Increased patient concern after false-positive mammograms - Clinician documentation and subsequent ambulatory visits
Increased patient concern after false-positive mammograms - Clinician documentation and subsequent ambulatory visits
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DOI：
10.1046/j.1525-1497.2001.00329.x
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发表时间：
2001-03-01
影响因子：
5.7
通讯作者：
Fletcher, SW
中科院分区：
文献类型：
--
作者：
Barton, MB;Moore, S;Fletcher, SW
目的：根据乳房x光检查结果（正常，或真阴性与假阳性），测量在乳房x光检查后的医疗记录中记录乳房相关问题的频率，并测量乳房x光检查后一年内医疗保健利用的变化。设计:队列研究。单位：新英格兰大型健康护理机构。患者：496名乳房x光检查假阳性的妇女为一组，496名乳房x光检查正常的妇女为对照组，地点和乳房x光检查年份相匹配。测量和主要结果：1)临床医生记录患者对乳房的关注；2)乳房x光检查后一年的门诊保健利用情况，包括乳房相关和非乳房相关。在496名乳房x光检查假阳性的女性中，有50名（10%）在乳房x光检查后的12个月内有乳房相关疾病的记录，而乳房x光检查正常的女性中只有1名（0.2%）（P =.001）。随着推荐随访的强度增加，记录的担忧也随之增加（P = 0.009）。在乳房x光检查为假阳性的女性中，与筛查性乳房x光检查无关的后续门诊就诊在乳房x光检查后的一年内有所增加，无论是与乳房相关的就诊（发病率比为3.07；95%可信区间[CI]， 1.69至5.93）还是与乳房无关的门诊就诊（发病率比，1.14；95%可信区间[CI]， 1.03至1.25）。结论：临床医生记录了10%的乳房x光假阳性妇女对乳腺癌的担忧。乳房x光检查结果为假阳性的妇女随后使用保健服务的人数增加。
OBJECTIVE: To measure how often a breast-related concern was documented in medical records after screening mammography according to the mammogram result (normal, or true-negative vs false-positive) and to measure changes in health care utilization in the year after the mammogram.DESIGN:Cohort study.SETTING: Large health maintenance organization in New England.PATIENTS: Group of 496 women with false-positive screening mammograms and a comparison group of 496 women with normal screening mammograms, matched for location and year of mammogram.MEASUREMENTS AND MAIN RESULTS: 1) Documentation in clinicians' notes of patient concern about the breast and 2) ambulatory health care utilization, both breast-related and non-breast-related, in the year after the mammogram. Fifty (10%) of 496 women with false-positive mammograms had documentation of breast-related concern during the 12 months after the mammogram, compared to 1 (0.2%) woman with a normal mammogram (P =.001). Documented concern increased with the intensity of recommended followup (P =.009). Subsequent ambulatory visits, not related to the screening mammogram, increased in the year after the mammogram among women with false-positive mammograms, both in terms of breast-related visits (incidence ratio, 3.07; 95% confidence interval [CI], 1.69 to 5.93) and non-breast-related visits (incidence ratio, 1.14; 95% CI, 1.03 to 1.25).CONCLUSIONS: Clinicians document concern about breast cancer in 10% of women who have false-positive mammograms. and subsequent use of health care services are increased among women with false-positive mammogram results.