Ask an answerable question (PICO)：
The diet habit for the people in Taiwan has been changed, so the possibility to suffer colon cancer and colon polyposis has increased, and the age of the people to suffer them has also decreased. The colonoscopy is the optimal tool to be applied to discover and screen the polyp and cancer early. Before the implementation of colonoscopy, the bowel preparation trace needs to be done first, to increase the rate that adenoma being detected and minimize all the possible risk during the examination. The bowel preparation needs to be done along with cathartics, and it may require the patient to be dietary restriction. The patient who has the traditional clean liquid diet will easily feel hungry, dizzy, and being hypoglycemic. The recent research indicates that the patient uses the clean liquid diet and the low residue diet does not show the apparent evidence to the result of bowel preparation. However, the patient has a low residue diet seemed to have higher satisfaction and tolerance. Therefore the evidence-based method is applied and to discuss the low residue diet in clinical.
The Method and Analysis of Literature Review：
The study is based on the evidence-based and follow the sequence of keywords of Mesh term, Boolean logic, Truncation, Limited column, to search Cochrane, PubMed, Embase, CINAHL, Airiti Library and National Digital Library of theses and dissertations in Taiwan. We try to find the article which is in line with PICO and selected two articles to critical appraisal, included with three broad heading VIP: V(Validity/Reliability), I (Importance/Impact), P(Practice/Applicability).
Critical Appraisal：
It is a therapeutic type to criticize and analysis PICO’s question. According to the suggested grade at Oxford CEBM, two of the studies are level 1 and level 2. The result of the analysis: for the subject of bowel preparation , there is no significant difference between the CLD team and the LRD team (the quality of index of proceeding the colonoscopy: BBPS、Aronchick scale or Ottawa scale. For the issue of a patient's satisfaction and tolerance, the low residue diet has a higher score than the clean liquid diet. As to the expenditure and harm, it is no noticeable difference. The result of the critical appraisal skill of quality to two of the bibliography indicates consistency. The assessment system of GRADE to justify the quality, the evidence of analysis is categorized as “high,” the suggestion strength is classified as “strong.”
Results, Conclusions and Recommendations：
The colonoscopy is the best tool for early diagnosis and screen colon polyp and colon cancer. There are quite a few factors to achieve the success of inspection of colonoscopy. The primary factor is the quality of bowel preparation. According to the suggestion indicated in the bibliography, to practice a hygiene education to adopt the low residue diet does help to enhance the full feeling and it increases the patient ‘s willingness to operability, satisfaction and repeating preparation during the preparation before the implementation of colonoscopy than to adopt a clean liquid diet. The suggestion is to replace the clean liquid diet by the low residues diet before the implementation of colonoscopy and also standardize the procedure.
