Li Ruicen, Chai Qi, Chen Feng, Liu Qing, Zhang Hong
Department of Health Management Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Industrial Engineering and Engineering Management, College of Business, Sichuan University, Chengdu, Sichuan, China.
Front Oncol. 2023 Jan 4;12:1049096. doi: 10.3389/fonc.2022.1049096. eCollection 2022.
The study aimed to investigate the influencing factors of physicians in recommending low-dose computed tomography (LDCT) for lung cancer screening to high-risk groups. A total of 1767 participants with good knowledge of LDCT were included in a cross-sectional study. Data about physicians' demographics, perception of barriers on LDCT screening, medical conditions for practicing medicine and the behavior of recommending LDCT were collected by a questionnaire. Physicians who care about the transportation convenience of patients were less likely to recommend LDCT (OR 0.568, 95% CI (0.423 to 0.763), < 0.05). The physicians who considered LDCT expensive, recommended LDCT less than others (OR 0.308, 95% CI (0.186 to 0.510), < 0.05). The false positive rate of LDCT can decrease the possibility of physicians' recommending (OR 0.542, 95% CI (0.387 to 0.758), < 0.05). The physicians in oncology department and health management center were more likely to recommend LDCT (OR 2.282, 95% CI (1.557 to 3.345); OR 2.476, 95% CI (1.618 to 3.791)). The convenience of transportation, the price, and the\ false positive rate may be the main concerns among physicians on recommending LDCT to high-risk groups. The influencing factors of physicians' recommending on LDCT was various. Information technology, government support in price and self-improvement of LDCT should be gathered together to break the barriers on physicians' recommending on LDCT.
该研究旨在调查医生向高危人群推荐低剂量计算机断层扫描（LDCT）进行肺癌筛查的影响因素。一项横断面研究共纳入了1767名对LDCT有充分了解的参与者。通过问卷调查收集了医生的人口统计学数据、对LDCT筛查障碍的认知、行医的医疗条件以及推荐LDCT的行为。关心患者交通便利性的医生推荐LDCT的可能性较小（比值比[OR]为0.568，95%置信区间[CI]为[0.423至0.763]，P<0.05）。认为LDCT费用高昂的医生推荐LDCT的次数少于其他医生（OR为0.308，95%CI为[0.186至0.510]，P<0.05）。LDCT的假阳性率会降低医生推荐的可能性（OR为0.542，95%CI为[0.387至0.758]，P<0.05）。肿瘤科和健康管理中心的医生更有可能推荐LDCT（OR分别为2.282，95%CI为[1.557至3.345]；OR为2.476，95%CI为[1.618至3.791]）。交通便利性、价格和假阳性率可能是医生向高危人群推荐LDCT时的主要关注点。医生推荐LDCT的影响因素多种多样。应整合信息技术、政府在价格方面的支持以及LDCT自身的改进，以打破医生推荐LDCT的障碍。
