{
  "abstract": "Background Pain during colonoscopy is a barrier to colorectal cancer screening. A simple and practical predictive model for colonoscopy pain using readily available variables is still lacking. This study aimed to develop a clinical scoring system for identifying patients more prone to experience pain.Methods The predictive model was prospectively developed from 503 patients at an endoscopy center and externally validated in 176 patients at another endoscopy center. External validation was performed to assess the model’s discriminative ability and calibration. The primary outcome was pain, which was rated with a validated four-level verbal rating scale.Results Painful colonoscopy was observed in 103 patients (20.48%) in the development cohort (n = 503) ( IDDF2026-ABS-0224 Figure 1. Flow chart of patient inclusion). Multivariate analysis revealed that a body mass index of ≤ 19 kg/m2 (odds ratio [OR] = 11.52, 95% confidence interval [CI]: 4.96 – 26.76; P < 0.001), female sex (OR = 2.79, 95% CI: 1.54 – 5.04; P = 0.001), history of pelvic surgery (OR = 1.94, 95% CI: 1.05–3.61; P = 0.035), and constipation (OR = 4.86, 95% CI: 2.91 – 8.12; P < 0.001) were independently related to painful colonoscopy. The model achieved an area under the receiver operating characteristic curve (AUROC) of 0.81(95% CI: 0.77 – 0.86) and good calibration. Patients undergoing unsedated colonoscopy were classified as low risk (0 – 5 points) or high risk (6 – 11 points) (IDDF2026-ABS-0224 Table 1). In the external validation cohort (n = 176), the discrimination was moderately good (AUROC = 0.74, 95% CI: 0.64 – 0.84) (IDDF2026-ABS-0224 Figure 2. ROC curve for discrimination (A) ROC curve in the internal cohort (AUC = 0.813). (B) ROC curve in the external cohort (AUC = 0.740)), and calibration was verified (IDDF2026-ABS-0224 Figure 3. Calibration plot of the predictive model (A) Calibration in internal cohort. (B) Calibration in external cohort).Conclusions A simple score may help identify patients at higher risk of pain during unsedated colonoscopy and guide individualized strategies.Abstract IDDF2026-ABS-0224 Figure 1Abstract IDDF2026-ABS-0224 Table 1Algorithm’s score for each variablePredictive factorPredictive ScoreBody mass index ≤ 19 kg/m25Female sex2Pelvic surgery1Constipation3Abstract IDDF2026-ABS-0224 Figure 2Abstract IDDF2026-ABS-0224 Figure 3",
  "authors": [
    {
      "affiliations": [
        "Health Science Center, Ningbo University, Ningbo, Zhejiang Province, China"
      ],
      "name": "Xinzhi Jiang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China"
      ],
      "name": "Lei Xu"
    }
  ],
  "title": "IDDF2026-ABS-0224 Development and external validation of a predictive score of pain in unsedated colonoscopy",
  "uid": "92eb66cc-d568-5ea4-a5e1-86d955a64367"
}