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CT Colonography and Colonoscopy: Assessment of Patient Preference in a 5-week Follow-up Study¹

¹ From the Departments of Radiology (R.E.v.G., J.F., M.P.S., J.S.L., J.S.), Social Medicine (Public Health) (E.B., G.J.B.), and Gastroenterology (J.F.B.), Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; and Department of Gastroenterology, Slotervaart Hospital, Amsterdam, the Netherlands (P.S.). From the 2003 RSNA scientific assembly. Received August 4, 2003; revision requested September 30; revision received December 17; accepted February 4, 2004. Supported by the Netherlands Organization for Health Research and Development (grant no. 2100.0059). Address correspondence to R.E.v.G. (e-mail: r.e.vangelder@amc.uva.nl).

View larger version (34K): [in a new window]   Figure 1. Flow chart shows patient participation and study design. A total of 288 patients participated; 249 patients who underwent successful bowel preparation, CT colonography, and colonoscopy were analyzed. In one patient, both unsatisfactory bowel preparation and CT colonography examination failure occurred; thus, 39 patients were not analyzed. In a 7-week time frame, patients completed five questionnaires. Q1 = questionnaire completed 2 weeks before examination. Patient characteristics and reluctance were reported. Q2 = questionnaire completed on the day of examination, before the examinations. Patients evaluated bowel preparation experience. Q3 = questionnaire completed after CT colonography. Patients evaluated CT colonography experience. Q4 = questionnaire completed after colonoscopy. Patients evaluated colonoscopy experience, and the first preference measurement was obtained. Q5 = questionnaire completed at 5-week follow-up. Patients evaluated their CT colonography and colonoscopy experience, and the second preference measurement was obtained.

View larger version (22K): [in a new window]   Figure 2. Graph shows pretest reluctance and posttest appraisal of the most burdensome event: bowel preparation, CT colonography, or colonoscopy. On questionnaire 1 (Q1), a similar percentage of patients indicated that they were most reluctant to undergo bowel preparation and colonoscopy. Patients indicated that bowel preparation was the most burdensome event after the examination on questionnaires 4 (Q4) and 5 (Q5).

View larger version (44K): [in a new window]   Figure 3. Graphs show patient experience with CT colonography and colonoscopy, as measured directly after both examinations and at 5-week follow-up. Differences in pain and discomfort between CT colonography and colonoscopy were statistically significant (P < .001) at both time points, whereas the differences in embarrassment were not. Numbers indicate percentage of the patient group.

View larger version (21K): [in a new window]   Figure 4. Graph shows preference of patients for CT colonography (CTC) or colonoscopy (CS) directly after both examinations and at 5-week follow-up and the strength of this preference. Numbers indicate percentage of the patient group. The majority of patients prefer CT colonography to colonoscopy (P < .001). This preference is present after 5 weeks (P < .001), although it decreased significantly (P < .001).