196
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Reduction of Claustrophobia with Short-Bore versus Open Magnetic Resonance Imaging: A Randomized Controlled Trial

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Claustrophobia is a common problem precluding MR imaging. The purpose of the present study was to assess whether a short-bore or an open magnetic resonance (MR) scanner is superior in alleviating claustrophobia.

          Methods

          Institutional review board approval and patient informed consent were obtained to compare short-bore versus open MR. From June 2008 to August 2009, 174 patients (139 women; mean age = 53.1 [SD 12.8]) with an overall mean score of 2.4 (SD 0.7, range 0 to 4) on the Claustrophobia Questionnaire (CLQ) and a clinical indication for imaging, were randomly assigned to receive evaluation by open or by short-bore MR. The primary outcomes were incomplete MR examinations due to a claustrophobic event. Follow-up was conducted 7 months after MR imaging. The primary analysis was performed according to the intention-to-treat strategy.

          Results

          With 33 claustrophobic events in the short-bore group (39% [95% confidence interval [CI] 28% to 50%) versus 23 in the open scanner group (26% [95% CI 18% to 37%]; P = 0.08) the difference was not significant. Patients with an event were in the examination room for 3.8 min (SD 4.4) in the short-bore and for 8.5 min (SD 7) in the open group ( P = 0.004). This was due to an earlier occurrence of events in the short-bore group. The CLQ suffocation subscale was significantly associated with the occurrence of claustrophobic events ( P = 0.003). New findings that explained symptoms were found in 69% of MR examinations and led to changes in medical treatment in 47% and surgery in 10% of patients. After 7 months, perceived claustrophobia increased in 32% of patients with events versus in only 11% of patients without events ( P = 0.004).

          Conclusions

          Even recent MR cannot prevent claustrophobia suggesting that further developments to create a more patient-centered MR scanner environment are needed.

          Trial Registration

          ClinicalTrials.gov NCT00715806

          Related collections

          Most cited references50

          • Record: found
          • Abstract: not found
          • Article: not found

          Assessment of fear of fear in agoraphobics: the body sensations questionnaire and the agoraphobic cognitions questionnaire.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Use of the CONSORT statement and quality of reports of randomized trials: a comparative before-and-after evaluation.

            The Consolidated Standards for Reporting of Trials (CONSORT) statement was developed to help improve the quality of reports of randomized controlled trials (RCTs). To date, a paucity of data exists regarding whether it has achieved this goal. To determine whether use of the CONSORT statement is associated with improvement in the quality of reports of RCTs. Comparative before-and-after evaluation in which reports of RCTs published in 1994 (pre-CONSORT) were compared with RCT reports from the same journals published in 1998 (post-CONSORT). We included 211 reports from BMJ, JAMA, and The Lancet (journals that adopted CONSORT) as well as The New England Journal of Medicine (a journal that did not adopt CONSORT and was used as a comparator). Number of CONSORT items included in a report, frequency of unclear reporting of allocation concealment, and overall trial quality score based on the Jadad scale, a 5-point quality assessment instrument. Compared with 1994, the number of CONSORT checklist items in reports of RCTs increased in all 4 journals in 1998, and this increase was statistically significant for the 3 adopter journals (pre-CONSORT, 23.4; mean change, 3.7; 95% confidence interval [CI], 2.1-5.3). The frequency of unclear reporting of allocation concealment decreased for each of the 4 journals, and this change was statistically significant for adopters (pre-CONSORT, 61%; mean change, -22%; 95% CI, -38% to -6%). Similarly, 3 of the 4 journals showed an improvement in the quality score for reports of RCTs, and this increase was statistically significant for adopter journals overall (pre-CONSORT, 2.7; mean change, 0.4; 95% CI, 0.1-0.8). Use of the CONSORT statement is associated with improvements in the quality of reports of RCTs.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial.

              Non-pharmacological behavioural adjuncts have been suggested as efficient safe means in reducing discomfort and adverse effects during medical procedures. We tested this assumption for patients undergoing percutaneous vascular and renal procedures in a prospective, randomised, single-centre study. 241 patients were randomised to receive intraoperatively standard care (n=79), structured attention (n=80), or self-hypnotic relaxation (n=82). All had access to patient-controlled intravenous analgesia with fentanyl and midazolam. Patients rated their pain and anxiety on 0-10 scales before, every 15 min during and after the procedures. Pain increased linearly with procedure time in the standard group (slope 0.09 in pain score/15 min, p<0.0001), and the attention group (slope 0.04/15 min; p=0.0425), but remained flat in the hypnosis group. Anxiety decreased over time in all three groups with slopes of -0.04 (standard), -0.07 (attention), and -0.11 (hypnosis). Drug use in the standard group (1.9 units) was significantly higher than in the attention and hypnosis groups (0.8 and 0.9 units, respectively). One hypnosis patient became haemodynamically unstable compared with ten attention patients (p=0.0041), and 12 standard patients (p=0.0009). Procedure times were significantly shorter in the hypnosis group (61 min) than in the standard group (78 min, p=0.0016) with procedure duration of the attention group in between (67 min). Structured attention and self-hypnotic relaxation proved beneficial during invasive medical procedures. Hypnosis had more pronounced effects on pain and anxiety reduction, and is superior, in that it also improves haemodynamic stability.
                Bookmark

                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                22 August 2011
                : 6
                : 8
                : e23494
                Affiliations
                [1 ]Department of Radiology, Charité, Medical School, Humboldt Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
                [2 ]Department of Biostatistics and Clinical Epidemiology, Charité, Medical School, Humboldt Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
                [3 ]Division of Neuroradiology, Department of Radiology, Charité, Medical School, Humboldt-Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
                [4 ]Department of Clinical Psychology, Charité, Medical School, Humboldt-Universität zu Berlin and Freie Universität Berlin, Berlin, Germany
                Federal University of Rio de Janeiro, Brazil
                Author notes

                Conceived and designed the experiments: JE EZ MR PM RK PA CK GD MW UT TB BH MD. Performed the experiments: JE EZ MR RK GD MW MD. Analyzed the data: JE EZ MR PM RK UT TB MD. Wrote the paper: JE EZ MD. Biostatistics analysis: JE PM MD. Administrative, technical, or material support: RK PA CK GD MW UT BH. Supervision of the study: BH MD. Guarantor for the study: MD.

                Article
                PONE-D-11-09184
                10.1371/journal.pone.0023494
                3161742
                21887259
                7923fe8c-8071-4f8a-8f04-d3d4a6bfd3d2
                Enders et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 16 May 2011
                : 18 July 2011
                Page count
                Pages: 10
                Categories
                Research Article
                Biology
                Biotechnology
                Bioengineering
                Medical Devices
                Neuroscience
                Neuroimaging
                Medicine
                Diagnostic Medicine
                Drugs and Devices
                Medical Devices
                Mental Health
                Psychiatry
                Adolescent Psychiatry
                Anxiety Disorders
                Psychology
                Clinical Psychology
                Neurology
                Neuroimaging
                Radiology
                Diagnostic Radiology
                Magnetic Resonance Imaging
                Medical Physics
                Physics
                Medical Physics

                Uncategorized
                Uncategorized

                Comments

                Comment on this article