Provider Ordering and Patient Refusal of Colorectal Cancer Screening PDF Download
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Author: Polly A. Baird
Publisher:
ISBN:
Category :
Languages : en
Pages : 190
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Book Description
Background. Mass screening for colorectal cancer (CRC) and removal of precursor lesions dramatically reduces both incidence and mortality from CRC. Most of the eligible population has not been screened. Disparity of screening exists within populations across the domains of race/ethnicity, gender and age. Objective. To describe the patients eligible for colorectal cancer screening and the practice of provider ordering and patient refusal of colorectal cancer screening in one Veteran's Affairs Healthcare setting (VA). Design. Descriptive cross sectional study utilizing a secondary analysis of data from the VA electronic medical record system, Veterans Health Information Systems & Technology Architecture (VISTA). Participants. 4,315 men and women aged 50 years and older eligible for CRC screening between August 2004 and January 2005 at the San Francisco VA Medical Center and its Community Based Outpatient Clinics, CBOCs. Measurements. Independent variables were the demographic characteristics age, gender and race. Dependent variables were provider screening order, type of screening (FOBT, sigmoidoscopy, or colonoscopy), provider decision screening not indicated and patient refusal of screening. Results. Overall 1,751 (38.9%) of those eligible had screening ordered. Of the remaining eligible patients 1,311 (29.2%) refused screening and 1,433 (31.9%) had no screening ordered due to a provider determining it was not indicated. CRC screening rate was equivalent for men and women. For every 10 years younger a patient was 1.62 times more likely to be screened (95% CI 1.529
Author: Polly A. Baird
Publisher:
ISBN:
Category :
Languages : en
Pages : 190
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Book Description
Background. Mass screening for colorectal cancer (CRC) and removal of precursor lesions dramatically reduces both incidence and mortality from CRC. Most of the eligible population has not been screened. Disparity of screening exists within populations across the domains of race/ethnicity, gender and age. Objective. To describe the patients eligible for colorectal cancer screening and the practice of provider ordering and patient refusal of colorectal cancer screening in one Veteran's Affairs Healthcare setting (VA). Design. Descriptive cross sectional study utilizing a secondary analysis of data from the VA electronic medical record system, Veterans Health Information Systems & Technology Architecture (VISTA). Participants. 4,315 men and women aged 50 years and older eligible for CRC screening between August 2004 and January 2005 at the San Francisco VA Medical Center and its Community Based Outpatient Clinics, CBOCs. Measurements. Independent variables were the demographic characteristics age, gender and race. Dependent variables were provider screening order, type of screening (FOBT, sigmoidoscopy, or colonoscopy), provider decision screening not indicated and patient refusal of screening. Results. Overall 1,751 (38.9%) of those eligible had screening ordered. Of the remaining eligible patients 1,311 (29.2%) refused screening and 1,433 (31.9%) had no screening ordered due to a provider determining it was not indicated. CRC screening rate was equivalent for men and women. For every 10 years younger a patient was 1.62 times more likely to be screened (95% CI 1.529
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309377722
Category : Medical
Languages : en
Pages : 473
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Book Description
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Author: Nereo Segnan
Publisher:
ISBN:
Category : Colon (Anatomy)
Languages : en
Pages : 452
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Book Description
Recoge: 1. Introduction -- 2. Organisation -- Guiding principles for organising a colorectal cancer screening programme -- 3. Evaluation and interpretation of screening outcomes -- 4. Faecal occult blood testing -- 5. Quality assurance in endoscopy in colorectal cancer screening and diagnosis -- 6. Professional requirements and training -- 7. Quality assurance in pathology in colorectal cancer screening and diagnosis -- 8. Management of lesions detected in colorectal cancer screening -- 9. Colonoscopic surveillance following adenoma removal --10. Communication -- Appendices.
Author: Joseph Anderson, MD
Publisher: Springer Science & Business Media
ISBN: 1607613980
Category : Medical
Languages : en
Pages : 210
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Book Description
Colorectal Cancer Screening provides a complete overview of colorectal cancer screening, from epidemiology and molecular abnormalities, to the latest screening techniques such as stool DNA and FIT, Computerized Tomography (CT) Colonography, High Definition Colonoscopes and Narrow Band Imaging. As the text is devoted entirely to CRC screening, it features many facts, principles, guidelines and figures related to screening in an easy access format. This volume provides a complete guide to colorectal cancer screening which will be informative to the subspecialist as well as the primary care practitioner. It represents the only text that provides this up to date information about a subject that is continually changing. For the primary practitioner, information on the guidelines for screening as well as increasing patient participation is presentedd. For the subspecialist, information regarding the latest imaging techniques as well as flat adenomas and chromoendoscopy are covered. The section on the molecular changes in CRC will appeal to both groups. The text includes up to date information about colorectal screening that encompasses the entire spectrum of the topic and features photographs of polyps as well as diagrams of the morphology of polyps as well as photographs of CT colonography images. Algorithms are presented for all the suggested guidelines. Chapters are devoted to patient participation in screening and risk factors as well as new imaging technology. This useful volume explains the rationale behind screening for CRC. In addition, it covers the different screening options as well as the performance characteristics, when available in the literature, for each test. This volume will be used by the sub specialists who perform screening tests as well as primary care practitioners who refer patients to be screened for colorectal cancer.
