Development, simplification, and prospective methodological exploration of a Chinese endoscopy patient experience scale and a decision support system.

BACKGROUND AND OBJECTIVE: Chinese-language patient-reported experience measures (PREMs) for gastrointestinal endoscopy remain limited. We developed and psychometrically evaluated a 54-item Endoscopy Patient Experience Scale (EPES) for Chinese patients; because the field survey had a valid-response rate of 99.28% (965/972), simplification was framed as a prospective methodological exploration rather than as a response to demonstrated burden. METHODS: Colonoscopy responses (n = 662) were split by stratified random sampling into an exploration set (n = 463) for exploratory factor analysis and a validation set (n = 199) for confirmatory factor analysis. A 303-patient gastroscopy cohort was used only as a cross-procedure applicability test. A multi-objective black-winged kite algorithm selected Simplified EPES (S-EPES) items to reproduce EPES dimension scores under reliability and item-reduction constraints, and an exploratory decision support system (EPE-DSS) was built from S-EPES and clustering outputs. RESULTS: The EPES showed acceptable structural, convergent and discriminant validity and reliability in the colonoscopy validation set, and the retained structure was compatible with gastroscopy after removal of bowel-preparation dimensions. The 24-item S-EPES achieved per-dimension R2 > 0.85 against EPES dimension scores; post-hoc classification yielded a weighted-average F1 of 0.917 in colonoscopy data. CONCLUSION: The main contribution is the Chinese EPES. S-EPES and EPE-DSS are exploratory prototypes demonstrating score-prediction feasibility, not validated clinical instruments; multicenter validation, comparison with conventional item-reduction methods, and measurement-invariance testing are required.