顺序选择与结肠镜外展用于结肠直肠癌查:实用随机临床试验的设计和理由
Shivan J Mehta1, Pamela A Shaw2, Catherine Reitz1
1Perelman School of Medicine, University of Pennsylvania, United States of America; Center for Health Care Transformation & Innovation, University of Pennsylvania, United States of America.
这项研究比较了使用顺序选择外展与结肠镜外展的结肠直肠癌 (CRC) 查完成,并结合了电子健康记录 (EHR) 推动来提高查率.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结肠直肠癌 (CRC) 查率仍然低于最佳水平.
- 需要有效的宣传策略,提供结肠镜检查或便检查.
- 电子健康记录 (EHR) 提供了实施行为推动的潜力.
研究的目的:
- 评估顺序选择外展对CRC查完成的影响,与结肠镜外展相比.
- 评估在CRC查上EHR促进的行为推动的有效性.
- 为了比较不同外展和推动策略之间的CRC查完成率.
主要方法:
- 实用随机临床试验,患者被分配到常规护理,结肠镜外展或顺序选择 (结肠镜然后FIT).
- 干预组接受了通常的护理或通过患者短信的EHR促进的临床医生指导的推动.
- 主要结局:在3年内完成CRC查,通过结肠镜或便免疫化学检测 (FIT) 结果定义.
主要成果:
- 分析将在外展部门和没有外展部门之间比较CRC查完成情况.
- 仅结肠镜和顺序选择手臂之间的完成率的比较.
- 评估基于访问的推动的效果与外展机构内的通常护理相比.
结论:
- 这项试验独特地评估了对CRC查的顺序选择的长期有效性.
- 该研究采用了多层次的设计,整合了集中推广和基于访问的干预措施.
- 调查结果将通过各种医疗保健提供模式,为改善CRC查采用策略提供信息.
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