随机临床试验:中心化患者导航的便免疫化学试验呈阳性后,随机结肠镜检查的时间:随机临床试验
Anisha P Ganguly1,2, Meghan C O'Leary3,4, Seth D Crockett5
1Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Anisha_ganguly@med.unc.edu.
Journal of general internal medicine
|February 4, 2026
概括
集中式的患者导航显著提高了后续结肠镜完成率,并在联邦合格卫生中心积极的便免疫化学测试后减少了程序的时间. 这种干预措施支持及时解决结直肠癌查问题.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 胃肠病学 胃肠病学
背景情况:
- 联邦合格卫生中心 (FQHCs) 在便免疫化学测试 (FIT) 呈阳性后,面临着及时完成随访结肠镜检查 (FC) 的挑战.
- 延迟FC与增加结直肠癌 (CRC) 发病率,晚期诊断和死亡率有关.
研究的目的:
- 评估集中患者导航在提高FC完成率方面的有效性.
- 评估患者导航对在FIT阳性后减少FC的时间的影响.
主要方法:
- 一项随机临床试验的子分析,该试验涉及在FQHC系统中获得FIT阳性结果的患者.
- 在一年内,接受集中式电话导航和接受常规护理的患者之间的结果比较.
- 使用生存分析来比较受限制的平均时间与FC.
主要成果:
- 与常规护理相比,集中的患者导航导致了显著更高的FC完成率 (69.0%对38.7%,p=0.006).
- 在导航组中,FC的平均时间减少了80.4天 (p=0.018).
- 增加了对航行的关注,进一步提高了降低到FC的时间.
结论:
- 集中式患者导航是提高FC完成和减少在FQHC设置中FIT结果阳性后的诊断延迟的高效干预.
- 患者导航在确保在服务不足的人群中对阳性CRC查的及时诊断解决方面发挥着至关重要的作用.
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