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Steve Halligan - One of the best experts on this subject based on the ideXlab platform.
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computed tomographic colonography versus Barium Enema for diagnosis of colorectal cancer or large polyps in symptomatic patients siggar a multicentre randomised trial
The Lancet, 2013Co-Authors: Steve Halligan, C Von Wagner, Edward Dadswell, Katherine Wooldrage, Robert Edwards, Ines Kraljhans, Guiqing Yao, Clive Kay, David Burling, Omar FaizAbstract:Background Barium Enema (BE) is widely available for diagnosis of colorectal cancer despite concerns about its accuracy and acceptability. Computed tomographic colonography (CTC) might be a more sensitive and acceptable alternative. We aimed to compare CTC and BE for diagnosis of colorectal cancer or large polyps in symptomatic patients in clinical practice. Methods This pragmatic multicentre randomised trial recruited patients with symptoms suggestive of colorectal cancer from 21 UK hospitals. Eligible patients were aged 55 years or older and regarded by their referring clinician as suitable for radiological investigation of the colon. Patients were randomly assigned (2:1) to BE or CTC by computer-generated random numbers, in blocks of six, stratified by trial centre and sex. We analysed the primary outcome-diagnosis of colorectal cancer or large (≥10 mm) polyps-by intention to treat. The trial is an International Standard Randomised Controlled Trial, number 95152621. Findings 3838 patients were randomly assigned to receive either BE (n=2553) or CTC (n=1285). 34 patients withdrew consent, leaving for analysis 2527 assigned to BE and 1277 assigned to CTC. The detection rate of colorectal cancer or large polyps was significantly higher in patients assigned to CTC than in those assigned to BE (93 [7.3%] of 1277 vs 141 [5.6%] of 2527, relative risk 1.31, 95% CI 1.01-1.68; p=0.0390). CTC missed three of 45 colorectal cancers and BE missed 12 of 85. The rate of additional colonic investigation was higher after CTC than after BE (283 [23.5%] of 1206 CTC patients had additional investigation vs 422 [18.3%] of 2300 BE patients; p=0.0003), due mainly to a higher polyp detection rate. Serious adverse events were rare. Interpretation CTC is a more sensitive test than BE. Our results suggest that CTC should be the preferred radiological test for patients with symptoms suggestive of colorectal cancer. Funding NIHR Health Technology Assessment Programme, NIHR Biomedical Research Centres funding scheme, Cancer Research UK, EPSRC Multidisciplinary Assessment of Technology Centre for Healthcare, and NIHR Collaborations for Leadership in Applied Health Research and Care.
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patient acceptability of ct colonography compared with double contrast Barium Enema results from a multicentre randomised controlled trial of symptomatic patients
European Radiology, 2011Co-Authors: C Von Wagner, Steve Halligan, Richard J Lilford, Dion Morton, Samuel G Smith, Alex Ghanouni, Emily Power, Edward Dadswell, Wendy AtkinAbstract:Objectives To determine patient acceptability of Barium Enema (BE) or CT colonography (CTC).
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patient experiences of colonoscopy Barium Enema and ct colonography a qualitative study
British Journal of Radiology, 2009Co-Authors: C Von Wagner, K Knight, Steve Halligan, Wendy Atkin, Richard J Lilford, Dion Morton, Jane WardleAbstract:Previous studies of patient experience with bowel screening tests, in particular CT colonography (CTC), have superimposed global rating scales and not explored individual experience in detail. To redress this, we performed qualitative interviews in order to characterize patient expectations and experiences in depth. Following ethical permission, 16 patients undergoing CTC, 18 undergoing colonoscopy and 15 undergoing Barium Enema agreed to a semi-structured interview by a health psychologist. Interviews were recorded, responses transcribed and themes extracted with the aim of assimilating individual experiences to facilitate subsequent development and interpretation of quantitative surveys of overall satisfaction with each diagnostic test. Transcript analysis identified three principal themes: physical sensations, social interactions and information provision. Physical sensations differed for each test but were surprisingly well tolerated overall. Social interactions with staff were perceived as very important in colouring the whole experience, particularly in controlling the feelings of embarrassment, which was critical for all procedures. information provision was also an important determinant of experience. Verbal feedback was most common during colonoscopy and invariably reassuring. However, patients undergoing CTC received little visual or verbal feedback and were often confused regarding the test outcome. Barium Enema had no specific advantage over other tests, Qualitative interviews provided important perspectives on patient experience. Our data demonstrated that models describing the quality of medical encounters are applicable to single diagnostic episodes. Staff interactions and information provision were particularly important. We found advantages specific to both CTC and colonoscopy but none for Barium Enema. CTC could benefit greatly from improved information provision following examination.
