Browse by author
Lookup NU author(s): Dr Laura Neilson, Professor Colin Rees
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2025. The Author(s).Background Patient experience is a fundamental element of colonoscopy. The Gloucester Comfort Scale (GCS) is used by clinicians to report patient comfort. However, insights regarding the extent to which clinician-reported GCS scores represent the patient s experience are lacking. We assessed the level of agreement between clinician-reported GCS scores and patient-reported discomfort and pain. Methods Consecutive patients undergoing colonoscopy at two Dutch endoscopy clinics were included. Patient comfort during colonoscopy was reported using the GCS (1 5 scale). Patients colonoscopy experiences were assessed using the Newcastle ENDOPREM, a validated endoscopy patient-reported experience measure (PREM). Patients reported both discomfort and pain levels experienced during colonoscopy on a 1 5 scale. Levels of agreement were assessed using Cohen s kappa statistic. Results For 243 included patients, the GCS score was higher than the PREM discomfort score in 52 patients (21%) and lower in 72 (30%). GCS score was higher than the PREM pain score in 39 patients (16%) and lower in 71 (29%). Moderateto-severe discomfort and pain (scores ?3) were reported by 53 patients (22%) for discomfort and 60 patients (25%) for pain. For these patients, the GCS underestimated discomfort and pain levels in almost all cases (discomfort 49/53 [92%], pain 54/60 [90%]). Agreement between GCS scores and PREM discomfort and pain scores were minimal (Cohen s ? 0.34) and weak (Cohen s ? 0.47), respectively. Conclusions Clinician-reported GCS scores frequently underestimated the level of discomfort and pain reported by patients. For accurate monitoring of patients colonoscopy experiences, the use of PREMs should be considered.
Author(s): Van Bokhorst QNE, Geerlings CV, Van Der Vlugt M, Nass KJ, Borkent JW, Neilson LJ, Fockens P, Rees CJ, Dekker E
Publication type: Article
Publication status: Published
Journal: Endoscopy
Year: 2025
Pages: epub ahead of print
Online publication date: 29/01/2025
Acceptance date: 26/01/2025
Date deposited: 24/03/2025
ISSN (print): 0013-726X
ISSN (electronic): 1438-8812
Publisher: Georg Thieme Verlag
URL: https://doi.org/10.1055/a-2528-5578
DOI: 10.1055/a-2528-5578
PubMed id: 39880000
Altmetrics provided by Altmetric
