Differences in continuous variables were compared using unpaired t-tests and the data reported

as the mean ± standard deviation (SD). Categorical variables were compared using the chi-squared test. The three endoscopists’ assessments of each EGD step were analyzed separately. In addition, the assessment results from all three reviewers were compiled and the median score was calculated for each item using the Mann-Whitney U-test. For all statistical calculations, P-values were determined using SPSS (version 12.0 for Windows; SPSS, Inc., Chicago, Illinois) and values of P < 0.05 were deemed statistically significant. All 80 patients enrolled in this study underwent EGD and MK0683 colonoscopy on the same Ixazomib molecular weight day. No patient experienced unexpected failure or procedure-related complications due to either EGD or colonoscopy. Groups I and II were similar in terms of demographic and clinical data (Table 1). The indications for endoscopy were as follows: 48 patients underwent endoscopy for screening, 14 patients for investigation of GI complaints, 11 patients for post-polypectomy surveillance, and seven patients for evaluation of anemia. The pathological findings of EGD were as follows: In Group I, five patients had peptic ulcers, 10 patients exhibited peptic erosion, and one patient had

early gastric cancer; In Group II, six patients had ulcers, 11 patients exhibited peptic erosion, and one patient had early gastric cancer. Colorectal polyps were frequently found in both groups by colonoscopy (Group I, 13 patients; Group II, 16 patients). On the analysis of interobserver agreement of 18 EGD steps using Kappa statistic, strength of agreement of 6 EGD steps was fair and that of Branched chain aminotransferase 12 EGD steps was slight among three reviewers. The median scores for each EGD item are summarized in Table 2. The median scores for all parameters in Group I were less

than or equal to (i.e. higher quality) those in Group II. In particular, Group I showed significantly better median scores than Group II for retroflexion-related steps (P11–13; all median of Group I vs Group II = 2:3; P < 0.01), visualization of the angular fold (P10; Group I vs Group II = 2:3; P = 0.048), and general assessment of the stomach (P17; Group I vs Group II = 2:3; P = 0.008) and upper GI tract (P15; Group I vs Group II = 2:3; P = 0.047). To avoid inter-observer variation, a single physician performed all colonoscopy procedures. Colonoscopic parameters including insertion time, total time, and prolonged insertion ratio did not differ between the two groups and there were no unexpected colonoscopic failure in either group. (Table 3) Analyses of patient questionnaires revealed that EGD was perceived to be more stressful by those in Group II than in Group I (median scores of Group I vs Group II = 2.75:5.00; P < 0.001). However, there were no observed differences in measures of subjective colonoscopy-related discomfort parameters between the two groups.