RACE/ETHNIC DIFFERENCES IN EVALUATION OF ABNORMAL MAMMOGRAPHY

对异常乳腺X线摄影筛查的评估和随访尚未得到证实。 研究了种族和收入群体在及时性方面可能存在的差异， 诊断测试的类型。我们建议进行一项1000人的队列研究， 女性，40至79岁，以前没有乳腺癌， 四个种族群体（白色，非洲裔美国人，拉丁裔，中国人）， 异常乳房X线摄影检查定义为解释为 放射科医生发现新的异常并需要随访 不到一年的时间里，考试。我们计划进行基线电话 访谈比较人口统计学，病人对这个过程的看法， 医疗保健的可及性变量，临床评估， 他们的主要临床医生的期望，自付费用， 我们的概念框架所指示的其他预测变量， 三个月后，指数异常筛查乳房X光检查。主要 评价的结果包括首次诊断试验的时间、 决议或最终处置，意图坚持，意图 继续筛查，间隔乳房X线检查筛查，焦虑，和 功能状态然后我们会在12点和24点进行后续采访 月后指数检查，以解决是否预测变量 影响对异常乳腺X线检查评价的及时依从性，意图 继续筛查，间隔乳房X光检查，对护理的满意度， 自付成本、焦虑和功能健康。队列设计 将允许对医疗保健变化的影响进行评估 系统可能对这些女性的这些结果产生影响。最后我们将 与150名妇女一起制定和试行干预战略， 有效解决筛查性乳房X线摄影的异常， 减少对这些妇女功能状况的潜在不利影响。

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.