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design of a multicentre randomized trial to evaluate ct colonography versus colonoscopy or Barium Enema for diagnosis of colonic cancer in older symptomatic patients the siggar study
Trials, 2007Co-Authors: Steve Halligan, Richard J Lilford, Dion Morton, Jane Wardle, Pauline Rogers, Katherine Wooldrage, Robert Edwards, Reshma Kanani, Urvi Shah, Wendy AtkinAbstract:Background and Aims The standard whole-colon tests used to investigate patients with symptoms of colorectal cancer are Barium Enema and colonoscopy. Colonoscopy is the reference test but is technically difficult, resource intensive, and associated with adverse events, especially in the elderly. Barium Enema is safer but has reduced sensitivity for cancer. CT colonography ("virtual colonoscopy") is a newer alternative that may combine high sensitivity for cancer with safety and patient acceptability. The SIGGAR trial aims to determine the diagnostic efficacy, acceptability, and economic costs associated with this new technology.
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observer variation in the detection of colorectal neoplasia on double contrast Barium Enema implications for colorectal cancer screening and training
Clinical Radiology, 2004Co-Authors: Steve Halligan, C. I. Bartram, Stuart A Taylor, Paul Bassett, M Marshall, Christopher Cardwell, Wendy AtkinAbstract:AIM: To assess inter-observer error for the diagnosis of neoplasia on double contrast Barium Enema (DCBE) in the light of claims that no additional interpretative training would be needed for implementation in a national screening programme. MATERIALS AND METHODS: 10 experts, 10 consultants, and 10 experienced trainees each reported 20 DCBE studies, of which two showed cancer, three showed large polyps, four showed small polyps, and 12 were normal. Inter-observer variation was compared using odds ratios with the trainee group as reference (baseline group). RESULTS: Experts were significantly more likely to correctly identify neoplasia on DCBE than trainees. The odds of a correct diagnosis for experts were 2.79 (95% CI 2.04, 3.81) for cancer, 2.36 (1.88, 2.97) for large polyps, and 3.50 (1.98, 6.18) for small polyps. While consultants were more likely to correctly diagnose a large polyp than trainees, 1.45 (1.15, 1.84), there was no significant difference between these two groups for the correct diagnosis of either cancer, 1.24 (0.52, 2.96), or small polyps, 1.26 (0.83, 1.90). A cancer was missed by 6 (60%) experts, 9 (90%) consultants, and 8 (80%) trainees. Large polyps were missed by 4 (40%) experts, 5 (50%) consultants, and 6 (60%) trainees. There was no significant difference between any group when false positive diagnoses were considered. CONCLUSIONS: There is considerable inter-observer perceptive error for the diagnosis of neoplasia on DCBE. Experts performed significantly better than other observers but the overall standard of performance was poor, even amongst experts.
John C Lappas - One of the best experts on this subject based on the ideXlab platform.
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colonoscopy evaluations justification by cost
The American Journal of Gastroenterology, 1996Co-Authors: D K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:The type of colonic imaging (radiological vs colonoscopic) for evaluating symptomatic patients without evidence of bleeding in both an efficacious and cost-conserving manner has become a very debated issue. In a randomized, controlled clinical trial, the authors hoped to examine the prevalence of neoplasm and the effectiveness and cost-effectiveness of initial diagnostic strategies of colonoscopy versus flexible sigmoidoscopy and air contrast Barium Enema in patients without evidence of intestinal bleeding. One hundred forty-nine patients over the age of 40 with symptoms suggestive a colonic disease without evidence of bleeding (no hematechezia, negative test for fecal occult blood, and normal serum hemoglobin) were randomized to undergo either initial colonoscopy or flexible sigmoidoscopy plus Barium Enema. Patients with incomplete lower GI tests were referred for the corresponding alternative imaging modality. Cost analyses using sensitivity analysis were performed. Baseline information with respect to age, race, sex, inpatient status, reason for referral, mean weight loss, hemoglobin, blood urea nitrogen, and albumin were similar in both groups. Eighteen patients (24%) who initially received air contrast Barium Enema and flexible sigmoidoscopy then required colonoscopy, whereas only five patients (6%) who initially underwent colonoscopy first required air contrast Barium Enema plus flexible sigmoidoscopy. The study found that: a) The prevalence of cancer in the study was low (one of 149 patients); b) initial colonoscopy detected more persons with adenomas than that of air contrast Barium Enema plus flexible sigmoidoscopy (23 of 75 patients vs 13 of 74 patients, odds radio, 2.07, CI,0.90-4.92; this approached significance); and c) air contrast Barium Enema plus flexible sigmoidoscopy detected more diverticulosis (46 of 74 patients vs 31 of 75 patients, odds ratio, 0.41, 95% CI, 0.21-0.87). The significant conclusions were that patients undergoing flexible sigmoidoscopy plus air contrast Barium Enema were more likely to undergo alternative procedures and that sensitivity analysis suggested that, for most areas in the United States, initial colonoscopy would be more cost-effective for the outcome of detection of adenomas (1).
