Patient-Centered Assessment of the Value of Oral Contrast Material

Abstract

Purpose: The aim of this study was to measure the value of oral contrast material from the patient's point of view.

Methods: A prospective HIPAA-compliant survey was administered from August 30, 2016, to March 9, 2017, at two outpatient centers to consecutive outpatients immediately after oral contrast material consumption for abdominopelvic CT. The survey included validated measures of temporary health disutility and oral contrast-specific questions vetted by patient advocates with experience in survey design. Descriptive statistics were calculated.

Results: The response rate (93% [218 of 234]) and completion rate (100% [218 of 218]) were excellent. When given a hypothetical choice to not drink oral contrast, most subjects (89% [193 of 218]) stated that they would always drink it for fear of missing an important finding, and only 5 (2%) stated that they would never drink it regardless of risk. Twenty (9%) said that the decision to drink oral contrast would depend on the level of risk, with 18 (8%) indicating that they would accept a 0.01% to 1.00% risk for missing an important finding if they did not have to drink oral contrast. Most patients rated the oral contrast taste as tolerable (55% [120 of 218]); a minority rated it bad or terrible (10% [21 or 218]). Thirty-six subjects (17%) experienced concern or unease (8 minimal, 15 mild, 10 moderate, 3 extreme) when they learned that they had to drink oral contrast, and 36 (17%) experienced oral contrast-induced nausea or abdominal discomfort (10 minimal, 15 mild, 10 moderate, 1 extreme).

Conclusions: If oral contrast material has any diagnostic benefit, most outpatients (89%) would rather drink it than accept any risk for missing an important finding.

Keywords: Oral contrast; health disutility; patient preferences; value.