一项关于选择加入与选择退出的结直肠癌筛查外展的随机对照试验。
A Randomized Controlled Trial of Opt-in Versus Opt-Out Colorectal Cancer Screening Outreach.
机构信息
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Incentives and Behavioral Economics, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Leonard and Madlyn Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA. Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, PA, USA.
出版信息
Am J Gastroenterol. 2018 Dec;113(12):1848-1854. doi: 10.1038/s41395-018-0151-3.
Abstract
OBJECTIVES
METHODS:: RESULTS:: Patients randomized to opt-in agreed to participate 23.1% of the time, and only 2.5% of those in opt-out chose not to participate. FIT kits were mailed to 22.4% and 93% of patients in opt-in and opt-out arms, respectively. In intention-to-screen analysis, patients in the opt-out arm had a higher FIT completion rate (29.1%) than in the opt-in arm (9.6%) (absolute difference 19.5%; 95% confidence interval, 10.9-27.9%; P < .001). Results were similar in subgroup analysis of those sent initial messaging through the EHR portal (9.5% opt-in versus 37.5% in opt-out).
摘要
目的
方法：结果：选择参与的患者随机分配到同意组的比例为 23.1%，而选择不参与的患者中只有 2.5%来自退出组。意向性筛选分析中，退出组的 FIT 完成率（29.1%）高于同意组（9.6%）（绝对差异 19.5%；95%置信区间，10.9-27.9%；P <.001）。在通过电子病历门户发送初始消息的亚组分析中，结果相似（9.5%的同意组与退出组的 37.5%）。
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