What is the most effective way to communicate results after endoscopy?
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Rubin, DT and Ulitsky, A and Poston, J and Day, R and Huo, D, What is the most effective way to communicate results after endoscopy?, Gastrointestinal Endoscopy, 66, (1) pp. 108-112. ISSN 0016-5107 (2007) [Refereed Article]
Background: The growing demand for endoscopy associated with colorectal cancer screening has resulted in busier endoscopy units and an increase in the practice of open-access endoscopy, in which patients are referred for procedures without prior consultation by the gastroenterologist, all of which may result in less-informed patients. Objective: We sought to determine whether providing patients with a written copy of their standard endoscopy report at the conclusion of their procedure enhanced recall of the findings and recommendations. Design: Eighty consecutive outpatients who presented to 3 endoscopists were randomized to receive the results of their upper or lower endoscopy via standard verbal report (VR) or by standard VR followed by receipt of a computer-generated endoscopy report (VR + WR) from the Olympus ImageManager report generator. The endoscopist communicated the VR after a standard postprocedure recovery period of 30 to 60 minutes and routinely discussed all findings and recommendations as mentioned in the WR. The endoscopist was blinded as to whether the patient subsequently received the WR. Recall of the endoscopic procedure was assessed by using a piloted 11-question survey instrument to be filled out 3 days after the procedure. Results were calculated by using the Fisher exact and Wilcoxon rank sum tests. Patients: Referral for endoscopy from University of Chicago physicians. Results: Seventy-eight of 80 patients (98%) approached about the study agreed to participate. The response rate was 77%. Patients in the VR + WR group overall had a greater composite score than patients in the VR group (8.9/10 vs 7.7/10, P < .01). Patients in the VR + WR group were also significantly more likely to recall the recommendations for therapy or follow-up (72% vs 42%, P < .01) and the name of the endoscopist (97% vs 74%, P < .05). Limitations: Patients with an education beyond the 10th-grade level were not formally accessed in this study. Because of this, we could not evaluate whether differences in educational attainment affected patient understanding of endoscopy procedure details and findings. Conclusions: A computer-generated endoscopy report (WR) significantly improved patient recall of endoscopic procedure information compared with a VR alone. Despite this, patients were unable to recall 28% of recommendations. Additional study to determine if such enhanced physician-patient communication improves patient satisfaction or follow-up, and whether more specific patient-directed results further improve recall needs to occur. © 2007 American Society for Gastrointestinal Endoscopy.
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