TY - JOUR
T1 - Patient Acceptability and Psychologic Consequences of CT Colonography Compared with Those of Colonoscopy: Results from a Multicenter Randomized Controlled Trial of Symptomatic Patients
AU - von Wagner, C
AU - Ghanouni, A
AU - Halligan, S
AU - Smith, Stuart
AU - Dadswell, E
AU - Lilford, Richard
AU - Morton, Dion
AU - Atkin, W
AU - Wardle, J
PY - 2012/3/21
Y1 - 2012/3/21
N2 - Purpose:To use a randomized design to compare patients' short- and longer-term experiences after computed tomographic (CT) colonography or colonoscopy.Materials and Methods:After ethical approval, the trial was registered. Patients gave written informed consent. Five hundred forty-seven patients with symptoms suggestive of colorectal cancer who had been randomly assigned at a ratio of 2:1 to undergo either colonoscopy (n = 362) or CT colonography (n = 185) received a validated questionnaire to assess immediate test experience (including satisfaction, worry, discomfort, adverse effects) and a 3-month questionnaire to assess psychologic outcomes (including satisfaction with result dissemination and reassurance). Data were analyzed by using Mann-Whitney U, Kruskal-Wallis, and χ(2) test statistics.Results:Patients undergoing colonoscopy were less satisfied than those undergoing CT colonography (median score of 61 and interquartile range [IQR] of 55-67 vs median score of 64 and IQR of 58-70, respectively; P = .008) and significantly more worried (median score of 16 [IQR, 12-21] vs 15 [IQR, 9-19], P = .007); they also experienced more physical discomfort (median score of 39 [IQR, 29-51] vs 35 [IQR, 24-44]) and more adverse events (82 of 246 vs 28 of 122 reported feeling faint or dizzy, P = .039). However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR, 3-4] vs 3 [IQR, 3-3], P <.0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P <.0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect.Conclusion:CT colonography has superior patient acceptability compared with colonoscopy in the short term, but colonoscopy offers some benefits to patients that become apparent after longer-term follow-up. The respective advantages of each test should be balanced when referring symptomatic patients.© RSNA, 2012Clinical trial registration no. ISRCT95152621Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12111523/-/DC1.
AB - Purpose:To use a randomized design to compare patients' short- and longer-term experiences after computed tomographic (CT) colonography or colonoscopy.Materials and Methods:After ethical approval, the trial was registered. Patients gave written informed consent. Five hundred forty-seven patients with symptoms suggestive of colorectal cancer who had been randomly assigned at a ratio of 2:1 to undergo either colonoscopy (n = 362) or CT colonography (n = 185) received a validated questionnaire to assess immediate test experience (including satisfaction, worry, discomfort, adverse effects) and a 3-month questionnaire to assess psychologic outcomes (including satisfaction with result dissemination and reassurance). Data were analyzed by using Mann-Whitney U, Kruskal-Wallis, and χ(2) test statistics.Results:Patients undergoing colonoscopy were less satisfied than those undergoing CT colonography (median score of 61 and interquartile range [IQR] of 55-67 vs median score of 64 and IQR of 58-70, respectively; P = .008) and significantly more worried (median score of 16 [IQR, 12-21] vs 15 [IQR, 9-19], P = .007); they also experienced more physical discomfort (median score of 39 [IQR, 29-51] vs 35 [IQR, 24-44]) and more adverse events (82 of 246 vs 28 of 122 reported feeling faint or dizzy, P = .039). However, at 3 months, they were more satisfied with how results were received (median score of 4 [IQR, 3-4] vs 3 [IQR, 3-3], P <.0005) and less likely to require follow-up colonic investigations (17 of 230 vs 37 of 107, P <.0005). No differences were observed between the tests regarding 3-month psychologic consequences of the diagnostic episode, except for a trend toward a difference (P = .050) in negative affect (unpleasant emotions such as distress), with patients undergoing CT colonography reporting less intense negative affect.Conclusion:CT colonography has superior patient acceptability compared with colonoscopy in the short term, but colonoscopy offers some benefits to patients that become apparent after longer-term follow-up. The respective advantages of each test should be balanced when referring symptomatic patients.© RSNA, 2012Clinical trial registration no. ISRCT95152621Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12111523/-/DC1.
U2 - 10.1148/radiol.12111523
DO - 10.1148/radiol.12111523
M3 - Article
C2 - 22438366
SN - 0033-8419
JO - Radiology
JF - Radiology
ER -