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flexible sigmoidoscopy plus air contrast Barium Enema versus colonoscopy for evaluation of symptomatic patients without evidence of bleeding
Gastrointestinal Endoscopy, 1995Co-Authors: Douglas K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:One hundred forty-nine patients aged 40 years or more with symptoms suggestive of colonic disease but without evidence of gastrointestinal bleeding (absence of hematochezia, normal serum levels of hemoglobin, and at least one test negative for fecal occult blood) were randomized to undergo either initial colonoscopy or initial flexible sigmoidoscopy plus air-contrast Barium Enema. Patients with incomplete initial colonoscopy and certain patients with polyps seen on flexible sigmoidoscopy plus Barium Enema underwent the alternative procedure (Barium Enema or colonoscopy). The main results were as follows: First, the overall prevalence of cancer in the study was very low (0.67%). Second, initial flexible sigmoidoscopy plus Barium Enema detected more patients with diverticulosis than did initial colonoscopy (46% versus 31%; p = .01). Initial colonoscopy detected more persons with adenomas (p = .06) than did initial flexible sigmoidoscopy plus Barium Enema. Patients undergoing initial flexible sigmoidoscopy plus Barium Enema require the alternative procedure (24%) than were patients undergoing initial colonoscopy (6%; p = .002). Third, sensitivity analyses suggested that for most areas in the United States, initial colonoscopy would be more cost-effective for the outcomes of detection of adenomas and detection of large adenomas, although very few patients in the study had large adenomas. We conclude that the prevalence of colorectal cancer in persons with colonic symptoms but no evidence of bleeding is low and is comparable with the prevalence in an asymptomatic population. Cost-effective selection of imaging strategies in this population can be based on demographic factors such as age and sex, which are better predictors of the presence of adenomas than are symptoms.
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quality of air contrast Barium Enema performed the same day as incomplete colonoscopy with air insufflation
Gastrointestinal Endoscopy, 1992Co-Authors: David Mark, Douglas K Rex, John C LappasAbstract:The quality of 17 air contrast Barium Enemas performed the same day as incomplete colonoscopies using air insufflation was compared with 21 air contrast Barium Enemas performed on a different day from incomplete colonoscopies. A gastrointestinal radiologist blinded to the timing of the procedures reviewed the Barium studies scoring them as 1 (unsatisfactory) to 4 (excellent) in four areas. The mean overall quality score for the air contrast Barium Enemas done the same day as incomplete colonoscopy was 3.29 vs. 2.97 for those done on a different day (p = 0.24). There were no significant differences in quality scores between same-day versus different-day air contrast Barium Enemas for the specific parameters of quality of distention, Barium coating, and amount of spasm. We conclude that when colonoscopy using air insufflation is incomplete because of looping or angulation, air contrast Barium Enema can be done the same day without impairing the quality of the Barium study.
David Mark - One of the best experts on this subject based on the ideXlab platform.
