Department of Medicine, University of Pennsylvania Medical Center, 1316 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104; Philadelphia VA Medical Center, Philadelphia, PA.
Fred Hutchinson Cancer Research Center, Seattle, Washington.
Acad Radiol. 2018 Sep;25(9):1118-1127. doi: 10.1016/j.acra.2017.12.028. Epub 2018 Feb 9.
The objective of this study was to evaluate the association of communication practices with timely follow-up of screening mammograms read as Breast Imaging Reporting and Data Systems (BI-RADS) 0 in the Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium.
A radiology facility survey was conducted in 2015 with responses linked to screening mammograms obtained in 2011-2014. We considered timely follow-up to be within 15 days of the screening mammogram. Generalized estimating equation models were used to evaluate the association between modes of communication with patients and providers and timely follow-up, adjusting for PROSPR site, patient age, and race and ethnicity.
The analysis included 34,680 mammography examinations with a BI-RADS 0 assessment among 28 facilities. Across facilities, 85.6% of examinations had a follow-up within 15 days. Patients in a facility where routine practice was to contact the patient by phone if follow-up imaging was recommended were more likely to have timely follow-up (odds ratio [OR] 4.63, 95% confidence interval [CI] 2.76-7.76), whereas standard use of mail was associated with reduced timely follow-up (OR 0.47, 95% CI 0.30-0.75). Facilities that had standard use of electronic medical records to report the need for follow-up imaging to a provider had less timely follow-up (OR 0.56, 95% CI 0.35-0.90). Facilities that routinely contacted patients by mail if they missed a follow-up imaging visit were more likely to have timely follow-up (OR 1.65, 95% CI 1.02-2.69).
Our findings support the value of telephone communication to patients in relation to timely follow-up. Future research is needed to evaluate the role of communication in completing the breast cancer screening episode.
本研究旨在评估沟通实践与人群为基础的研究优化筛查通过个体化方案(PROSPR)联盟中乳腺影像报告和数据系统(BI-RADS)0 类筛查乳房 X 光片及时随访之间的关联。
2015 年进行了一项放射科设施调查,调查结果与 2011-2014 年获得的筛查乳房 X 光片相关联。我们认为及时随访是指在筛查乳房 X 光片后 15 天内。使用广义估计方程模型评估与患者和提供者沟通的模式与及时随访之间的关联,同时调整 PROSPR 地点、患者年龄、种族和族裔。
该分析包括 28 个设施的 34680 例乳房 X 光检查,其中 BI-RADS 0 评估为 85.6%的检查在 15 天内进行了随访。如果建议进行随访成像,在常规实践中通过电话联系患者的设施中的患者更有可能及时进行随访(比值比[OR]4.63,95%置信区间[CI]2.76-7.76),而标准使用邮件则与及时随访减少相关(OR 0.47,95%CI 0.30-0.75)。标准使用电子病历向提供者报告需要进行随访成像的设施的及时随访较少(OR 0.56,95%CI 0.35-0.90)。如果患者错过随访成像就诊,常规通过邮件联系患者的设施更有可能进行及时随访(OR 1.65,95%CI 1.02-2.69)。
我们的研究结果支持电话沟通对患者及时随访的价值。需要进一步研究沟通在完成乳腺癌筛查过程中的作用。