The Ohio Patient Navigation Research Program: Does the American Cancer Society Patient Navigation Model Improve Time to Resolution in Patients with Abnormal Screening Tests?
The Ohio Patient Navigation Research Program: Does the American Cancer Society Patient Navigation Model Improve Time to Resolution in Patients with Abnormal Screening Tests?
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DOI：
10.1158/1055-9965.epi-12-0523
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发表时间：
2012-10-01
影响因子：
3.8
通讯作者：
Murray, David M.
中科院分区：
文献类型：
--
作者：
Paskett, Electra D.;Katz, Mira L.;Murray, David M.
背景资料：患者导航（PN）被建议作为减少癌症健康差异的一种方法;然而，存在许多PN模型，并且大多数尚未经过仔细评估。本研究的目的是测试的俄亥俄州美国癌症协会模型的PNAS，它涉及到减少时间诊断决议异常乳腺癌，宫颈癌，结直肠癌筛查试验或symptoms.Methods：共862例患者从18个诊所参加了这一组随机试验。病历审查记录了异常日期和解决日期。主要分析使用共享脆弱模型来检验PN对至消退时间的影响。结果：HR在6个月时变得显著;在随机临床效应的条件下，PN组15个月时的缓解率高出65（P = 0.012，两组间缓解率差异; P = 0.009，HR随时间增加）。结论：与未分配至PN的受试者相比，分配至PN的受试者的癌症筛查试验或症状异常消退更快。PN的效果在检测到异常后6个月开始变得明显。影响：PN可能有助于通过减少癌症筛查试验异常后的解决时间来解决健康差异。癌症流行病学生物标志物Prev; 21（10）; 1620-8。(c)2012年AACR。
Background: Patient navigation (PN) has been suggested as a way to reduce cancer health disparities; however, many models of PN exist and most have not been carefully evaluated. The goal of this study was to test the Ohio American Cancer Society model of PNas it relates to reducing time to diagnostic resolution among persons with abnormal breast, cervical, or colorectal cancer screening tests or symptoms.Methods: A total of 862 patients from 18 clinics participated in this group-randomized trial. Chart review documented the date of the abnormality and the date of resolution. The primary analysis used shared frailty models to test for the effect of PN on time to resolution. Crude HR were reported as there was no evidence of confounding.Results: HRs became significant at 6 months; conditional on the random clinic effect, the resolution rate at 15 months was 65% higher in the PN arm (P = 0.012 for difference in resolution rate across arms; P = 0.009 for an increase in the HR over time).Conclusions: Participants with abnormal cancer screening tests or symptoms resolved faster if assigned to PN compared with those not assigned to PN. The effect of PN became apparent beginning six months after detection of the abnormality.Impact: PN may help address health disparities by reducing time to resolution after an abnormal cancer screening test. Cancer Epidemiol Biomarkers Prev; 21(10); 1620-8. (c) 2012 AACR.