Author: National Research Council
Publisher: National Academies Press
ISBN: 0309170133
Category : Medical
Languages : en
Pages : 564
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Book Description
Cancer ranks second only to heart disease as a leading cause of death in the United States, making it a tremendous burden in years of life lost, patient suffering, and economic costs. Fulfilling the Potential for Cancer Prevention and Early Detection reviews the proof that we can dramatically reduce cancer rates. The National Cancer Policy Board, part of the Institute of Medicine, outlines a national strategy to realize the promise of cancer prevention and early detection, including specific and wide-ranging recommendations. Offering a wealth of information and directly addressing major controversies, the book includes: A detailed look at how significantly cancer could be reduced through lifestyle changes, evaluating approaches used to alter eating, smoking, and exercise habits. An analysis of the intuitive notion that screening for cancer leads to improved health outcomes, including a discussion of screening methods, potential risks, and current recommendations. An examination of cancer prevention and control opportunities in primary health care delivery settings, including a review of interventions aimed at improving provider performance. Reviews of professional education and training programs, research trends and opportunities, and federal programs that support cancer prevention and early detection. This in-depth volume will be of interest to policy analysts, cancer and public health specialists, health care administrators and providers, researchers, insurers, medical journalists, and patient advocates.
Author: Hayden Bosworth
Publisher: Springer Science & Business Media
ISBN: 1441958665
Category : Medical
Languages : en
Pages : 363
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Book Description
Despite its direct effect on a patient’s health, the literature on treatment adherence does not yet include a summary of proven methods for identifying and addressing patient non-adherence. Improving Patient Treatment Adherence Across Multiple Behaviors: A Clinician's Guide differs significantly from many treatment adherence books on the market by focusing on clinicians and the practical tactics they need to improve patient adherence. The book is orgnaized by behavior and special issues as opposed to other texts, which look at treatment adherence as a theoretical concept. Each chapter provides a summary of existing literature regarding the impact of patient non-adherence, including costs, clinical outcomes and health-related quality of life, as well as a review of patient factors related to treatment adherence across behaviors, diseases, and special populations. A discussion of methods for improving treatment adherence takes a look at both proven methods and new technological advances in the field. Each chapter includes a table listing 3-5 key bullets that a clinician could use to address treatment adherence. Actual questions and scoring algorithms for widely used measures of treatment adherence make this book a useful guide for practicing clinicans.
Author: Robert A. Smith
Publisher: Elsevier Health Sciences
ISBN: 0323789544
Category : Medical
Languages : en
Pages : 185
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Book Description
This issue of Medical Clinics, guest edited by Dr. Robert A. Smith and Dr. Kevin Oeffinger, is devoted to Cancer Screening and Prevention. Articles in this important issue cover the development of cancer screening guidelines, implementing cancer screening in the clinical setting, and screening for colorectal, lung, cervical, prostate, skin, and ovarian cancer.
Author: Graeme P. Young
Publisher: W.B. Saunders Company
ISBN:
Category : Medical
Languages : en
Pages : 410
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Book Description
This is an overview of the issues involved in prevention and early detection of colorectal cancer providing up-to-date, practical advice for clinicians. Possible management strategies for those at risk are provided, taking into account the biological principles of colorectal cancer development, epidemiological data and emerging genetic information, as well as social and environmental factors.
Author: Denise Polit
Publisher: Lippincott Williams & Wilkins
ISBN: 1975153995
Category : Medical
Languages : en
Pages : 623
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Book Description
Complete with full research reports, critiques, and the innovative online Toolkit, this knowledge-building companion to Nursing Research: Generating and Assessing Evidence for Nursing Practice reinforces the acquisition of basic research skills and enhances students’ ability to confidently conduct, appraise, and critique research studies. Learning exercises emphasize careful reading and critical appraisal; robust appendices deliver fast access to a wide range of nursing research reports; and the timesaving online Toolkit provides best-practice research resources that can be easily adapted to meet individual needs. Crossword Puzzles provide an entertaining and challenging review of key terms and concepts. Study Questions encourage critical thinking and reinforce the most relevant content from each textbook chapter. Application Exercises hone students’ ability to read, comprehend and critique nursing studies most effectively. Full research reports in the robust appendices cover a wide range of endeavors. TheToolkit delivers fast online access to dozens of timesaving, adaptable resources that can be downloaded and customized to meet your specific needs.
Author: Scott R. Steele
Publisher: Springer
ISBN: 3319259709
Category : Medical
Languages : en
Pages : 1269
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Book Description
This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.
