Interventions to Improve Follow-up of Positive Results on Fecal Blood Tests: A Systematic Review.

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Version: Author's accepted manuscript
License: CC BY 4.0
Serval ID
serval:BIB_6D8E6D585246
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Interventions to Improve Follow-up of Positive Results on Fecal Blood Tests: A Systematic Review.
Journal
Annals of internal medicine
Author(s)
Selby K., Baumgartner C., Levin T.R., Doubeni C.A., Zauber A.G., Schottinger J., Jensen C.D., Lee J.K., Corley D.A.
ISSN
1539-3704 (Electronic)
ISSN-L
0003-4819
Publication state
Published
Issued date
17/10/2017
Peer-reviewed
Oui
Volume
167
Number
8
Pages
565-575
Language
english
Notes
Publication types: Journal Article ; Review ; Systematic Review
Publication Status: ppublish
Abstract
Fecal immunochemical testing is the most commonly used method for colorectal cancer screening worldwide. However, its effectiveness is frequently undermined by failure to obtain follow-up colonoscopy after positive test results.
To evaluate interventions to improve rates of follow-up colonoscopy for adults after a positive result on a fecal test (guaiac or immunochemical).
English-language studies from the Cochrane Central Register of Controlled Trials, PubMed, and Embase from database inception through June 2017.
Randomized and nonrandomized studies reporting an intervention for colonoscopy follow-up of asymptomatic adults with positive fecal test results.
Two reviewers independently extracted data and ranked study quality; 2 rated overall strength of evidence for each category of study type.
Twenty-three studies were eligible for analysis, including 7 randomized and 16 nonrandomized studies. Three were at low risk of bias. Eleven studies described patient-level interventions (changes to invitation, provision of results or follow-up appointments, and patient navigators), 5 provider-level interventions (reminders or performance data), and 7 system-level interventions (automated referral, precolonoscopy telephone calls, patient registries, and quality improvement efforts). Moderate evidence supported patient navigators and provider reminders or performance data. Evidence for system-level interventions was low. Seventeen studies reported the proportion of test-positive patients who completed colonoscopy compared with a control population, with absolute differences of -7.4 percentage points (95% CI, -19 to 4.3 percentage points) to 25 percentage points (CI, 14 to 35 percentage points).
More than half of studies were at high or very high risk of bias; heterogeneous study designs and characteristics precluded meta-analysis.
Patient navigators and giving providers reminders or performance data may help improve colonoscopy rates of asymptomatic adults with positive fecal blood test results. Current evidence about useful system-level interventions is scant and insufficient.
National Cancer Institute. (PROSPERO: CRD42016048286).
Keywords
Aftercare, Bias, Colonoscopy/statistics & numerical data, Colorectal Neoplasms/diagnosis, Humans, Occult Blood, Patient Navigation
Pubmed
Web of science
Create date
05/06/2023 20:52
Last modification date
15/05/2024 5:59
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