Warren-Mears Victoria, Dankovchik Jenine, Patil Meena, Fu Rongwei
Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, OR 97201, USA.
J Cancer Educ. 2013 Mar;28(1):109-18. doi: 10.1007/s13187-012-0436-y.
The patient navigator model has not been widely implemented in American Indian/Alaska Native (AI/AN) communities, but may be effective in improving cancer outcomes for this population. Subjects were enrolled from eight clinics at Tribes throughout the Northwest (n = 1,187). Four clinics received navigation. Time between abnormal finding and definitive diagnosis was recorded. We examined whether odds of obtaining definitive diagnosis by 60, 90, and 365 days differed between the two groups. The odds of definitive diagnosis within 365 days for navigated subjects was 3.6 times (95 % CI, 1.47, 8.88; p = 0.01) the odds for control subjects. The outcome at 60 and 90 days did not significantly differ between the two groups. Our findings indicate that patient navigation did not significantly impact chance of diagnosis by 60 or 90 days from abnormal finding. However, it did improve the chance of avoiding extreme delays in obtaining a definitive diagnosis.
患者导航模式尚未在美国印第安/阿拉斯加原住民（AI/AN）社区广泛实施，但可能对改善该人群的癌症治疗结果有效。研究对象来自西北部各部落的八家诊所（n = 1187）。四家诊所接受了导航服务。记录了从异常发现到确诊的时间。我们研究了两组在60天、90天和365天内获得确诊的几率是否存在差异。接受导航服务的受试者在365天内确诊的几率是对照组受试者的3.6倍（95%可信区间，1.47, 8.88；p = 0.01）。两组在60天和90天的结果没有显著差异。我们的研究结果表明，患者导航在异常发现后的60天或90天内对诊断几率没有显著影响。然而，它确实提高了避免在获得确诊方面出现极端延迟的几率。
