Turner K M, Wilson B J, Gilbert F J
Department of Public Health, University of Aberdeen Medical School, Foresterhill, United Kingdom.
J Med Screen. 1994 Jul;1(3):199-202. doi: 10.1177/096914139400100313.
Firstly, to determine whether the acceptance rate of the second invitation for breast screening (sent to women who have failed to attend after the first invitation) might be increased by an accompanying letter from a general practitioner (GP letter). Secondly, to identify the additional costs of sending such a letter.
465 women registered with four practices in a single health centre were recruited into a randomised controlled trial in which the intervention was the inclusion of a standard, photocopied letter signed by the non-attender's doctor with the second invitation to attend for breast screening. The control group received only the standard invitation from the breast screening centre. The costs associated with the intervention were assessed from data supplied by the breast screening centre, supplemented by direct observation of the preparation of second invitations and semistructured interviews with the staff taking part.
The attendance rate of the test group one month after the second invitation for screening was significantly higher than that of the control group (21% v 10%, P < 0.01). The average cost of a GP letter included with the invitation was 1.1 pence and the marginal cost for each extra attender was 9.6 pence. No non-monetary costs were identified.
The inclusion of a GP letter appeared to be effective and feasible in increasing the attendance rate to the second invitation. This intervention should be tested in other screening groups to confirm the effectiveness of a GP letter and its cost effectiveness.
第一，确定全科医生附函（全科医生信件）是否能提高第二次乳腺癌筛查邀请（发给首次邀请后未参加者）的接受率。第二，确定发送此类信件的额外费用。
在一个健康中心的四个诊所登记的465名女性被纳入一项随机对照试验，干预措施是在第二次乳腺癌筛查邀请中附上由未参加者的医生签署的标准影印信件。对照组仅收到来自乳腺癌筛查中心的标准邀请。根据乳腺癌筛查中心提供的数据评估与干预相关的费用，并通过直接观察第二次邀请的准备过程以及与参与工作人员的半结构化访谈进行补充。
第二次筛查邀请发出一个月后，试验组的出勤率显著高于对照组（21%对10%，P<0.01）。邀请中附上全科医生信件的平均费用为1.1便士，每个额外参加者的边际成本为9.6便士。未发现非货币成本。
附上全科医生信件在提高第二次邀请的出勤率方面似乎是有效且可行的。这种干预措施应在其他筛查群体中进行测试，以确认全科医生信件的有效性及其成本效益。
