RACE/ETHNIC DIFFERENCES IN EVALUATION OF ABNORMAL MAMMOGRAPHY

钼靶异常筛查的评价和随访 研究了种族和收入群体在及时性和 诊断测试的类型。我们建议进行一项1000人的队列研究 女性，年龄在40岁到79岁之间，没有乳腺癌病史，年龄在 四个民族(白人、非裔美国人、拉丁裔、中国人) 异常乳房X光检查被定义为被解释为 放射科医生有新的异常，需要随访 在不到一年的时间里考试。我们计划进行基线电话 访谈以比较人口统计数据、患者对这一过程的看法 医疗保健、医疗保健变量的获取、临床评估、 主治医生的期望，自付费用，以及 我们的概念框架指出的其他预测变量，在 三个月后对指标进行异常筛查，进行乳房X光检查。主 要评估的结果包括第一次诊断测试的时间、 决议或最终处置、坚持意向、意向 继续筛查、间歇性乳房X光检查、焦虑和 功能状态。然后我们将在12点和24点进行后续采访 在指数检查后数月解决预测变量是否 影响及时遵守与评估异常的乳房X光检查，意向 继续筛查，间隔乳房X光检查，对护理的满意度，出院- 自掏腰包的成本、焦虑和功能健康。队列设计 将允许对医疗保健改革的影响进行评估 系统可能会对这些女性的结果产生影响。最后，我们会 与150名妇女一起制定和试行测试干预策略，以促进 钼靶X线筛查中异常的有效解决 减少对这些女性功能状态的潜在不利影响。

The evaluation and follow-up of abnormal mammography screening has not bee studied for possible ethnic and income group differences in timeliness and type of diagnostic tests. We propose to conduct a cohort study of 1000 women, 40 to 79 years of age, without previous breast cancer, and from four ethnic groups (white, African American, Latina, Chinese) with abnormal mammography examination defined as an examination interpreted as having a new abnormality by the radiologist and requiring a follow-up examination in less than one year. We plan to conduct baseline telephone interviews to compare demographics, patient perceptions about the process of care, access to health care variables, clinical assessments, expectations from their primary clinician, out-of-pocket expenses, and other predictor variables indicated by our conceptual framework, within three months after the index abnormal screening mammography. The main outcomes to be evaluated include time to first diagnostic test, time to resolution or final disposition, intention to adhere, intention to continue screening, interval mammography screening, anxiety, and functional status. We will then conduct follow-up interviews at 12 and 24 months after the index examination to address whether predictor variables affect timely adherence with evaluation of abnormal mammography, intention to continue screening, interval mammography, satisfaction with care, out- of-pocket costs, anxiety, and functional well-being. The cohort design will permit an evaluation of the effect that changes in health care systems may have on these outcomes in these women. Finally, we will develop and pilot test intervention strategies with 150 women to promote the efficient resolution of abnormalities on screening mammography and to reduce potential adverse effects on functional status of these women.