The University of Toledo Translation Journal of Medical Sciences 
Gastroenterology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 05; 11(1):e1-e1 

Use of Smartphone Applications to Augment Colonoscopy 
Preparation Instructions and Effect on Quality of 
Colonoscopy Preparation and Adenoma Detection Rate – 
A Systematic Review and Meta-Analysis 

S Ghazaleh1*, M Karrick1, M Aziz1, A Ramadugu1, A Renno1, S Stanley1, T 
Sodeman1, A Nawras1

1Division of Gastroenterology and Hepatology, Department of Medicine, The 
University of Toledo, Toledo, OH 43614 

*Corresponding author: Sami.Ghazaleh@utoledo.edu

Published: 05 May 2023 

Introduction: Adequate preparation of the large bowel is essential for a successful colonoscopy. 
Patients should be provided with clear instructions prior to the procedure, which can be achieved by 
verbal, written, and more recently, digital tools. A few studies have evaluated the role of smartphone 
applications to augment colonoscopy preparation instructions. 

Methods: We conducted a systematic review and meta-analysis. We performed a comprehensive search 
in the databases of PubMed/MEDLINE, Embase, and the Cochrane from inception through October 11, 
2021. The primary outcome was adequate bowel preparation, defined as per Boston bowel preparation 
scale (BBPS). The secondary outcome was adenoma detection rate (ADR), which was defined as 
patients with ≥1 adenoma detected on colonoscopy. The random-effects model was used. A p value 
<0.05 was considered statistically significant. Heterogeneity was assessed using the Higgins I2 index.  

Results: Nine randomized controlled trials involving 2933 patients were included in the meta-analysis. 
Eight studies reported adequate bowel preparation, which was significantly higher in patients who used 
smartphone applications compared with controls (RR 1.17, 95% CI 1.06 – 1.30, p < 0.003, I2 = 90%). 
Five studies reported ADR, which was also significantly higher in patients who used smartphone 
applications compared with controls (RR 1.37, 95% CI 1.19 – 1.58, p < 0.0001, I2 = 0%).  

Conclusion: Our meta-analysis demonstrated that the use of smartphone applications to augment 
colonoscopy preparation instructions improves the quality of colonoscopy preparation and adenoma 
detection rate. Further randomized controlled trials are needed to confirm our findings. 

https://dx.doi.org/10.46570/utjms.vol11-2023-670 

https://dx.doi.org/10.46570/utjms.vol11-2023-670
mailto:Sami.Ghazaleh@utoledo.edu