title: Choosing between CT colonography and colonoscopy in the diagnostic context: a qualitative study of influences on patient preferences.
abstract: OBJECTIVE
  To explore information needs and preferences on diagnostic bowel tests and elicit preferences for CT colonography (CTC) vs. colonoscopy (CC).
  
  
  BACKGROUND
  CTC is a new technology for large-bowel imaging that has been widely assumed to be more acceptable than CC because it is non-invasive.
  
  
  METHODS
  Semi-structured focus groups discussing information choices and procedure preferences.
  
  
  METHODS
  Non-patient sample of 26 asymptomatic volunteers (mean age 64 years).
  
  
  METHODS
  Information choices and CC-vs.-CTC preferences were recorded following stepwise presentation of different test attributes. Qualitative thematic analysis was used to examine transcripts of group discussions.
  
  
  RESULTS
  On the basis of minimal information about the two tests, a majority of participants preferred CTC to CC (65% vs. 11%), while 24% had no preference. However, once they had received information on all aspects, this was reversed, with 80% of participants preferring CC compared with 8% preferring CTC. Thematic analysis of the discussion showed that participants almost unanimously considered information about test sensitivity to be the most important feature, and perceived relatively modest differences in test sensitivity to be highly significant. Information about risks and side-effects was considered to be the second most important aspect and attracted questions about risks of bowel perforation and health consequences following exposure to radiation.
  
  
  CONCLUSIONS
  Patients place high value on quality rather than comfort for medical investigations. This has important implications for the development of educational materials supporting informed choice as well as future directions in refinement of CTC technology.
authors.affiliation: Cancer Research UK, Health Behavior Research Centre, University College London, London, UK. c.wagner@ucl.ac.uk
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
authors.forename: Steve
authors.initials: S
authors.lastname: Halligan
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Atkin
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Lilford
authors.forename: Dion
authors.initials: D
authors.lastname: Morton
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D000368:Aged; D002755:Choice Behavior; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D006113:United Kingdom