对实用阶梯集群的协议随机临床试验测试行为经济实施策略,以增加乳房MRI查在乳房非常密集的患者中
Anne Marie McCarthy1,2,3, Claudia Fernandez Perez4, Rinad S Beidas5
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. annemcc@pennmedicine.upenn.edu.
Implementation science : IS
|November 24, 2023
概括
行为推动可以增加乳房MRI查补充乳房的女性有密集的乳房,改善早期癌症检测. 这项研究测试了患者和临床医生的推动,以解决查率的差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 行为经济学是一种行为经济学.
背景情况:
- 密集的乳腺组织增加了癌症的风险,降低了乳房扫描的准确性.
- 补充乳腺核磁共振显著改善癌症检测在女性有密集的乳房.
- 补充乳腺MRI的查率很低,特别是在少数群体中.
研究的目的:
- 评估行为经济学信息的推动在促进补充乳腺MRI查中的有效性.
- 为了测试针对患者,临床医生或两者的点击,以增加查吸收率.
- 检查健康差异和推动乳腺癌查有效性的调节者.
主要方法:
- 这是一项实用随机试验,涉及32家诊所的约1600名患者和1100名临床医生.
- 一个2x2的因数设计测试推动患者 (文本消息) 和临床医生 (EHR集成).
- 临床医生推动的阶梯设计,结果包括MRI订购,安排和完成.
主要成果:
- 主要结局:订购或安排额外的乳房MRI.
- 二次结果:MRI完成率,癌症检测率和错误阳性率.
- 分析患者社会人口统计和临床水平变量作为推动效果的调节者.
结论:
- 行为推动显示增加基于证据的查实践的希望.
- 研究设计允许测试可扩展,低成本的实施策略.
- 这些发现可能会为减少早期乳腺癌检测差异的干预措施提供信息.
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