title: Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients.
abstract: OBJECTIVE
  To determine patient acceptability of barium enema (BE) or CT colonography (CTC).
  
  
  METHODS
  After ethical approval, 921 consenting patients with symptoms suggestive of colorectal cancer who had been randomly assigned and completed either BE (N = 606) or CTC (N = 315) received a questionnaire to assess experience of the clinical episode including bowel preparation, procedure and complications. Satisfaction, worry and physical discomfort were assessed using an adapted version of a validated acceptability scale. Non-parametric methods assessed differences between the randomised tests and the effect of patient characteristics.
  
  
  RESULTS
  Patients undergoing BE were significantly less satisfied (median 61, interquartile range [IQR] 54-67 vs. median 64, IQR 56-69; p = 0.003) and experienced more physical discomfort (median 40, IQR 29-52 vs. median 35.5, IQR 25-47; p < 0.001) than those undergoing CTC. Post-test, BE patients were significantly more likely to experience 'abdominal pain/cramps' (68% vs. 57%; p = 0.007), 'soreness' (57% vs. 37%; p < 0.001), 'nausea/vomiting' (16% vs. 8%; p = 0.009), 'soiling' (31% vs. 23%; p = 0.034) and 'wind' (92% vs. 84%; p = 0.001) and in the case of 'wind' to also rate it as severe (27% vs. 15%; p < 0.001).
  
  
  CONCLUSIONS
  CTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
authors.forename: Samuel
authors.initials: S
authors.lastname: Smith
authors.forename: Steve
authors.initials: S
authors.lastname: Halligan
authors.forename: Alex
authors.initials: A
authors.lastname: Ghanouni
authors.forename: Emily
authors.initials: E
authors.lastname: Power
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Lilford
authors.forename: Dion
authors.initials: D
authors.lastname: Morton
authors.forename: Edward
authors.initials: E
authors.lastname: Dadswell
authors.forename: Wendy
authors.initials: W
authors.lastname: Atkin
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D015746:Abdominal Pain; D000368:Aged; D001464:Barium; D002755:Choice Behavior; D003110:Colonic Neoplasms / Q000175:diagnosis*; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy / Q000379:methods*; D003287:Contrast Media / Q000494:pharmacology*; D004733:Enema / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
chemical_list: D003287:Contrast Media; D001464:Barium