Small Bowel CLEansing Assessment and Report (SB‐CLEAR): Standardizing bowel preparation report in capsule endoscopy

Background and aim Small‐bowel (SB) cleansing is crucial to assess the reliability of capsule endoscopy (CE) findings. However, the presence of multiple grading systems is hampering their use in clinical practice. In 2020, Colon CLeansing Assessment and Report (CC‐CLEAR) was created and validated. We sought to develop and validate a new score for the evaluation of the SB cleansing, adapted from CC‐CLEAR, aiming to standardize CE reporting regarding the quality of preparation. Methods The new grading score, SB CLeansing Assessment and Report (SB‐CLEAR), divided the SB into three tertiles, each being scored depending on the percentage of visualized mucosa (0, 75%; 3, > 90%). The overall classification was a sum of each segment score, graded between excellent, good, and inadequate (0–5). Any segment scoring ≤1 resulted in inadequate overall classification. CE videos were prospectively evaluated by two experienced CE readers blinded to each other. Results We included 52 CEs, 41(78.8%) female, with a mean age of 57.9 ± 17.9 years. Inter‐observer agreement was very strong for each tertile (first: r = 0.863; second: r = 0.865; third: r = 0.861; P