Biometrika 80 : Navigators thus faced several logistic hurdles awaiting formal referral, contacting and consenting patients that were not present in the control group. Statistical Analysis Our analytic approach was based on the cluster randomized trial CRT design [ 22 ] of the study in which participants may be clustered by clinic. Shared frailty Cox proportional hazards models were used to estimate the PN effect. Conclusions PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. Maladies chroniques au Canada: Each clinic was a cluster that contributes multiple patients to the input data set. About half the participants were married, with navigated patients being more likely to be married For patients who did not achieve definitive diagnosis, the date of last follow-up was recorded.
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Am J Manag Care 17 : — However, some of these studies had limitations in research design, necessitating the conduct of larger, controlled trials of PN.
Persons with delayed resolution may have substantial barriers to care and require greater assistance to reach resolution. Future research is needed to better define which patients are most likely to benefit from PN so that this resource can be targeted.
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Demographic and clinical variables at baseline were compared between the groups, using the generalized linear mixed effects models in which the clinic was treated as a random effect.
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As participation of control patients was limited to medical record abstraction, informed consent was waived by the IRB. Each clinic was a cluster that contributes multiple patients to the input data set.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Similar to the demographic characteristics of the Tampa Bay region [ 23 ], the populations served by the primary care clinics in this study were mostly Hispanic, African-American, and White.
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|Most studies that have evaluated whether PN is associated with better adherence to recommended diagnostic care or more timely receipt of diagnostic care following an abnormal screening mammogram or symptom of breast cancer have found that PN is indeed a promising strategy [ 14 - 17 ].
Most studies that have evaluated whether PN is associated with better adherence to recommended diagnostic care or more timely receipt of diagnostic care following an abnormal screening mammogram or symptom of breast cancer have found that PN is indeed a promising strategy [ 14 - 17 ].
Cancer patients were not included in our analysis due to the primary outcome of time to definitive resolution. The benefit of PN, therefore, seems to begin occurring around three months, and by about 5 months, PN was superior to usual care in reducing the time to diagnostic resolution of the screening abnormality. Non-English 1. The medical records of participants at control clinics were reviewed when it was determined that a patient met inclusion criteria.
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