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：
10.1111/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，测量筛查性乳房X光检查后医疗记录中记录乳房相关问题的频率（正常，或真阴性vs假阳性），并测量乳房X线检查后一年内医疗保健利用的变化。设计：队列研究。地点：新英格兰的大型健康维护组织。患者：一组496名妇女与假阳性筛查乳房X线照片和对照组496名妇女与正常筛查乳房X线照片，匹配的位置和一年的乳房X线照片。1）临床医生记录患者对乳房的担忧，2）乳房X光检查后一年内与乳房相关和非乳房相关的门诊医疗保健利用情况。在496名乳房X线检查假阳性的妇女中，有50名（10%）在乳房X线检查后的12个月内记录了乳房相关的问题，而乳房X线检查正常的妇女只有1名（0.2%）（P = 0.001）。记录的关注随着建议随访的强度而增加（P =.009）。在乳房X光检查假阳性的妇女中，与筛查乳房X光检查无关的后续门诊就诊在乳房X光检查后一年增加，（发生率比，3.07; 95%置信区间[CI]，1.69 - 5.93）和非乳腺相关访视结论：临床医生记录了10%的乳房X线检查假阳性的妇女对乳腺癌的担忧。在乳房X光检查结果呈假阳性的妇女中，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.