McPhee S J, Bird J A, Jenkins C N, Fordham D
Department of Medicine, University of California, San Francisco 94143-0320.
Arch Intern Med. 1989 Aug;149(8):1866-72. doi: 10.1001/archinte.149.8.1866.
To determine effective methods of promoting routine cancer screening, we randomly assigned 62 internal medicine residents to receive cancer screening reminders (computer-generated lists of overdue tests at patients' visits), audit with feedback (monthly seminars about screening, with feedback about their performance rates), or no intervention (controls). Half of the residents in each group also were randomized to receive patient education (patients received literature and notices of overdue tests). We reviewed a sample of each physician's medical records to assess performance of seven tests during 9-month periods before and after initiating the interventions. Cancer screening reminders increased performance of six of seven tests; audit with feedback, four of seven tests; and patient education, one of two targeted breast cancer screening tests. The results indicate that the cancer screening reminders strategy was the most effective in promoting the performance of routine cancer screening tests.
为确定促进常规癌症筛查的有效方法，我们将62名内科住院医师随机分为三组，分别接受癌症筛查提醒（患者就诊时由计算机生成的逾期检查清单）、有反馈的审核（每月关于筛查的研讨会，并反馈其执行率）或不进行干预（对照组）。每组中有一半的住院医师还被随机分配接受患者教育（患者收到有关逾期检查的资料和通知）。我们查阅了每位医生的部分病历样本，以评估在干预措施实施前后9个月期间7项检查的执行情况。癌症筛查提醒使7项检查中的6项执行率提高；有反馈的审核使7项检查中的4项执行率提高；患者教育使两项目标乳腺癌筛查检查中的1项执行率提高。结果表明，癌症筛查提醒策略在促进常规癌症筛查检查的执行方面最为有效。
