The Medical journal of Australia · 2002
Applying evidence-based guidelines improves use of colonoscopy resources in patients with a moderate risk of colorectal neoplasia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bampton Peter A, Sandford Jayne J, Young Graeme P
Аннотация
OBJECTIVES: To determine whether applying National Health and Medical Research Council (NHMRC) guidelines for colorectal cancer prevention would reduce the number of follow-up colonoscopies.
DESIGN: A prospective audit of colonoscopic surveillance decisions before and after the intervention.
SETTING: The endoscopy suite at a metropolitan tertiary hospital three months before and after January 2000.
INTERVENTION: Dissemination of NHMRC guidelines, and supervision of application of the guidelines by a nurse coordinator.
SUBJECTS: We compared colonoscopic surveillance decisions before and after the intervention in two groups of 100 consecutive patients after polypectomy and in two groups of 50 consecutive patients with a family history of colorectal cancer after a normal colonoscopy.
MAIN OUTCOME MEASURES: Change in concordance of decisions with NHMRC guidelines; and effect on number of follow-up colonoscopies.
RESULTS: After the intervention, the proportion of postpolypectomy surveillance decisions matching the guidelines increased from 37% to 96% (P < 0.05). The mean time to repeat colonoscopy after polypectomy increased from 2.7 to 3.5 years (P < 0.005) (ie, a 23% reduction in the number of postpolypectomy surveillance colonoscopies performed per year). Likewise, the proportion of family-history surveillance decisions matching the guidelines increased from 63% to 96%. Adhering to the guidelines resulted in a 17% reduction in colonoscopies performed on the basis of a family history of colorectal cancer.
CONCLUSIONS: Supervised application of evidence-based guidelines to a colorectal cancer surveillance program significantly reduces the number of surveillance colonoscopies performed.
DESIGN: A prospective audit of colonoscopic surveillance decisions before and after the intervention.
SETTING: The endoscopy suite at a metropolitan tertiary hospital three months before and after January 2000.
INTERVENTION: Dissemination of NHMRC guidelines, and supervision of application of the guidelines by a nurse coordinator.
SUBJECTS: We compared colonoscopic surveillance decisions before and after the intervention in two groups of 100 consecutive patients after polypectomy and in two groups of 50 consecutive patients with a family history of colorectal cancer after a normal colonoscopy.
MAIN OUTCOME MEASURES: Change in concordance of decisions with NHMRC guidelines; and effect on number of follow-up colonoscopies.
RESULTS: After the intervention, the proportion of postpolypectomy surveillance decisions matching the guidelines increased from 37% to 96% (P < 0.05). The mean time to repeat colonoscopy after polypectomy increased from 2.7 to 3.5 years (P < 0.005) (ie, a 23% reduction in the number of postpolypectomy surveillance colonoscopies performed per year). Likewise, the proportion of family-history surveillance decisions matching the guidelines increased from 63% to 96%. Adhering to the guidelines resulted in a 17% reduction in colonoscopies performed on the basis of a family history of colorectal cancer.
CONCLUSIONS: Supervised application of evidence-based guidelines to a colorectal cancer surveillance program significantly reduces the number of surveillance colonoscopies performed.