IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0074542.html
   My bibliography  Save this article

Patient Navigation and Time to Diagnostic Resolution: Results for a Cluster Randomized Trial Evaluating the Efficacy of Patient Navigation among Patients with Breast Cancer Screening Abnormalities, Tampa, FL

Author

Listed:
  • Ji-Hyun Lee
  • William Fulp
  • Kristen J Wells
  • Cathy D Meade
  • Ercilia Calcano
  • Richard Roetzheim

Abstract

Objectives: The objective of this study was to evaluate a patient navigation (PN) program that attempts to reduce the time between a breast cancer screening abnormality and definitive diagnosis among medically underserved populations of Tampa Bay, Florida. Methods: The Moffitt Patient Navigation Research Program conducted a cluster randomized design with 10 primary care clinics. Patients were navigated from time of a breast screening abnormality to diagnostic resolution. This paper examined the length of time between breast abnormality and definitive diagnosis, using a shared frailty Cox proportional hazard model to assess PN program effect. Results: 1,039 patients were eligible for the study because of an abnormal breast cancer screening/clinical abnormality (494 navigated; 545 control). Analysis of PN effect by two time periods of resolution (0-3 months and > 3 months) showed a lagged effect of PN. For patients resolving in the first three months, the adjusted Hazard Ratio (aHR) was 0.85 (95% Confidence Interval [CI]: 0.64-1.13) suggesting that PN had no effect on resolution time during this period. Beyond three months, however, navigated patients resolved more quickly to diagnostic resolution compared with the control group (aHR 2.8, 95%CI: 1.30-6.13). The predicted aHR at 3 months was 1.2, which was not statistically significant, while PN had a significant positive effect beyond 4.7 months. Conclusions: PN programs may increase the timeliness of diagnostic resolution for patients with a breast cancer-related abnormality. PN did not speed diagnostic resolution during the initial three months of follow up but started to reduce time to diagnostic resolution after three months and showed a significant effect after 4.7 months. Trial Registration: ClinicalTrials.gov NCT00375024

Suggested Citation

  • Ji-Hyun Lee & William Fulp & Kristen J Wells & Cathy D Meade & Ercilia Calcano & Richard Roetzheim, 2013. "Patient Navigation and Time to Diagnostic Resolution: Results for a Cluster Randomized Trial Evaluating the Efficacy of Patient Navigation among Patients with Breast Cancer Screening Abnormalities, Ta," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-1, September.
    • Handle: RePEc:plo:pone00:0074542
    DOI: 10.1371/journal.pone.0074542
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0074542
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0074542&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0074542?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Ji-Hyun Lee & Michael J Schell & Richard Roetzheim, 2009. "Analysis of Group Randomized Trials with Multiple Binary Endpoints and Small Number of Groups," PLOS ONE, Public Library of Science, vol. 4(10), pages 1-9, October.
    2. