Evidence map›Paper›PMID 1571644›Full record

Trial reportBMJ (Clinical research ed.)1992

Cancer: improving early detection and prevention. A community practice randomised trial.

A J Dietrich, G T O'Connor, A Keller, P A Carney, D Levy, F S Whaley

Registry-linked trialOpen access · bronzeAbstract readClinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 1992. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03604393 (Increasing Human Papillomavirus), which is not on this map. Cited by 68 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 10 pooled it
14.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03604393 naunknown statusnot on this mapstarted 2019, after this paper: background citation

Increasing Human Papillomavirus (HPV) Immunization Rates: The Rural Adolescent Vaccine Enterprise (RAVE)

TypeinterventionalSponsorOregon Health and Science UniversityRan2019 to 2023Enrolled22,000ConditionsHuman Papilloma VirusArmsPractice facilitation
3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 10 syntheses or guidelines pooled it, 238 citations in OpenAlex.

  1. Pooled it
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  3. Training health professionals in smoking cessation.The Cochrane database of systematic reviews · 2012
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  7. Recommendations for future studies: a systematic review of educational interventions in primary care settings.The British journal of general practice : the journal of the Royal College of General Practitioners · 1999
    Pooled it
  8. Recruitment of women by GPs for pap tests: a meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998
    Pooled it
  9. No magic bullets: a systematic review of 102 trials of interventions to improve professional practice.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1995
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  19. Evidence to action: a tailored multifaceted approach to changing family physician practice patterns and improving preventive care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2001
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8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

A J DietrichDepartment of Community and Family Medicine, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
G T O'Connor
A Keller
P A Carney
D Levy
F S Whaley
Dartmouth Hospital · GBDartmouth College · US

Funding

Translational Engineering in Cancer (TEC)P30CA023108 · NCI · DARTMOUTH COLLEGE · PI Steven D Leach · 1985 to 2026
$91.3M
IMPROVING CANCER CONTROL BY PRIMARY CARE PHYSICIANSR01CA046075 · NCI · DARTMOUTH COLLEGE · PI DIETRICH, ALLEN J. · 1987 to 1989
–
NCI NIH HHS CA23108NCI NIH HHS R01CA46075
6 · The paper itself

Abstract

objectiveTo test the impact of physician education and facilitator assisted office system interventions on cancer early detection and preventive services.

designA randomised trial of two interventions alone and in combination. SETTING AND SUBJECTS: Physicians in 98 ambulatory care practices in the United States.

interventionsThe education intervention consisted of a day long physician meeting directed at improving knowledge, attitudes, and skills relevant to cancer prevention and early detection. The office system intervention consisted of assistance from a project facilitator in establishing routines for providing needed services. These routines included division of responsibilities for providing services among physicians and their staff and the use of medical record flow sheets.

main outcome measuresThe proportions of patients provided the cancer prevention and early detection services indicated annually according to the US National Cancer Institute.

resultsBased on cross sectional patient surveys, the office system intervention was associated with an increase in mammography, the recommendation to do breast self examination, clinical breast examination, faecal occult blood testing, advice to quit smoking, and the recommendation to decrease dietary fat. Education was associated only with an increase in mammography. Record review for a patient cohort confirmed cross sectional survey findings regarding the office system for mammography and faecal occult blood testing.

conclusionCommunity practices assisted by a facilitator in the development and implementation of an office system can substantially improve provision of cancer early detection and preventive services.

Indexed as

AdultAgedCommunity MedicineCross-Sectional StudiesEducation, Medical, ContinuingFemaleHumansMaleMiddle AgedNeoplasmsNew HampshirePractice Management, MedicalPreventive Health ServicesVermont

Identifiers

PMID1571644
PMCPMC1881551
OpenAlexW1965252944

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.