Department of Medicine, Gastroenterology Service, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
J Am Coll Radiol. 2013 Jan;10(1):30-6. doi: 10.1016/j.jacr.2012.05.014.
The National Committee for Quality Assurance developed the Healthcare Effectiveness Data and Information Set(®) (HEDIS(®)) to provide quality measures for the evaluation of standards of medical care across health plans. Screening for colorectal cancer (CRC) has been shown to increase the detection of early-stage disease and reduce mortality. Current HEDIS measures for CRC screening include fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. The aim of this analysis was to quantify the use of CT colonography (CTC) for CRC screening and demonstrate the potential impact of including CTC as a HEDIS-acceptable screening modality.
Demographic and health care utilization data from the Military Health System Population Health Portal for January 1, 2005, through December 31, 2010, for individuals aged 50 to 75, were analyzed to determine the degree of overall utilization of CTC. Screening compliance for CRC per HEDIS was also estimated, and the incremental impact of adding HEDIS-eligible patients who had undergone CTC as their only CRC screening test was then evaluated for two similarly sized, regional Navy medical centers.
Across all sites (10 Army, 4 Navy, 3 Air Force), 17,187 CTC studies were performed, with increasing utilization during the 6-year study period. At the two Navy medical centers, screening compliance ranged from 33.8% to 67.9% without CTC and from 33.8% to 84.0% with CTC.
CTC is actively being used for CRC screening across military treatment facilities. The inclusion of CTC as a HEDIS-compliant CRC screening test has the potential to significantly increase health care system compliance for National Committee for Quality Assurance CRC screening measures.
美国医疗质量改进协会开发了医疗保健效果数据和信息集（HEDIS®），以提供医疗保健计划中医疗保健标准评估的质量措施。结直肠癌（CRC）筛查已被证明可以提高早期疾病的检出率并降低死亡率。目前 HEDIS 对 CRC 筛查的评估包括粪便潜血试验、乙状结肠镜检查和结肠镜检查。本分析旨在量化 CT 结肠成像（CTC）在 CRC 筛查中的应用，并展示将 CTC 纳入 HEDIS 可接受的筛查方式的潜在影响。
分析了 2005 年 1 月 1 日至 2010 年 12 月 31 日期间军事医疗系统人群健康门户的人口统计学和医疗保健利用数据，以确定 CTC 的总体利用程度。还估计了 CRC 筛查的 HEDIS 符合率，并评估了在两个规模相似的海军医疗中心，将仅接受 CTC 作为 CRC 筛查测试的 HEDIS 合格患者纳入 HEDIS 的增量影响。
在所有地点（10 个陆军、4 个海军、3 个空军），共进行了 17187 次 CTC 检查，在 6 年的研究期间，使用率逐渐增加。在这两个海军医疗中心，不包括 CTC 时的筛查符合率为 33.8%至 67.9%，包括 CTC 时的筛查符合率为 33.8%至 84.0%。
CTC 正在被用于军事治疗机构的 CRC 筛查。将 CTC 纳入 HEDIS 合规性 CRC 筛查测试有可能显著提高医疗保健系统对美国医疗质量改进协会 CRC 筛查措施的合规性。
