Please use this identifier to cite or link to this item:
Title: Predictors of the experience of a Cytosponge test: analysis of patient survey data from the BEST3 trial
Authors: Ghimire, B
Landy, R
Maroni, R
Smith, SG
Debiram-Beecham, I
Sasieni, PD
Fitzgerald, RC
Rubin, G
Walter, FM
Waller, J
Attwood, S
Parmar, M
Delaney, B
de Caestecker, J
Atkin, W
Hackshaw, A
van Heyningen, C
Underwood, T
Stella, A
Saxby, C
Lorincz, A
Turnbull, N
Doorbar, J
Mannion-Krase, G
Kaimi, I
Kasanicki, M
Kelleher, S
Stockley, L
Assari, T
Kadyan, S
Hollamby, V
Edwards, K
MacDonald, H
Shaw, V
Leishman, H
Roper, H
McCloskey, K
Jung, H
Phillips, A
Masjak-Newman, G
Fell, K
Collins, H
Zolle, O
McGlone, P
Crabb, T
Merrin, L
Cross, M
Jones, A
Simpson, T
Murray, E
Perugia, A
Thompson, M
Dumbleton, J
Morar, M
Frowd, N
Hardcastle, A
Carmichael, D
Maxton, F
Farnworth, F
Baddeley, E
Offman, J
Keywords: Barrett’s oesophagus;cytosponge;patient experience;inventory to assess patient satisfaction
Issue Date: 10-Jan-2023
Publisher: BioMed Central
Citation: Ghimire, B. et al. (2023) 'Predictors of the experience of a Cytosponge test: analysis of patient survey data from the BEST3 trial', BMC Gastroenterology, 23 (1), 7, pp. 1 - 10. doi: 10.1186/s12876-022-02630-1.
Abstract: Copyright © The Author(s) 2023. Background: The Cytosponge is a cell-collection device, which, coupled with a test for trefoil factor 3 (TFF3), can be used to diagnose Barrett’s oesophagus, a precursor condition to oesophageal adenocarcinoma. BEST3, a large pragmatic, randomised, controlled trial, investigated whether offering the Cytosponge-TFF3 test would increase detection of Barrett’s. Overall, participants reported mostly positive experiences. This study reports the factors associated with the least positive experience. Methods: Patient experience was assessed using the Inventory to Assess Patient Satisfaction (IAPS), a 22-item questionnaire, completed 7–14 days after the Cytosponge test. Study cohort: All BEST3 participants who answered ≥ 15 items of the IAPS (N = 1458). Statistical analysis: A mean IAPS score between 1 and 5 (5 indicates most negative experience) was calculated for each individual. ‘Least positive’ experience was defined according to the 90th percentile. 167 (11.4%) individuals with a mean IAPS score of ≥ 2.32 were included in the ‘least positive’ category and compared with the rest of the cohort. Eleven patient characteristics and one procedure-specific factor were assessed as potential predictors of the least positive experience. Multivariable logistic regression analysis using backwards selection was conducted to identify factors independently associated with the least positive experience and with failed swallow at first attempt, one of the strongest predictors of least positive experience. Results: The majority of responders had a positive experience, with an overall median IAPS score of 1.7 (IQR 1.5–2.1). High (OR = 3.01, 95% CI 2.03–4.46, p < 0.001) or very high (OR = 4.56, 95% CI 2.71–7.66, p < 0.001) anxiety (relative to low/normal anxiety) and a failed swallow at the first attempt (OR = 3.37, 95% CI 2.14–5.30, p < 0.001) were highly significant predictors of the least positive patient experience in multivariable analyses. Additionally, sex (p = 0.036), height (p = 0.032), alcohol intake (p = 0.011) and education level (p = 0.036) were identified as statistically significant predictors. Conclusion: We have identified factors which predict patient experience. Identifying anxiety ahead of the procedure and discussing particular concerns with patients or giving them tips to help with swallowing the capsule might help improve their experience. Trial registration ISRCTN68382401.
Description: Availability of data and materials: The trial protocol, statistical analysis plan, and statistical report are available via the University of Cambridge data repository ( Datasets will be available from R Fitzgerald ( on request.
Other Identifiers: 7
Appears in Collections:Dept of Health Sciences Research Papers

Files in This Item:
File Description SizeFormat 
FullText.pdfCopyright © The Author(s) 2023. Rights and permissions: Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.866.86 kBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons