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Background and Aims: Colorectal cancer (CRC) is the third most common cause of cancer worldwide. Studies have shown a strong association between screening colonoscopy and a reduced risk of death from colorectal cancers. The incidence of poor bowel preparation has been reported in up to 25% cases. We conducted a systematic review and comprehensive meta‐analysis to evaluate the effect of patient education using multimedia platforms on adenoma detection rate and adequacy of bowel preparation. Methods: Multiple databases were searched through May 2020 for studies that reported the efficacy of multimedia education (smartphone app and online audio‐visual aids) in improving quality of bowel preparation and its effect on adenoma detection rate (ADR). Meta‐analysis was performed to determine whether multimedia based patient education (MM) helps improve ADR and bowel preparation quality as compared to controls (CT). Results: We included 13 randomized controlled trials with a total of 3754 patients. Eight studies reported outcomes on ADR and 12 reported on adequacy of bowel preparation. Overall ADR was higher in patients receiving multimedia based education as compared to CT (risk ratio (RR) 1.25, confidence interval (CI) 1.01–1.56, P = 0.04). A higher proportion of patients receiving multimedia based education achieved adequate bowel preparation (RR 1.2, CI 1.1–1.3, P = 0.001). In patients with mean age over 50 years, ADR was better in MM cohort as compared to controls (RR 1.3, CI 1.1–1.6, P = 0.001). Conclusion: Pre‐colonoscopy patient education using multimedia based platforms seems to improve ADR and the adequacy of bowel preparation. [ABSTRACT FROM AUTHOR]

Background & Aims Pretransplant renal failure is commonly reported to be a poor prognostic indicator affecting survival after liver transplantation ( LT). However, whether the impact of renal failure on patient outcome varies according to the aetiology of the underlying liver disease is largely unknown. Methods We investigated the association between renal failure at the time of LT and patient outcome in patients with alcoholic liver disease ( ALD) ( n = 6920), non-alcoholic steatohepatitis ( NASH) ( n = 2956) and hepatitis C ( HCV) ( n = 14 922) using the United Network for Organ Sharing ( UNOS) database between February 2002 and December 2013. A total of 24 798 transplant recipients were included. Results The presence of renal failure was more frequently seen in patients with ALD (23.95%) and NASH (23.27%) compared to patients with HCV (19.38%) ( P < 0.001). In multivariate analysis, renal failure was an independent predictor of poor survival. Renal failure showed detrimental effect on patient survival in the overall series ( HR = 1.466, P < 0.0001). Importantly, the impact of renal failure was less marked in patients with ALD ( HR = 1.31, P < 0.0001) than in patients with NASH ( HR = 1.73, P < 0.0001) or HCV ( HR = 1.52, P < 0.0001). Despite a higher model for end-stage liver disease ( MELD) score at the time of LT, ALD patients with renal failure had better long-term prognosis than non- ALD patients. Conclusions Renal failure at the time of LT conferred a lower patient and graft survival post- LT. However, renal failure has less impact on the outcome of patients with ALD than that of patients with non-alcoholic liver disease after LT. [ABSTRACT FROM AUTHOR]