The inconvenience of investigations used in hepatology: patients' and hepatologists' opinions

The purpose of this study was to estimate and compare the inconvenience of six investigations used in hepatology, as experienced by 113 inpatients and imagined by 80 hepatologists. For patients, the investigations, in order of increased inconvenience rate were: (1) venous puncture, (2) BSP clearance, (3) transvenous liver biopsy, (4) percutaneous liver biopsy, (5) laparoscopy and (6) oesogastroscopy. Hepatologists gave a higher inconvenience rate for all investigations than patients and the ranking of the crude inconvenience rate of each investigation was different for hepatologists and patients. For 84% of patients, oesogastroscopy was over 10 times more inconvenient than a venous puncture, whereas only 15% of hepatologists considered oesogastroscopy over 10 times more inconvenient (p less than 0.001). Multidimensional analysis indicated that hepatologists underestimated the role of pain in the rejection of re-investigation for transvenous liver biopsy, percutaneous liver biopsy and oesogastroscopy. These results suggest that hepatologists must improve the psychological and pharmacological premedication of these investigations according to the reaction of their patients, especially before oesogastroscopy.