Prospective Comparison of Patient Experience with Colon Imaging Tests

Bosworth, Hayden B.; Rockey, Don C.; Paulson, Erik K.; Niedzwiecki, Donna; Davis, Wendy; Sanders, Linda L.; Yee, Judy; Henderson, Jim; Hatten, Paul; Burdick, Steve; Sanyal, Arun; Rubin, David T.; Sterling, Mark; Akerkar, Geetanjali; Bhutani, Manoop S.; Binmoeller, Kenneth; Garvie, John; Bini, Edmund J.; McQuaid, Kenneth; Foster, William L.; Thompson, William M.; Dachman, Abe; Halvorsen, Robert

doi:10.1016/j.amjmed.2006.02.013

« Previous Next »The American Journal of Medicine
Volume 119, Issue 9 , Pages 791-799, September 2006

Prospective Comparison of Patient Experience with Colon Imaging Tests

Hayden B. Bosworth, PhD
- Center for Health Services Research in Primary Care, Durham VA Medical Center
- Department of Medicine Duke University Medical Center
Don C. Rockey, MD
- Department of Medicine Duke University Medical Center
- Requests for reprints should be addressed to Don C. Rockey, MD, University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Digestive and Liver Diseases, 5323 Harry Hines Blvd, Dallas TX 75390-8887.
Erik K. Paulson, MD
- Department of Medicine Duke University Medical Center
Donna Niedzwiecki, PhD
- Department of Medicine Duke University Medical Center
Wendy Davis, MD
- Durham VA Medical Center/Duke University Medical Center, Durham, NC
Linda L. Sanders, MPH
- Department of Medicine Duke University Medical Center
Judy Yee, MD
- San Francisco VA Medical Center/The University of California at San Francisco, Calif
Jim Henderson, MD
- Troy Internal Medicine, Troy, Mich
Paul Hatten, MD
- Indian River Radiology, Vero Beach, Fla
Steve Burdick, MD
- The University of Texas Southwestern, Dallas
Arun Sanyal, MD
- Virginia Commonwealth University Medical Center, Richmond
David T. Rubin, MD
- University of Chicago, Ill
Mark Sterling, MD
- The University of Medicine and Dentistry of New Jersey, Newark
Geetanjali Akerkar, MD
- Seacoast Gastroenterology, Exeter, NH
Manoop S. Bhutani, MD
- The University of Texas Medical Branch, Galveston
Kenneth Binmoeller, MD
- California Pacific Medical Center, San Francisco
John Garvie, MD
- University of California at San Diego
Edmund J. Bini, MD
- New York University, New York
Kenneth McQuaid, MD
- San Francisco VA Medical Center/The University of California at San Francisco, Calif
William L. Foster, MD
- Durham VA Medical Center/Duke University Medical Center, Durham, NC
William M. Thompson, MD
- Department of Medicine Duke University Medical Center
Abe Dachman, MD
- University of Chicago, Ill
Robert Halvorsen, MD
- Virginia Commonwealth University Medical Center, Richmond

Received in revised form 6 February 2006

Abstract

Purpose

Patient experience varies with the currently available colon imaging tests, including air contrast barium enema, computed tomographic colonography, and colonoscopy. We examined differences in patient experience with colon imaging tests and whether they varied with gender, age, and race.

Subjects and methods

Patients with fecal occult blood, hematochezia, iron-deficiency anemia, or a family history of colon cancer underwent air contrast barium enema followed 7 to 14 days later by computed tomographic colonography and colonoscopy. Validated patient experience questionnaires that measured the experience for each test and a separate questionnaire that obtained an overall summary measure were administered after testing. Eleven patient experiences including pain, embarrassment, difficulty with bowel preparation, and satisfaction with tests were examined.

Results

A total of 614 subjects completed all 3 imaging tests. The test most patients were willing to repeat was colonoscopy; it also was reported to be the least painful procedure. Patients were least satisfied with air contrast barium enema, and fewer would undergo air contrast barium enema compared with computed tomographic colonography or colonoscopy. There were limited racial and gender differences in perceptions of the tests. Younger adults perceived air contrast barium enema to be more painful than older adults.

Conclusion

Taking into account a wide variety of patient experience measures, patients preferred colonoscopy to air contrast barium enema and computed tomographic colonography. This finding has important implications for physicians considering different colon imaging tests.

Keywords: Air contrast barium enema, Virtual colonoscopy, Computed tomography, Computed tomographic colonography, Colonoscopy, Cancer screening, Patient preference, Colon cancer, Satisfaction