Biomedical subjects

Kenneth Binmoeller

Publications and source records attributed to Kenneth Binmoeller.

3 recordsLinked to original sources

PubMed2006

Prospective comparison of patient experience with colon imaging tests.

PURPOSE: Patient experience varies with the currently available colon imaging tests, including air contrast barium enema, computed tomographic colonography, and colonoscopy. We examined differences in patient experience with colon imaging tests and whether they varied with gender, age, and race. SUBJECTS AND METHODS: Patients with fecal occult blood, hematochezia, iron-deficiency anemia, or a family history of colon cancer underwent air contrast barium enema followed 7 to 14 days later by computed tomographic colonography and colonoscopy. Validated patient experience questionnaires that measured the experience for each test and a separate questionnaire that obtained an overall summary measure were administered after testing. Eleven patient experiences including pain, embarrassment, difficulty with bowel preparation, and satisfaction with tests were examined. RESULTS: A total of 614 subjects completed all 3 imaging tests. The test most patients were willing to repeat was colonoscopy; it also was reported to be the least painful procedure. Patients were least satisfied with air contrast barium enema, and fewer would undergo air contrast barium enema compared with computed tomographic colonography or colonoscopy. There were limited racial and gender differences in perceptions of the tests. Younger adults perceived air contrast barium enema to be more painful than older adults. CONCLUSION: Taking into account a wide variety of patient experience measures, patients preferred colonoscopy to air contrast barium enema and computed tomographic colonography. This finding has important implications for physicians considering different colon imaging tests.

Barium Sulfate↗

PubMed2006

What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers.

BACKGROUND: Performance parameters for double-balloon enteroscopy (DBE) have not been described. OBJECTIVE: To determine the learning curve for DBE. DESIGN: Prospective cohort study. SETTING: Six U.S. tertiary centers. PATIENTS: A total of 188 subjects undergoing 237 DBE procedures; 130 (69%) with obscure GI bleeding. INTERVENTIONS: Performance parameters from each center's initial 10 cases were compared to the subsequent examinations. MAIN OUTCOME MEASUREMENTS: Exam duration, depth of insertion, and findings on DBE examination. RESULTS: DBE was introduced by mouth in 149 (63%) cases, by rectum in 77 (33%) cases, and through a stoma in 6 (2.5%) patients. The mean (+/-SD) duration was 109.1 +/- 44.6 minutes for the first 10 cases and 92.4 +/- 37.6 minutes for subsequent cases (P = .005) but did not change for rectal DBE procedures. There was no change in mean depth of insertion, but the mean fluoroscopy time declined significantly (P = .025). Diagnostic or therapeutic maneuvers were performed in 64% of cases; DBE led to a diagnosis in 81 (43%) patients. A total of 78% of patients had prior capsule endoscopy (CE) with significant agreement between DBE and CE (kappa = 0.74). One perforation occurred (0.4%). Per-rectal cases failed to reach the small bowel in 24 (31%) cases. LIMITATIONS: All patients did not undergo initial CE. The therapeutic DBE scope was not available for the initial 8 months of the study. CONCLUSIONS: There was a significant decline in overall procedural time and fluoroscopy time after the initial 10 DBE cases. There was no improvement in performance parameters when DBE was performed via the rectal approach despite increased, but limited, operator experience.

Adolescent↗

PubMed2003

A direct comparison of ERCP teaching models.

BACKGROUND: Several teaching models for ERCP are now available. Live, anesthetized porcine models have been used for many years, but harvested porcine organ preparations have recently been developed, and computer-based endoscopy simulators now incorporate ERCP modules. Each has proven to be a useful educational modality, but there is no direct comparison among these models. This study compared the performance of these 3 ERCP teaching models. METHODS: Twenty endoscopists used each ERCP training model (computer simulator, harvested porcine organ, live anesthetized pig) and then completed a survey grading the realism and performance of each model compared with performance of ERCP in patients. A rank order was established for the models relative to their realism, educational utility, ease of use, and ease of incorporation into a training program. RESULTS: The harvested porcine organ model scored highest on indices of realism, usefulness, and performance, although this reached statistical significance only for "ease of use" (p < 0.05). Conversely, the computer simulator scored significantly lower in most realism scores, although it was felt to be the one model most easily incorporated into a training program. CONCLUSIONS: Although each ERCP teaching model has proven to be a useful training modality, the harvested porcine organ model was felt to be the most realistic as well as the most favorable model for instruction in both basic and advanced ERCP.

Adult↗