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colonoscopy evaluations justification by cost
The American Journal of Gastroenterology, 1996Co-Authors: D K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:The type of colonic imaging (radiological vs colonoscopic) for evaluating symptomatic patients without evidence of bleeding in both an efficacious and cost-conserving manner has become a very debated issue. In a randomized, controlled clinical trial, the authors hoped to examine the prevalence of neoplasm and the effectiveness and cost-effectiveness of initial diagnostic strategies of colonoscopy versus flexible sigmoidoscopy and air contrast Barium Enema in patients without evidence of intestinal bleeding. One hundred forty-nine patients over the age of 40 with symptoms suggestive a colonic disease without evidence of bleeding (no hematechezia, negative test for fecal occult blood, and normal serum hemoglobin) were randomized to undergo either initial colonoscopy or flexible sigmoidoscopy plus Barium Enema. Patients with incomplete lower GI tests were referred for the corresponding alternative imaging modality. Cost analyses using sensitivity analysis were performed. Baseline information with respect to age, race, sex, inpatient status, reason for referral, mean weight loss, hemoglobin, blood urea nitrogen, and albumin were similar in both groups. Eighteen patients (24%) who initially received air contrast Barium Enema and flexible sigmoidoscopy then required colonoscopy, whereas only five patients (6%) who initially underwent colonoscopy first required air contrast Barium Enema plus flexible sigmoidoscopy. The study found that: a) The prevalence of cancer in the study was low (one of 149 patients); b) initial colonoscopy detected more persons with adenomas than that of air contrast Barium Enema plus flexible sigmoidoscopy (23 of 75 patients vs 13 of 74 patients, odds radio, 2.07, CI,0.90-4.92; this approached significance); and c) air contrast Barium Enema plus flexible sigmoidoscopy detected more diverticulosis (46 of 74 patients vs 31 of 75 patients, odds ratio, 0.41, 95% CI, 0.21-0.87). The significant conclusions were that patients undergoing flexible sigmoidoscopy plus air contrast Barium Enema were more likely to undergo alternative procedures and that sensitivity analysis suggested that, for most areas in the United States, initial colonoscopy would be more cost-effective for the outcome of detection of adenomas (1).
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flexible sigmoidoscopy plus air contrast Barium Enema versus colonoscopy for evaluation of symptomatic patients without evidence of bleeding
Gastrointestinal Endoscopy, 1995Co-Authors: Douglas K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:One hundred forty-nine patients aged 40 years or more with symptoms suggestive of colonic disease but without evidence of gastrointestinal bleeding (absence of hematochezia, normal serum levels of hemoglobin, and at least one test negative for fecal occult blood) were randomized to undergo either initial colonoscopy or initial flexible sigmoidoscopy plus air-contrast Barium Enema. Patients with incomplete initial colonoscopy and certain patients with polyps seen on flexible sigmoidoscopy plus Barium Enema underwent the alternative procedure (Barium Enema or colonoscopy). The main results were as follows: First, the overall prevalence of cancer in the study was very low (0.67%). Second, initial flexible sigmoidoscopy plus Barium Enema detected more patients with diverticulosis than did initial colonoscopy (46% versus 31%; p = .01). Initial colonoscopy detected more persons with adenomas (p = .06) than did initial flexible sigmoidoscopy plus Barium Enema. Patients undergoing initial flexible sigmoidoscopy plus Barium Enema require the alternative procedure (24%) than were patients undergoing initial colonoscopy (6%; p = .002). Third, sensitivity analyses suggested that for most areas in the United States, initial colonoscopy would be more cost-effective for the outcomes of detection of adenomas and detection of large adenomas, although very few patients in the study had large adenomas. We conclude that the prevalence of colorectal cancer in persons with colonic symptoms but no evidence of bleeding is low and is comparable with the prevalence in an asymptomatic population. Cost-effective selection of imaging strategies in this population can be based on demographic factors such as age and sex, which are better predictors of the presence of adenomas than are symptoms.
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quality of air contrast Barium Enema performed the same day as incomplete colonoscopy with air insufflation
Gastrointestinal Endoscopy, 1992Co-Authors: David Mark, Douglas K Rex, John C LappasAbstract:The quality of 17 air contrast Barium Enemas performed the same day as incomplete colonoscopies using air insufflation was compared with 21 air contrast Barium Enemas performed on a different day from incomplete colonoscopies. A gastrointestinal radiologist blinded to the timing of the procedures reviewed the Barium studies scoring them as 1 (unsatisfactory) to 4 (excellent) in four areas. The mean overall quality score for the air contrast Barium Enemas done the same day as incomplete colonoscopy was 3.29 vs. 2.97 for those done on a different day (p = 0.24). There were no significant differences in quality scores between same-day versus different-day air contrast Barium Enemas for the specific parameters of quality of distention, Barium coating, and amount of spasm. We conclude that when colonoscopy using air insufflation is incomplete because of looping or angulation, air contrast Barium Enema can be done the same day without impairing the quality of the Barium study.
