Divisions of Gastroenterology and Hepatology.
Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN.
J Clin Gastroenterol. 2018 Nov/Dec;52(10):880-884. doi: 10.1097/MCG.0000000000000991.
To determine patient preference for the Barrett esophagus (BE) screening techniques.
Sedated esophagogastroduodenoscopy (sEGD) and unsedated transnasal endoscopy (uTNE) are both potential techniques for BE screening. However, systematic assessment of patient preference for these 2 techniques is lacking. As part of a comparative effectiveness randomized trial of BE screening modalities, we measured short-term patient preferences for the following approaches: in-clinic uTNE (huTNE), mobile-based uTNE (muTNE), and sEGD using a novel assessment instrument.
Consenting community patients without known BE were randomly assigned to receive huTNE, muTNE, or sEGD, followed by a telephone administered preference and tolerability assessment instrument 24 hours after study procedures. Patient preference was measured by the waiting trade-off method.
In total, 201 patients completed screening with huTNE (n=71), muTNE (n=71), or sEGD (n=59), and a telephone interview. Patients' preferences for sEGD and uTNE using the waiting trade-off method were comparable (P=0.51). Although tolerability scores were superior for sEGD (P<0.001) compared with uTNE, scores for uTNE examinations were acceptable.
Patient preference is comparable between sEGD and uTNE for diagnostic examinations conducted in an endoscopy suite or in a mobile setting. Given acceptable tolerability, uTNE may be a viable alternative to sEGD for BE screening.
确定患者对 Barrett 食管（BE）筛查技术的偏好。
镇静食管胃十二指肠镜检查（sEGD）和非镇静经鼻内镜检查（uTNE）都是 BE 筛查的潜在技术。然而，缺乏对这两种技术的患者偏好的系统评估。作为 BE 筛查方式的一项比较效果随机试验的一部分，我们使用一种新的评估工具来衡量以下方法的短期患者偏好：门诊 uTNE（huTNE）、移动 uTNE（muTNE）和 sEGD。
同意参加的社区患者无已知 BE 被随机分配接受 huTNE、muTNE 或 sEGD，然后在研究程序后 24 小时通过电话进行偏好和耐受性评估工具。患者偏好通过等待权衡法进行测量。
共有 201 例患者完成了 huTNE（n=71）、muTNE（n=71）或 sEGD（n=59）筛查，并接受了电话采访。使用等待权衡法，患者对 sEGD 和 uTNE 的偏好相当（P=0.51）。尽管 sEGD 的耐受性评分明显优于 uTNE（P<0.001），但 uTNE 检查的评分是可以接受的。
在内镜室或移动环境中进行诊断性检查时，患者对 sEGD 和 uTNE 的偏好相当。鉴于 uTNE 具有可接受的耐受性，uTNE 可能是 BE 筛查的 sEGD 替代方案。
