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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Impact of a physician-oriented intervention on follow-up in colorectal cancer screening.
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Impact of a physician-oriented intervention on follow-up in colorectal cancer screening.

机译：以医生为导向的干预对结肠直肠癌筛查随访的影响。

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BACKGROUND: Complete diagnostic evaluation or CDE (i.e., colonoscopy or combined flexible sigmoidoscopy plus barium enema X-ray) is often not performed for persons with an abnormal screening fecal occult blood test (FOBT+) result. METHOD: This study evaluated the impact of a reminder-feedback and educational outreach intervention on primary care practice CDE recommendation and performance rates. Four hundred seventy primary care physicians (PCPs) in 318 practices participated in the study. Patients were mailed an FOBT kit annually as part of a screening program. Practices were randomly assigned to a Control Group (N = 198) or an Intervention Group (N = 120). During an 18-month pre-randomization period and a 9-month post-randomization period, 2992 screening FOBT+ patients were identified. Intervention practices received the screening program and the intervention. Control practices received only the screening program. Study outcomes were baseline-adjusted CDE recommendation and performance rates. RESULTS: At baseline, about two-thirds of FOBT+ patients received a CDE recommendation, and about half had a CDE performed. At endpoint, CDE recommendation and performance rates were both significantly higher for the Intervention as compared to the Control practices (OR = 2.28; 95% CI: 1.37, 3.78, and OR = 1.63; 95% CI: 1.06, 2.50, respectively). CONCLUSIONS: The reminder-feedback plus educational outreach intervention significantly increased CDE recommendation and performance.
机译：背景：对于粪便潜血筛查（FOBT +）结果异常的患者，通常不进行完整的诊断评估或CDE（即结肠镜检查或联合柔性乙状结肠镜检查和钡剂X线检查）。方法：本研究评估了提示反馈和教育外展干预对基层医疗实践CDE建议和绩效率的影响。 318个实践中的470位初级保健医师（PCP）参与了该研究。作为筛查计划的一部分，每年向患者邮寄FOBT试剂盒。实践被随机分配到对照组（N = 198）或干预组（N = 120）。在随机化前的18个月和随机化后的9个月期间，确定了2992例筛查的FOBT +患者。干预措施得到了筛查计划和干预措施。控制措施仅接受筛选程序。研究结果为经基线调整的CDE建议和绩效率。结果：基线时，约三分之二的FOBT +患者接受了CDE推荐，约一半进行了CDE。在终点，干预措施的CDE建议和执行率均显着高于对照实践（OR = 2.28; 95％CI：1.37、3.78和OR = 1.63; 95％CI：1.06、2.50）。结论：提示反馈和教育外展干预显着提高了CDE的推荐和效果。

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