Glen A Lehman - One of the best experts on this subject based on the ideXlab platform.
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colonoscopy evaluations justification by cost
The American Journal of Gastroenterology, 1996Co-Authors: D K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:The type of colonic imaging (radiological vs colonoscopic) for evaluating symptomatic patients without evidence of bleeding in both an efficacious and cost-conserving manner has become a very debated issue. In a randomized, controlled clinical trial, the authors hoped to examine the prevalence of neoplasm and the effectiveness and cost-effectiveness of initial diagnostic strategies of colonoscopy versus flexible sigmoidoscopy and air contrast Barium Enema in patients without evidence of intestinal bleeding. One hundred forty-nine patients over the age of 40 with symptoms suggestive a colonic disease without evidence of bleeding (no hematechezia, negative test for fecal occult blood, and normal serum hemoglobin) were randomized to undergo either initial colonoscopy or flexible sigmoidoscopy plus Barium Enema. Patients with incomplete lower GI tests were referred for the corresponding alternative imaging modality. Cost analyses using sensitivity analysis were performed. Baseline information with respect to age, race, sex, inpatient status, reason for referral, mean weight loss, hemoglobin, blood urea nitrogen, and albumin were similar in both groups. Eighteen patients (24%) who initially received air contrast Barium Enema and flexible sigmoidoscopy then required colonoscopy, whereas only five patients (6%) who initially underwent colonoscopy first required air contrast Barium Enema plus flexible sigmoidoscopy. The study found that: a) The prevalence of cancer in the study was low (one of 149 patients); b) initial colonoscopy detected more persons with adenomas than that of air contrast Barium Enema plus flexible sigmoidoscopy (23 of 75 patients vs 13 of 74 patients, odds radio, 2.07, CI,0.90-4.92; this approached significance); and c) air contrast Barium Enema plus flexible sigmoidoscopy detected more diverticulosis (46 of 74 patients vs 31 of 75 patients, odds ratio, 0.41, 95% CI, 0.21-0.87). The significant conclusions were that patients undergoing flexible sigmoidoscopy plus air contrast Barium Enema were more likely to undergo alternative procedures and that sensitivity analysis suggested that, for most areas in the United States, initial colonoscopy would be more cost-effective for the outcome of detection of adenomas (1).
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flexible sigmoidoscopy plus air contrast Barium Enema versus colonoscopy for evaluation of symptomatic patients without evidence of bleeding
Gastrointestinal Endoscopy, 1995Co-Authors: Douglas K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:One hundred forty-nine patients aged 40 years or more with symptoms suggestive of colonic disease but without evidence of gastrointestinal bleeding (absence of hematochezia, normal serum levels of hemoglobin, and at least one test negative for fecal occult blood) were randomized to undergo either initial colonoscopy or initial flexible sigmoidoscopy plus air-contrast Barium Enema. Patients with incomplete initial colonoscopy and certain patients with polyps seen on flexible sigmoidoscopy plus Barium Enema underwent the alternative procedure (Barium Enema or colonoscopy). The main results were as follows: First, the overall prevalence of cancer in the study was very low (0.67%). Second, initial flexible sigmoidoscopy plus Barium Enema detected more patients with diverticulosis than did initial colonoscopy (46% versus 31%; p = .01). Initial colonoscopy detected more persons with adenomas (p = .06) than did initial flexible sigmoidoscopy plus Barium Enema. Patients undergoing initial flexible sigmoidoscopy plus Barium Enema require the alternative procedure (24%) than were patients undergoing initial colonoscopy (6%; p = .002). Third, sensitivity analyses suggested that for most areas in the United States, initial colonoscopy would be more cost-effective for the outcomes of detection of adenomas and detection of large adenomas, although very few patients in the study had large adenomas. We conclude that the prevalence of colorectal cancer in persons with colonic symptoms but no evidence of bleeding is low and is comparable with the prevalence in an asymptomatic population. Cost-effective selection of imaging strategies in this population can be based on demographic factors such as age and sex, which are better predictors of the presence of adenomas than are symptoms.
Douglas K Rex - One of the best experts on this subject based on the ideXlab platform.
