Abstract:
BACKGROUND:Despite significant investment in colorectal cancer (CRC) screening, 40% of US adults are not up-to-date. Commitment devices, which are psychologically tailored approaches to enforce health goals, may be an effective method to increase CRC screening. OBJECTIVE:Compare the effectiveness of a commitment device (patient self-ordering fecal immunochemical test (FIT) kits) to standard CRC screening outreach. DESIGN:A retrospective observational study. PARTICIPANTS:Participants were > 49 years and < 75 years, had no history of CRC, and were eligible for CRC screening. INTERVENTION:An electronic screening reminder with an embedded order button allowed participants to order FIT kits directly from a patient portal. Those who used the order button were promptly sent a kit; those who did not were later mailed kits. MAIN MEASURES:Primary outcome was completion of FIT kits. Secondary outcomes included number of days to completion, completion of follow-up for positive results, and CRC diagnosis; we also examined prior use of FIT kit. We used inverse probability of treatment weights to control for pretreatment imbalances. KEY RESULTS:The cohort comprised 176,231 participants: 53% female; median age was 59; 11% were Asian, 21% Hispanic/Latino, 7% black, 51% White, 3% other/mixed race. Approximately 10% (N = 16,918) used the button. Using inverse probability of treatment weights, we found that those who used the button had 3.8 times the odds of completing a kit compared to participants who did not (odds ratio, 3.77; 95% confidence interval, 3.57-3.98). Within the button group, 63% of those eligible completed a FIT kit in the year prior to the button compared to 87% in the year after the button became available (p < 0.0001). CONCLUSION:The ability to self-order screening kits may act as a commitment device that increases CRC screening. Scalable tools leveraging existing patient portals such as this can complement existing CRC outreach strategies.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Hahn EE,Baecker A,Shen E,Haupt EC,Wakach W,Ahuja A,Imley TM,Gould MK,Kanter Mdoi
10.1007/s11606-020-06392-ysubject
Has Abstractpub_date
2021-01-20 00:00:00eissn
0884-8734issn
1525-1497pii
10.1007/s11606-020-06392-ypub_type
杂志文章abstract:BACKGROUND:In response to proposed federal legislation, the Accreditation Council for Graduate Medical Education limited resident work-hours in July 2003. The cost may be substantial but, if successful, the reform might lower preventable adverse event costs in hospital and after discharge. OBJECTIVES:This study sought...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0133.x
更新日期:2005-10-01 00:00:00
abstract::In this short story, through a challenging case where his sound diagnostic work has seemingly gone unrecognized, an internist is reminded of what is most important in clinical care. ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1363-4
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Urine drug testing (UDT) is an essential tool to monitor opioid misuse among patients on chronic opioid therapy. Inaccurate interpretation of UDT can have deleterious consequences. Providers' ability to accurately interpret and document UDT, particularly definitive liquid chromatography-tandem mass spectrome...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05514-5
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Perception of body size is a key factor driving health behavior. Mothers directly influence children's nutritional and exercise behaviors. Mothers of ethnic minority groups and lower socioeconomic status are less likely to correctly identify young children as overweight or obese. Little evaluation has been d...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3002-y
更新日期:2015-01-01 00:00:00
abstract::We present a 66-year-old woman with 2 months of visual hallucinations, unintentional weight loss, and short-term memory decline, whose clinical presentation and EEG supported a diagnosis of limbic encephalitis. Subsequent evaluation for a paraneoplastic etiology revealed a renal mass, which was resected and identified...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3172-7
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Routine screening for prostate cancer is controversial because of frequent false-positive results, the potential for slow, non-life-threatening growth of untreated cancer, the uncertainty regarding whether treatment can extend life, and the potential for treatment complications. This study examines how inform...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章
doi:10.1007/BF02600045
更新日期:1996-06-01 00:00:00
abstract:BACKGROUND:It is unclear how lack of health insurance or otherwise being underinsured contributes to observed racial disparities in health outcomes related to cardiovascular disease. OBJECTIVE:To determine the relative risk of death associated with insurance and race after hospital admission for an acute cardiovascula...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-012-2147-9
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:To determine the frequency with which an acute confusional state is caused by a stroke and to evaluate the usefulness of obtaining computed tomography scans in this setting. DESIGN:Retrospective analysis. SETTING:Tertiary referral center. PATIENTS:The authors reviewed 127 neurology consultations requested ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599217
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Aspirin reduces mortality for men and women with coronary heart disease (CHD). Previous research suggests women with acute coronary syndromes receive less aggressive care, including less frequent early administration of aspirin. The presence of gender differences in aspirin use for secondary prevention is le...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0116-5
更新日期:2007-01-01 00:00:00
abstract::General Internal Medicine research evolves in response to the needs of the patients to whom we provide care. Currently, many studies exclude older adults who deeply affect the clinical care of this population. With the number of older adults increasing, creating research protocols that include older adults with multip...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-013-2719-3
更新日期:2014-06-01 00:00:00
abstract::Implementation science is focused on developing and evaluating methods to reduce gaps between research and practice. As healthcare organizations become increasingly accountable for equity, quality, and value, attention has been directed to identifying specific implementation strategies that can accelerate the adoption...
