate bowel preparation was 9.8%. Multivariate analysis revealed that altered bowel movement frequency, stool consistency based on the Bristol Stool Scale, low polyethylene glycol (PEG) volume, and delayed last bowel movement were significant predictors of poor preparation. These variables were incorporated into a user-friendly scoring system that demonstrated good discriminative ability, with area under the curve values of 0.778 and 0.774 in the training and validation cohorts, respectively. A cutoff score of 3.0 yielded a sensitivity of 75.0%, specificity of 66.9%, and a negative predictive value of 96.3% in external validation. This model provides a practical, motility-informed approach for risk stratification and personalized preparation regimens, offering potential to enhance the effectiveness and efficiency of colonoscopy in diverse clinical settings.
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spelling doaj-art-1a7cee4984634ebbac221c674c64f6342025-08-20T03:42:41ZengNature PortfolioScientific Reports2045-23222025-08-011511910.1038/s41598-025-13739-0Development and validation of a gut motility based model for predicting bowel preparation qualityHongjiao Wu0Rui Wu1Yunyun Zhang2Xinyi Lu3Wei Zhao4Biyun Xu5Jun Liu6Nina Zhang7Department of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Gastroenterology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Biomedical Statistics, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Gastroenterology, Northern Jiangsu People’s Hospital Affiliated to Yangzhou UniversityDepartment of Gastroenterology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineAbstract Inadequate bowel preparation negatively impacts the quality of colonoscopy, potentially resulting in missed lesions and the need for repeat procedures. Although gut motility plays a key role in bowel cleansing, it is often neglected in risk prediction. This study developed and validated a predictive model and simplified scoring system that integrates gut motility parameters to identify individuals at risk of inadequate bowel preparation. A total of 1,165 patients from two hospitals were enrolled, with 815 forming the training set and 350 forming the external validation cohort. The overall rate of inadequate bowel preparation was 9.8%. Multivariate analysis revealed that altered bowel movement frequency, stool consistency based on the Bristol Stool Scale, low polyethylene glycol (PEG) volume, and delayed last bowel movement were significant predictors of poor preparation. These variables were incorporated into a user-friendly scoring system that demonstrated good discriminative ability, with area under the curve values of 0.778 and 0.774 in the training and validation cohorts, respectively. A cutoff score of 3.0 yielded a sensitivity of 75.0%, specificity of 66.9%, and a negative predictive value of 96.3% in external validation. This model provides a practical, motility-informed approach for risk stratification and personalized preparation regimens, offering potential to enhance the effectiveness and efficiency of colonoscopy in diverse clinical settings.https://doi.org/10.1038/s41598-025-13739-0Bowel preparationColonoscopyGastrointestinal motilityPredictive learning models
spellingShingle Hongjiao Wu
Rui Wu
Yunyun Zhang
Xinyi Lu
Wei Zhao
Biyun Xu
Jun Liu
Nina Zhang
Development and validation of a gut motility based model for predicting bowel preparation quality
Scientific Reports
Bowel preparation
Colonoscopy
Gastrointestinal motility
Predictive learning models
title Development and validation of a gut motility based model for predicting bowel preparation quality
title_full Development and validation of a gut motility based model for predicting bowel preparation quality
title_fullStr Development and validation of a gut motility based model for predicting bowel preparation quality
title_full_unstemmed Development and validation of a gut motility based model for predicting bowel preparation quality
title_short Development and validation of a gut motility based model for predicting bowel preparation quality
title_sort development and validation of a gut motility based model for predicting bowel preparation quality
topic Bowel preparation
Colonoscopy
Gastrointestinal motility
Predictive learning models
url https://doi.org/10.1038/s41598-025-13739-0
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