Evidence map›Paper›PMID 30877609›Full record

ArticleDigestive diseases and sciences2019

Patient-Initiated Colonoscopy Scheduling Effectively Increases Colorectal Cancer Screening Adherence.

Gautam Mankaney, Maged Rizk, Shashank Sarvepalli, Jeannie Bongorno, Ari Garber, Rocio Lopez, John McMichael, Carol A Burke

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Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 38% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
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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

8 authors at 1 institution in 1 country.

Gautam MankaneyDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA. mankang@ccf.org.ORCID 0000-0002-4320-7322
Maged RizkDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
Shashank SarvepalliDepartment of Medicine, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
Jeannie BongornoDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
Ari GarberDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
Rocio LopezDepartment of Biostatistics, and Quantitative Health Sciences, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
John McMichaelDepartment of General Surgery, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
Carol A BurkeDepartment of Gastroenterology and Hepatology, Digestive Disease and Surgical Institute, The Cleveland Clinic, 9500 Euclid Avenue/A30, Cleveland, OH, 44195, USA.
Cleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimWe identified patients without medical record evidence of up-to-date colorectal cancer (CRC) screening and sent an invitation letter to self-schedule a colonoscopy without requiring prior primary care or gastroenterologist consultation. The aim of the study was to evaluate the response rate to the letter and factors associated with colonoscopy completion.

methodsA computer algorithm invited patients not up to date with CRC screening, with an INR < 1.5, and living within 300 miles of the Cleveland Clinic main campus through a letter. Patients scheduled a colonoscopy through a dedicated phone line without any prior physician consultation. Clinical, demographic, and socioeconomic variables were extracted from the EMR through natural language algorithms. We analyzed the percentage of patients who completed a colonoscopy within 6 months of sending the letter and factors associated with colonoscopy completion.

resultsA total of 145,717 letters were sent. 1451 patients were deceased and excluded from analysis. 3.8% (5442) of letter recipients completed a colonoscopy. The strongest factors associated with colonoscopy completion on multivariate analysis included family history of polyps (OR 3.1, 95% CI 2.3, 4.2) or CRC (OR 2.1, 95% CI 1.7, 2.5). Other factors included younger age, male gender, married status, closer distance to endoscopy center, number of visits in the year prior, statin use, and diabetes. There were no immediate procedural complications.

conclusionsPatient-initiated colonoscopy in response to letter invitation for CRC screening is effective and safe with safeguards established a priori. Consultation with a gastroenterologist or primary care physician is not necessary prior to colonoscopy. To our knowledge, this is the first study to evaluate patient-initiated colonoscopy for CRC cancer screening.

Indexed as

AgedAppointments and SchedulesColonic PolypsColonoscopyColorectal NeoplasmsCorrespondence as TopicEarly Detection of CancerFemaleHumansMaleMedical History TakingMiddle AgedPatient CompliancePostal ServiceColon cancer screeningLetter invitation for colorectal cancer screeningPatient-initiated colonoscopyPopulation-based screening

Identifiers

PMID30877609
OpenAlexW2920910494

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.