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relative sensitivity of colonoscopy and Barium Enema for detection of colorectal cancer in clinical practice
Gastroenterology, 1997Co-Authors: Douglas K Rex, Emad Y Rahmani, Joseph H Haseman, Gregory T Lemmel, Steven Kaster, Joseph S BuckleyAbstract:Background & Aims: The relative sensitivities of Barium To better understand the relative performance of coEnema and colonoscopy for colorectal cancer are still lonoscopy and Barium Enema in clinical practice, we debated. The aim of this study was to determine the identified 2193 consecutive cases of colorectal cancer in relative sensitivity of Barium Enema and colonoscopy 20 different hospitals in central Indiana and determined in general clinical practice. Methods: Medical records the diagnostic procedures performed in these patients in of 2193 consecutive colorectal cancer cases identified the 3-year period preceding the diagnosis and whether in 20 central Indiana hospitals were reviewed. All pro- colonoscopy or Barium Enema had detected the cancer. cedures performed within 3 years of the diagnosis were To our knowledge, this is the first large study to deteridentified. Results: The sensitivity of colonoscopy for mine the relative sensitivity of colonoscopy and Barium colorectal cancer (95%) was greater than that for barEnema for detection of colorectal cancer in a broad range ium Enema (82.9%), with an odds ratio of 3.93 for a missed cancer by Barium Enema compared with colon- of clinical practice environments and a geographic region. oscopy. The sensitivity of double-contrast Barium Enema (85.2%) was not different from that of single-con
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flexible sigmoidoscopy plus air contrast Barium Enema versus colonoscopy for evaluation of symptomatic patients without evidence of bleeding
Gastrointestinal Endoscopy, 1995Co-Authors: Douglas K Rex, David Mark, Brian Clarke, John C Lappas, Glen A LehmanAbstract:One hundred forty-nine patients aged 40 years or more with symptoms suggestive of colonic disease but without evidence of gastrointestinal bleeding (absence of hematochezia, normal serum levels of hemoglobin, and at least one test negative for fecal occult blood) were randomized to undergo either initial colonoscopy or initial flexible sigmoidoscopy plus air-contrast Barium Enema. Patients with incomplete initial colonoscopy and certain patients with polyps seen on flexible sigmoidoscopy plus Barium Enema underwent the alternative procedure (Barium Enema or colonoscopy). The main results were as follows: First, the overall prevalence of cancer in the study was very low (0.67%). Second, initial flexible sigmoidoscopy plus Barium Enema detected more patients with diverticulosis than did initial colonoscopy (46% versus 31%; p = .01). Initial colonoscopy detected more persons with adenomas (p = .06) than did initial flexible sigmoidoscopy plus Barium Enema. Patients undergoing initial flexible sigmoidoscopy plus Barium Enema require the alternative procedure (24%) than were patients undergoing initial colonoscopy (6%; p = .002). Third, sensitivity analyses suggested that for most areas in the United States, initial colonoscopy would be more cost-effective for the outcomes of detection of adenomas and detection of large adenomas, although very few patients in the study had large adenomas. We conclude that the prevalence of colorectal cancer in persons with colonic symptoms but no evidence of bleeding is low and is comparable with the prevalence in an asymptomatic population. Cost-effective selection of imaging strategies in this population can be based on demographic factors such as age and sex, which are better predictors of the presence of adenomas than are symptoms.
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quality of air contrast Barium Enema performed the same day as incomplete colonoscopy with air insufflation
Gastrointestinal Endoscopy, 1992Co-Authors: David Mark, Douglas K Rex, John C LappasAbstract:The quality of 17 air contrast Barium Enemas performed the same day as incomplete colonoscopies using air insufflation was compared with 21 air contrast Barium Enemas performed on a different day from incomplete colonoscopies. A gastrointestinal radiologist blinded to the timing of the procedures reviewed the Barium studies scoring them as 1 (unsatisfactory) to 4 (excellent) in four areas. The mean overall quality score for the air contrast Barium Enemas done the same day as incomplete colonoscopy was 3.29 vs. 2.97 for those done on a different day (p = 0.24). There were no significant differences in quality scores between same-day versus different-day air contrast Barium Enemas for the specific parameters of quality of distention, Barium coating, and amount of spasm. We conclude that when colonoscopy using air insufflation is incomplete because of looping or angulation, air contrast Barium Enema can be done the same day without impairing the quality of the Barium study.