敏捷评估，包括两项关于采用数字筛查服务的实用试验。
Agile evaluation including two pragmatic trials on the uptake of a digital screening service.
作者信息
Tillmann Taavi, Copas Andrew, Stokes Paul, Udell Nick, Stead Jo, Lim Jin, Libow Gene
机构信息
Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
Institute for Global Health, University College London, London, UK.
出版信息
NPJ Digit Med. 2025 May 26;8(1):310. doi: 10.1038/s41746-025-01672-5.
Digital screening may divert lower-risk persons to lower-cost online screening, or offer higher-risk non-responders a more acceptable alternative. Population-based uptake estimates are lacking. We conducted four studies within four weeks by inviting 1700 Londoners (40-74 years, without cardiovascular disease) to a digital Health Check. A six-arm pragmatic unregistered randomised controlled trial (RCT) tested different Short Message Service (SMS) invitations. Uptake varied from 12% (standard SMS) to 20% (shortest SMS, P = 0.009). We tested three sequential reminders (an SMS, a second pragmatic trial [SMS vs postal reminder], and a final SMS). The first SMS reminder increased uptake by +3%. The postal reminder (+7%) was twice as effective as the SMS reminder (+3%, P < 0.0001). The "final reminder" SMS added +7%. Altogether, shorter invites, multi-modal reminders, and a "final reminder" all increased uptake. Adding digital care to in person care may raise uptake from 50 to 60%. Agile evaluations can rapidly improve invitation systems.
数字筛查可能会将低风险人群引导至成本较低的在线筛查，或者为高风险无响应者提供更可接受的替代方案。目前缺乏基于人群的接受率估计。我们在四周内开展了四项研究，邀请了1700名伦敦人（40 - 74岁，无心血管疾病）进行数字健康检查。一项六臂实用非注册随机对照试验（RCT）测试了不同的短信邀请方式。接受率从12%（标准短信）到20%（最短短信，P = 0.009）不等。我们测试了三种连续提醒方式（一条短信、第二项实用试验[短信与邮寄提醒对比]以及最后一条短信）。第一条短信提醒使接受率提高了3%。邮寄提醒（提高7%）的效果是短信提醒（提高3%）的两倍（P < 0.0001）。“最后提醒”短信又增加了7%。总体而言，更简短的邀请、多模式提醒以及“最后提醒”都提高了接受率。将数字护理添加到面对面护理中可能会使接受率从50%提高到60%。灵活的评估可以迅速改进邀请系统。
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