Background NICE recommend choosing “investigations that give the most information about diagnosis and staging with the least risk to the patient” when diagnosing and treating lung cancer. Patient experience data was collected in order to review our service and also as anecdotally it was felt that some investigations were better tolerated than others.
Methods Patients were identified following the weekly MDT; 127 consecutive adults who had undergone either EBUS, EUS, Bronchoscopy, FNA of a neck node or pleural aspiration were sent an anonymous, patient satisfaction questionnaire, 87 responded (69%). Simple questions regarding the practicalities of arranging the test were asked and participants were also required to rate their experience on a scale from1 (very poor) to 10 (excellent). Similarly they were asked to score various aspects of the investigations like pain and discomfort on a 10 point scale and the scores were compared between the investigations.
Results All respondents felt they had received an adequate explanation of the test including the indication and risks. The highest rated investigation (on a 1 to 10 scale) was an US guided FNA of a neck node. See Table 1.
The most ‘uncomfortable’ procedure was an EUS; this was also the endoscopic procedure that was most likely to be fully remembered. Less than 10% of patients undergoing a bronchoscopic procedure reported that they had full recall of the test.
When asked whether they would have the procedure again if advised, no patient said they would never have the test again.
The worst thing about the investigations was either cough or pain whilst the requirement to stay in one position was commented on by a significant number of patients undergoing a radiologically guided procedure.
Conclusions No one test appeared significantly more tolerable than any other but EUS seem to be the most uncomfortable test. This information will help the team to present clinical equipoise when recommending investigations.
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