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Lookup NU author(s): Emeritus Professor Greg RubinORCiD, Stephen Attwood
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2023, The Author(s).Background: The Cytosponge is a cell-collection device, which, coupled with a test for trefoil factor 3 (TFF3), can be used to diagnose Barrett’s oesophagus, a precursor condition to oesophageal adenocarcinoma. BEST3, a large pragmatic, randomised, controlled trial, investigated whether offering the Cytosponge-TFF3 test would increase detection of Barrett’s. Overall, participants reported mostly positive experiences. This study reports the factors associated with the least positive experience. Methods: Patient experience was assessed using the Inventory to Assess Patient Satisfaction (IAPS), a 22-item questionnaire, completed 7–14 days after the Cytosponge test. Study cohort: All BEST3 participants who answered ≥ 15 items of the IAPS (N = 1458). Statistical analysis: A mean IAPS score between 1 and 5 (5 indicates most negative experience) was calculated for each individual. ‘Least positive’ experience was defined according to the 90th percentile. 167 (11.4%) individuals with a mean IAPS score of ≥ 2.32 were included in the ‘least positive’ category and compared with the rest of the cohort. Eleven patient characteristics and one procedure-specific factor were assessed as potential predictors of the least positive experience. Multivariable logistic regression analysis using backwards selection was conducted to identify factors independently associated with the least positive experience and with failed swallow at first attempt, one of the strongest predictors of least positive experience. Results: The majority of responders had a positive experience, with an overall median IAPS score of 1.7 (IQR 1.5–2.1). High (OR = 3.01, 95% CI 2.03–4.46, p < 0.001) or very high (OR = 4.56, 95% CI 2.71–7.66, p < 0.001) anxiety (relative to low/normal anxiety) and a failed swallow at the first attempt (OR = 3.37, 95% CI 2.14–5.30, p < 0.001) were highly significant predictors of the least positive patient experience in multivariable analyses. Additionally, sex (p = 0.036), height (p = 0.032), alcohol intake (p = 0.011) and education level (p = 0.036) were identified as statistically significant predictors. Conclusion: We have identified factors which predict patient experience. Identifying anxiety ahead of the procedure and discussing particular concerns with patients or giving them tips to help with swallowing the capsule might help improve their experience. Trial registration ISRCTN68382401.
Author(s): Ghimire B, Landy R, Maroni R, Smith SG, Debiram-Beecham I, Sasieni PD, Fitzgerald RC, Rubin G, Walter FM, Waller J, Attwood S, Parmar M, Delaney B, de Caestecker J, Atkin W, Hackshaw A, van Heyningen C, Underwood T, Stella A, Saxby C, Lorincz A, Turnbull N, Doorbar J, Mannion-Krase G, Kaimi I, Kasanicki M, Kelleher S, Stockley L, Assari T, Kadyan S, Hollamby V, Edwards K, MacDonald H, Shaw V, Leishman H, Roper H, McCloskey K, Jung H, Phillips A, Masjak-Newman G, Fell K, Collins H, Zolle O, McGlone P, Crabb T, Merrin L, Cross M, Jones A, Simpson T, Murray E, Perugia A, Thompson M, Dumbleton J, Morar M, Frowd N, Hardcastle A, Carmichael D, Maxton F, Farnworth F, Baddeley E, Offman J
Publication type: Article
Publication status: Published
Journal: BMC Gastroenterology
Year: 2023
Volume: 23
Issue: 1
Online publication date: 10/01/2023
Acceptance date: 20/12/2022
Date deposited: 24/01/2023
ISSN (electronic): 1471-230X
Publisher: BioMed Central Ltd
URL: https://doi.org/10.1186/s12876-022-02630-1
DOI: 10.1186/s12876-022-02630-1
PubMed id: 36627580
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