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评估患者在筛查 CT 结肠成像前对肠道准备类型的偏好:便利性和舒适度与敏感性和特异性。

Evaluating patients' preferences for type of bowel preparation prior to screening CT colonography: convenience and comfort versus sensitivity and specificity.

机构信息

Department of Epidemiology and Public Health, University College London, London, UK.

出版信息

Clin Radiol. 2013 Nov;68(11):1140-5. doi: 10.1016/j.crad.2013.06.018. Epub 2013 Aug 12.

Abstract

AIMS

To explore the relative value patients place on comfort and convenience versus test sensitivity and specificity in the context of computed tomographic colonography (CTC) screening.

MATERIALS AND METHODS

Twenty semi-structured interviews were carried out with patients attending hospital for radiological tests unrelated to CTC. Preferences for CTC with different types of bowel preparation for CTC screening were examined and interviews were analysed thematically. The discussion guide included separate sections on CTC, bowel preparation methods (non-, reduced- and full-laxative), and sensitivity and specificity. Patients were given information on each topic in turn and asked about their views and preferences during each section.

RESULTS

Following information about the test, patients' attitudes towards CTC were positive. Following information on bowel preparation, full-laxative purgation was anticipated to cause more adverse physical and lifestyle effects than using reduced- or non-laxative preparation. However, stated preferences were approximately equally divided, largely due to patients anticipating that non-laxative preparations would reduce test accuracy (because the bowel was not thoroughly cleansed). Following information on sensitivity and specificity (which supported patients' expectations), the predominant stated preference was for full-laxative preparation.

CONCLUSIONS

Patients are likely to value test sensitivity and specificity over a more comfortable and convenient preparation. Future research should test this hypothesis on a larger sample.

摘要

目的

在计算机断层结肠成像(CTC)筛查的背景下,探讨患者对舒适度和便利性相对于检测灵敏度和特异性的相对价值。

材料和方法

对 20 名因与 CTC 无关的放射学检查而到医院就诊的患者进行了 20 次半结构式访谈。检查了对 CTC 筛查不同类型肠道准备的 CTC 的偏好,并对访谈进行了主题分析。讨论指南包括 CTC、肠道准备方法(非、低和全泻药)以及灵敏度和特异性的单独部分。患者依次获得每个主题的信息,并在每个部分询问他们的观点和偏好。

结果

在了解了测试信息后,患者对 CTC 的态度是积极的。在了解了肠道准备信息后,全泻药清肠预计会比使用低或无泻药清肠产生更多的不良身体和生活方式影响。然而,明确的偏好大致相同,这主要是因为患者预计非泻药准备会降低测试准确性(因为肠道没有彻底清洁)。在了解了灵敏度和特异性(支持了患者的预期)信息后,首选的是全泻药准备。

结论

患者可能更看重检测灵敏度和特异性,而不是更舒适和方便的准备。未来的研究应该在更大的样本中检验这一假设。

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