The University of Southampton
University of Southampton Institutional Repository

Detection of extracolonic pathologic findings with CT colonography: a discrete choice experiment of perceived benefits versus harms

Detection of extracolonic pathologic findings with CT colonography: a discrete choice experiment of perceived benefits versus harms
Detection of extracolonic pathologic findings with CT colonography: a discrete choice experiment of perceived benefits versus harms
Purpose
To determine the maximum rate of false-positive diagnoses that patients and health care professionals were willing to accept in exchange for detection of extracolonic malignancy by using computed tomographic (CT) colonography for colorectal cancer screening.
Materials and Methods

After obtaining ethical approval and informed consent, 52 patients and 50 health care professionals undertook two discrete choice experiments where they chose between unrestricted CT colonography that examined intra- and extracolonic organs or CT colonography restricted to the colon, across different scenarios. The first experiment detected one extracolonic malignancy per 600 cases with a false-positive rate varying across scenarios from 0% to 99.8%. One experiment examined radiologic follow-up generated by false-positive diagnoses while the other examined invasive follow-up. Intracolonic performance was identical for both tests. The median tipping point (maximum acceptable false-positive rate for extracolonic findings) was calculated overall and for both groups by bootstrap analysis.
Results

The median tipping point for radiologic follow-up occurred at a false-positive rate greater than 99.8% (interquartile ratio [IQR], 10 to >99.8%). Participants would tolerate at least a 99.8% rate of unnecessary radiologic tests to detect an additional extracolonic malignancy. The median tipping-point for invasive follow-up occurred at a false-positive rate of 10% (IQR, 2 to >99.8%). Tipping points were significantly higher for patients than for health care professionals for both experiments (>99.8 vs 40% for radiologic follow-up and >99.8 vs 5% for invasive follow-up, both P < .001).

Conclusion
Patients and health care professionals are willing to tolerate high rates of false-positive diagnoses with CT colonography in exchange for diagnosis of extracolonic malignancy. The actual specificity of screening CT colonography for extracolonic findings in clinical practice is likely to be highly acceptable to both patients and health care professionals.
0033-8419
144-52
Plumb, A.A.
0f3a0608-da56-4f99-ba20-381726d10f45
Boone, D.
b54da3ab-b521-4ef0-a50d-2425809e3569
Fitzke, H.
4f70be9f-630d-4ceb-aadf-9726a9f584df
Helbren, E.
419cb12c-ea4e-4f56-9bd6-0e6b8142f192
Mallett, S.
59832f8e-a54f-4ffe-9be5-4ead8aa6c6a1
Zhu, S.
19f66c61-95e9-4f6b-92db-64686bd581ad
Yao, G. L.
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Bell, N.
9502ade5-98f0-4ce9-ae86-7d58590e8c96
Ghanouni, A.
2f7d9446-2127-40f9-82be-7724138b6264
von Wagner, C.
2e0a9eb1-b1cf-41eb-ade1-dfb0234a9f66
Taylor, S.A.
fc691ddd-b33f-4f62-bb4c-641691726d0a
Altman, D.G.
c8c0dc66-dd65-4b27-bbce-40bc744536ff
Lilford, R.
5102134d-1c8d-491a-a8fc-e5b42d1c3009
Halligan, S.
d4660e12-21e6-498c-b52c-96a3262a914c
Plumb, A.A.
0f3a0608-da56-4f99-ba20-381726d10f45
Boone, D.
b54da3ab-b521-4ef0-a50d-2425809e3569
Fitzke, H.
4f70be9f-630d-4ceb-aadf-9726a9f584df
Helbren, E.
419cb12c-ea4e-4f56-9bd6-0e6b8142f192
Mallett, S.
59832f8e-a54f-4ffe-9be5-4ead8aa6c6a1
Zhu, S.
19f66c61-95e9-4f6b-92db-64686bd581ad
Yao, G. L.
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Bell, N.
9502ade5-98f0-4ce9-ae86-7d58590e8c96
Ghanouni, A.
2f7d9446-2127-40f9-82be-7724138b6264
von Wagner, C.
2e0a9eb1-b1cf-41eb-ade1-dfb0234a9f66
Taylor, S.A.
fc691ddd-b33f-4f62-bb4c-641691726d0a
Altman, D.G.
c8c0dc66-dd65-4b27-bbce-40bc744536ff
Lilford, R.
5102134d-1c8d-491a-a8fc-e5b42d1c3009
Halligan, S.
d4660e12-21e6-498c-b52c-96a3262a914c

Plumb, A.A., Boone, D., Fitzke, H., Helbren, E., Mallett, S., Zhu, S., Yao, G. L., Bell, N., Ghanouni, A., von Wagner, C., Taylor, S.A., Altman, D.G., Lilford, R. and Halligan, S. (2014) Detection of extracolonic pathologic findings with CT colonography: a discrete choice experiment of perceived benefits versus harms. Radiology, 273 (1), 144-52. (doi:10.1148/radiol.14131678). (PMID:24865308)

Record type: Article

Abstract

Purpose
To determine the maximum rate of false-positive diagnoses that patients and health care professionals were willing to accept in exchange for detection of extracolonic malignancy by using computed tomographic (CT) colonography for colorectal cancer screening.
Materials and Methods

After obtaining ethical approval and informed consent, 52 patients and 50 health care professionals undertook two discrete choice experiments where they chose between unrestricted CT colonography that examined intra- and extracolonic organs or CT colonography restricted to the colon, across different scenarios. The first experiment detected one extracolonic malignancy per 600 cases with a false-positive rate varying across scenarios from 0% to 99.8%. One experiment examined radiologic follow-up generated by false-positive diagnoses while the other examined invasive follow-up. Intracolonic performance was identical for both tests. The median tipping point (maximum acceptable false-positive rate for extracolonic findings) was calculated overall and for both groups by bootstrap analysis.
Results

The median tipping point for radiologic follow-up occurred at a false-positive rate greater than 99.8% (interquartile ratio [IQR], 10 to >99.8%). Participants would tolerate at least a 99.8% rate of unnecessary radiologic tests to detect an additional extracolonic malignancy. The median tipping-point for invasive follow-up occurred at a false-positive rate of 10% (IQR, 2 to >99.8%). Tipping points were significantly higher for patients than for health care professionals for both experiments (>99.8 vs 40% for radiologic follow-up and >99.8 vs 5% for invasive follow-up, both P < .001).

Conclusion
Patients and health care professionals are willing to tolerate high rates of false-positive diagnoses with CT colonography in exchange for diagnosis of extracolonic malignancy. The actual specificity of screening CT colonography for extracolonic findings in clinical practice is likely to be highly acceptable to both patients and health care professionals.

Full text not available from this repository.

More information

Published date: October 2014
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 372003
URI: https://eprints.soton.ac.uk/id/eprint/372003
ISSN: 0033-8419
PURE UUID: 32bd25ed-7fa8-47a3-9cee-0ef2e579346c

Catalogue record

Date deposited: 26 Nov 2014 12:08
Last modified: 15 Jul 2019 21:38

Export record

Altmetrics

Contributors

Author: A.A. Plumb
Author: D. Boone
Author: H. Fitzke
Author: E. Helbren
Author: S. Mallett
Author: S. Zhu
Author: G. L. Yao
Author: N. Bell
Author: A. Ghanouni
Author: C. von Wagner
Author: S.A. Taylor
Author: D.G. Altman
Author: R. Lilford
Author: S. Halligan

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×