Evidence map›Paper›PMID 18386103›Full record

Trial reportJournal of general internal medicine2008

Physician reminders to promote surveillance colonoscopy for colorectal adenomas: a randomized controlled trial.

John Z Ayanian, Thomas D Sequist, Alan M Zaslavsky, Richard S Johannes

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of general internal medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00397969 (Improving Surveillance for Colorectal Polyps), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT00397969 nacompletednot on this map

Improving Surveillance for Colorectal Polyps

TypeinterventionalSponsorHarvard Medical School (HMS and HSDM)Ran2005 to 2008Enrolled800ConditionsColorectal Cancer, Precancerous ConditionArmscounseling intervention, screening colonoscopy
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

John Z AyanianDivision of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. ayanian@hcp.med.harvard.edu
Thomas D Sequist
Alan M Zaslavsky
Richard S Johannes

Funding

Improving Surveillance for Colorectal PolypsR21CA112365 · NCI · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI AYANIAN, JOHN Z · 2005 to 2006
$362k
NCI NIH HHS R21 CA112365NCI NIH HHS R21-CA112365
6 · The paper itself

Abstract

backgroundMost colorectal cancers develop from adenomatous polyps. National guidelines recommend surveillance colonoscopy within 5 years after such polyps are removed.

objectiveTo determine whether surveillance colonoscopy can be increased among overdue patients by reminders to their primary physicians.

designRandomized, controlled trial of patient-specific reminders mailed to 141 physicians in 2 Massachusetts primary care networks during April, 2006. PATIENTS: Seven hundred seventeen patients who had colorectal adenomas removed during 1995 through 2000 and no follow-up colonoscopy identified via automated review of electronic records through March, 2006. MEASUREMENTS AND MAIN

resultsThe use of colonoscopy and detection of new adenomas or cancer were assessed at 6 months by a blinded medical record review in all patients. Among 358 patients whose physicians received reminders, 33 (9.2%) patients underwent colonoscopy within 6 months, compared with 16 (4.5%) of 359 patients whose physicians did not receive reminders (P = 0.009). In prespecified subgroups, this effect did not differ statistically between 2 primary care networks, elderly and nonelderly patients, or women and men (all P > 0.60 by Breslow-Day test). New adenomas or cancer were detected in 14 (3.9%) intervention patients and 6 (1.7%) control patients (P = 0.06), representing 42.4% and 37.5% of patients who underwent colonoscopy in each group, respectively. Despite using advanced electronic health records to identify eligible patients, 22.5% of enrolled patients had a prior follow-up colonoscopy ascertained only by visual record review, and physicians reported 27.9% of intervention patients were no longer active in their practice.

conclusionsAmong patients with prior colorectal adenomas, physician reminders increased the use of surveillance colonoscopy, but better systems are needed to identify eligible patients (ClinicalTrials.gov ID number NCT00397969).

Indexed as

Appointments and SchedulesReminder SystemsAdenomatous PolypsAgedAged, 80 and overColonic PolypsColonoscopyColorectal NeoplasmsFemaleHumansMaleMassachusettsMiddle AgedPrimary Health Care

Identifiers

PMID18386103
PMCPMC2517870

What OpenQuestion holds

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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.