{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T14:44:30Z","timestamp":1770993870471,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Patient understanding of disease can guide decision\u2010making in the management of anal fistula. This prospective feasibility study aimed to assess the acceptability and methods of assessing the impact of viewing realistic models on patients with anal fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>New referrals to a tertiary clinic participated in this single\u2010centre, parallel\u2010group randomized controlled study. Baseline characteristics, Decisional Conflict Scale and understanding of disease were assessed pre\u2010consultation. Participants were randomized to a standard consultation, where disease and treatment options were explained using magnetic resonance images and drawn diagrams, or a similar consultation supplemented with an appropriate generic three\u2010dimensional (3D) printed model. Understanding of disease and proposed surgery, Decisional Conflict Scale and ratings of visual aids were assessed post\u2010consultation, along with 3D model feedback.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 52 patients who were approached agreed to be randomized (25 standard, 27 3D consultation). Understanding of disease increased post\u2010consultation in both groups. Post\u2010consultation decisional conflict (0,\u2009no; 100,\u2009high decisional conflict) was low (median 27 post\u2010standard vs. 24 post\u20103D consultation). Patients scored highly on measures assessing understanding of proposed surgery. 3D models were rated highly, with 96% of patients wanting to see them again in future consultations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three\u2010dimensional printed fistula models are a welcome addition to outpatient consultations with results suggesting that understanding of surgery is improved. A future trial should be powered to detect whether 3D models result in a significant improvement in understanding beyond traditional methods of explanation and explore the conditions in which models have their maximal utility.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Registration ID<\/jats:title><jats:p>This study was registered on <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> (ID: NCT04069728). Registered on 23 August 2019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16861","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T13:31:14Z","timestamp":1705584674000},"page":"518-526","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Exploring methods of improving patient understanding and communication in a complex anal fistula clinic: results from a randomized controlled feasibility study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3264-7362","authenticated-orcid":false,"given":"Nusrat","family":"Iqbal","sequence":"first","affiliation":[{"name":"Robin Phillips' Fistula Research Unit St Mark's Hospital  Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London  London 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Phillips' Fistula Research Unit St Mark's Hospital  Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phil","family":"Tozer","sequence":"additional","affiliation":[{"name":"Robin Phillips' Fistula Research Unit St Mark's Hospital  Harrow UK"},{"name":"Department of Surgery and Cancer Imperial College London  London 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