journal_title:Journal of general internal medicine
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更新日期:2020-09-11 00:00:00
abstract:BACKGROUND:Little is known about the outcomes of in-hospital cardiopulmonary resuscitation (CPR) in Asian populations including elderly patients in Japan. OBJECTIVE:To determine the survival outcome of in-hospital CPR among elderly patients in Japan, and to identify predictors associated with survival. DESIGN:Retrosp...
journal_title:Journal of general internal medicine
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doi:10.1007/s11606-018-4747-5
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Approximately 25 million people in the USA are limited English proficient (LEP). When LEP patients receive care from physicians who are truly language concordant, some evidence show that language disparities are reduced, but others demonstrate worse outcomes. We conducted a systematic review of the literatur...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04847-5
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Global health measures represent an attractive option for researchers and clinicians seeking a brief snapshot of a patient's overall perspective on his or her health. Because scores on different global health measures are not comparable, comparative effectiveness research (CER) is challenging. OBJECTIVE:To ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3453-9
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Network meta-analysis (NMA) is a popular tool to compare multiple treatments in medical research. It is frequently implemented via Bayesian methods. The prior choice of between-study heterogeneity is critical in Bayesian NMAs. This study evaluates the impact of different priors for heterogeneity on NMA resul...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06357-1
更新日期:2021-01-05 00:00:00
abstract::Decision analysis is a tool that clinicians can use to choose an option that maximizes the overall net benefit to a patient. It is an explicit, quantitative, and systematic approach to decision making under conditions of uncertainty. In this article, we present two teaching tips aimed at helping clinical learners unde...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0918-8
更新日期:2009-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2007-7
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Previous studies indicate that medical trainees frequently experience discrimination by patients. Little is known about effective strategies to teach trainees to respond to this discrimination. AIM:To create a workshop for first-year residents utilizing standardized patients to improve skills in responding ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04881-3
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:To characterize prostate-specific antigen (PSA) testing practices in a hospital-based primary care clinic, and to determine the outcomes of PSA testing, including urology referrals, biopsies, cancers detected, and cancer treatments. DESIGN:Retrospective cohort study. Data were obtained from computerized Dep...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00026.x
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The patient-centered medical home (PCMH) model aims to provide patient-centered care, lower costs, and improve health outcomes. Medical students have not been meaningfully integrated in this model. AIM:To test the feasibility of a longitudinal clerkship based on PCMH principles and anchored by PCMH educatio...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2389-1
更新日期:2013-08-01 00:00:00
abstract::To describe the determinants of patient satisfaction with medical care, self-administered questionnaires were given to a consecutive sample of 237 patients coming to an ambulatory care practice for the treatment of upper respiratory infections (URIs). Patients' most important goal was to obtain a diagnosis (57%). They...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Many Americans lack health insurance. Despite good evidence that lack of insurance compromises access to care, few prospective studies examine its relationship to health outcomes. OBJECTIVE:To determine the relationship between insurance and cardiovascular outcomes and the relationship between insurance and...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0127-2
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these d...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600087
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:The World Health Organization encourages the development of youth friendly services, yet little is known on how youth currently present in general practice. OBJECTIVE:To describe the perspectives, expectations, and service receipt of young people presenting to family doctors to inform the development of you...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0177-5
更新日期:2007-06-01 00:00:00
abstract::Hepatitis C virus (HCV) infection is a significant health problem worldwide, and is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation in the United States. The management of HCV has changed significantly over the last 5 years, as treatments have become simpler and more efficacious. Me...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4280-y
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To determine patient characteristics associated with patient and proxy perceptions of physicians' recommendations for life-prolonging care versus comfort care, and with acceptance of such recommendations. DESIGN:Cross-sectional. SETTING:Five teaching hospitals in Denver, Colo. PATIENTS:We studied 239 hospi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2000.07004.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Most guidelines recommend against PSA-based screening for prostate cancer in men ≥ 70 years of age. Adherence to these guidelines is variable. OBJECTIVE:To determine whether the use of a "Best Practice Advisory" (BPA) intervention within the electronic medical record (EMR) system can alter the rate of PSA s...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06097-2
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Racial/ethnic minority patients are more likely to report experiences with discrimination in the healthcare setting, potentially leading to reduced access to appropriate care; however, few studies evaluate reports of discrimination with objectively measured quality of care indicators. OBJECTIVE:To evaluate ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-011-1729-2
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Few studies have examined the impact of inpatient interpreter use for limited English proficient (LEP) patients on length of stay (LOS), 30-day post discharge emergency department (ED) visits and 30-day hospital readmission rates for LEP patients. METHODS:A retrospective cohort analysis was conducted of all...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3213-x
更新日期:2015-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.21238.x
更新日期:2004-03-01 00:00:00