Memories of colonoscopy: a randomized trial
This is the randomised trial that followed, and it is the strongest evidence in the peak-end literature because it intervened rather than observed. Nearly seven hundred patients undergoing colonoscopy were randomly assigned either to the standard procedure or to one with a short period added at the end during which the instrument was left still, which is uncomfortable but much less so than the procedure itself. Patients in the extended group experienced the final moments as less painful, rated the whole experience as less unpleasant, and ranked it as less aversive against a list of other unpleasant experiences, despite having undergone strictly more discomfort in total. Over a median follow-up of more than five years, they were also somewhat more likely to return for a repeat examination. The authors are careful in their framing: a memory failure demonstrated in the laboratory can be used deliberately in a clinical setting to make necessary procedures more repeatable.
This is the randomised trial that followed, and it is the strongest evidence in the peak-end literature because it intervened rather than observed. Nearly seven hundred patients undergoing colonoscopy were randomly assigned either to the standard procedure or to one with a short period added at the end during which the instrument was left still, which is uncomfortable but much less so than the procedure itself. Patients in the extended group experienced the final moments as less painful, rated the whole experience as less unpleasant, and ranked it as less aversive against a list of other unpleasant experiences, despite having undergone strictly more discomfort in total. Over a median follow-up of more than five years, they were also somewhat more likely to return for a repeat examination. The authors are careful in their framing: a memory failure demonstrated in the laboratory can be used deliberately in a clinical setting to make necessary procedures more repeatable.
Written from the abstract, OpenAlex.
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104(1-2), 187-194. PubMed 12855328. 682 consecutive outpatients. Final moments 1.7 versus 2.5 on a ten-point pain scale; whole experience 4.4 versus 4.9; ranked 4.1 versus 4.6 against seven other unpleasant experiences, with 8 the worst. Return for repeat colonoscopy about 50.4 per cent overall over a median follow-up of about 5.3 years, odds ratio 1.41 for the extended-ending group.
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https://doi.org/10.1016/S0304-3959(03)00003-400003-4)
DOI: 10.1016/S0304-3959(03)00003-4