23 research outputs found
Teaching a Prisoner to Fish: Getting Tough on Crime by Preparing Prisoners to Reenter Society
Debunking the Stranger in the Bushes Myth: The Case for Sexual Assault Protection Orders
WASh multicentre randomised controlled trial: water-assisted sigmoidoscopy in English NHS bowel scope screening
Objectives: The English Bowel Cancer Screening
Programme invites 55 year olds for a sigmoidoscopy
(Bowel Scope Screening (BSS)), aiming to resect
premalignant polyps, thus reducing cancer incidence. A
national patient survey indicated higher procedural pain
than anticipated, potentially impacting on screening
compliance and effectiveness. We aimed to assess
whether water-assisted sigmoidoscopy (WAS), as
opposed to standard CO2
technique, improved procedural
pain and detection of adenomatous polyps.
Design: The WASh (Water-Assisted Sigmoidoscopy)
trial was a multicentre, single-blind, randomised control
trial for people undergoing BSS. Participants were
randomised to either receive WAS or CO2
from five sites
across England. The primary outcome measure was
patient-reported moderate/severe pain, as assessed by
patients on a standard Likert scale post procedure prior
to discharge. The key secondary outcome was adenoma
detection rate (ADR). The costs of each technique were
also measured.
Results: 1123 participants (50% women, mean age
55) were randomised (561 WAS, 562 CO2
). We found
no difference in patient-reported moderate/severe pain
between WAS and CO2
(14% in WAS, 15% in CO2;
p=0.47). ADR was 15% in the CO2
arm and 11% in
the WAS arm (p=0.03); however, it remained above the
minimum national performance standard in both arms.
There was no statistical difference in mean number of
adenomas nor overall polyp detection rate. There was
negligible cost difference between the two techniques.
Conclusion: In the context of enema-prepared
unsedated screening sigmoidoscopies performed by
screening-accredited endoscopists, no difference in
patient-reported pain was seen when using either a CO2
or WAS intubation technique.
Trial registration number: ISRCTN8146687