Understanding recommendations for screening colonoscopy intervals

了解筛查结肠镜检查间隔的建议

• 批准号: 8734397
• 负责人: Deborah A Fisher
• 金额: $ 19.63万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8734397
• 关键词: Advisory Committees; Ambulatory Care; Attitude; Behavior; Cancer Control; Cancer Detection; Clinical; Collaborations; Colonoscopy; Colorectal Cancer; Complication; Data; Databases; Documentation; Effectiveness; Electronic Mail; Electronics; Endoscopy; Funding; Future; Guidelines; Hospitals; Internet; Intervention; Investigation; Knowledge; Link; Mails; Measures; Medical Records; Outcomes Research; Patient Self-Report; Patients; Physicians; Preventive; Printing; Private Practice; Procedures; Publishing; Questionnaires; Recommendation; Registries; Reporting; Research; Resources; Risk; Role; Sampling; Services; Site; Surveys; Testing; United States; United States National Institutes of Health; Universities; Unnecessary Procedures; design; prevent; programs; public health relevance; response; screening; self reported behavior; successful intervention; wasting

DESCRIPTION (provided by applicant): Although guidelines recommend a 10-year interval for screening colonoscopy, up to 60% of average-risk patients with a normal colonoscopy are recommended to return for repeat screening colonoscopy in < 10 years. Overuse of screening colonoscopy wastes billions of dollars and reduces colonoscopy capacity for appropriate use. Understanding the reasons why physicians recommend shorter intervals is critical to designing successful interventions to prevent overuse. In addition, establishing that self-reported recommendation practices are reasonably accurate will facilitate future investigations of overuse. The specific aims of this study are 1) to identify the determinants of recommendations for repeat screening colonoscopy among average risk patients and 2) to directly compare physician self-reported screening recommendations to recommendations documented in medical records To accomplish these specific aims, the study will be conducted in collaboration with the Clinical Outcomes Research Initiative (CORI), which includes 70 practice sites (hospitals, ambulatory care centers, private practices, universities) in 24 states. The National Institutes of Health (NIH) has funded the CORI consortium to provide an endoscopy registry for research and quality improvement. Participating physicians use the CORI electronic endoscopy report program to generate the colonoscopy report for clinical use, and then the reports are electronically sent to a central data repository in the National Endoscopic Database (NED). This study will use the NED to obtain physician recommendations for repeat screening colonoscopy. Preliminary NED data (2009-2011) indicate that over 15,000 normal colonoscopies were performed for average risk screening by 315 CORI physicians. For the first aim, a previously developed and pilot-tested survey will be administered to all CORI physicians who have performed a normal colonoscopy for average risk screening. to assess the role of knowledge, attitudes, subjective norms, and external factors in physician recommendations for screening colonoscopy intervals. The expected sample is at least 120 physicians. For the second aim, self-reported recommendation behavior measured by the questionnaire and the recommendation as documented in the NED will be compared. We will ultimately use the information generated by this study to develop an intervention to prevent colonoscopy overuse.

描述（由申请人提供）：虽然指南建议筛查结肠镜检查的间隔时间为 10 年，但建议高达 60% 结肠镜检查正常的平均风险患者在 10 年内再次进行结肠镜筛查。过度使用筛查性结肠镜检查会浪费数十亿美元，并降低适当使用结肠镜检查的能力。了解医生建议缩短间隔时间的原因对于设计成功的干预措施以防止过度使用至关重要。此外，确定自我报告的推荐做法相当准确将有助于未来对过度使用的调查。本研究的具体目标是 1) 确定平均风险患者重复筛查结肠镜检查建议的决定因素，2) 直接比较医生自我报告的筛查建议与病历中记录的建议 为了实现这些特定目标，该研究将与临床结果研究计划 (CORI) 合作进行，该计划包括 24 年 70 个实践地点（医院、门诊护理中心、私人诊所、大学）。 州。美国国立卫生研究院 (NIH) 资助了 CORI 联盟，为研究和质量改进提供内窥镜注册中心。参与的医生使用 CORI 电子内窥镜报告程序生成供临床使用的结肠镜检查报告，然后将报告以电子方式发送到国家内窥镜数据库 (NED) 的中央数据存储库。本研究将使用 NED 获取医生关于重复筛查结肠镜检查的建议。 NED 初步数据（2009-2011 年）表明，315 名 CORI 医生对 15,000 多例正常结肠镜检查进行了平均风险筛查。为了第一个目标，将对所有进行过正常结肠镜检查的 CORI 医生进行一项先前开发和试点测试的调查，以进行平均风险筛查。评估知识、态度、主观规范和外部因素在医生建议的结肠镜检查间隔时间建议中的作用。预期样本至少为 120 名医生。对于第二个目标，将比较通过问卷测量的自我报告的推荐行为和 NED 中记录的推荐。我们最终将利用本研究产生的信息来制定干预措施，以防止结肠镜检查过度使用。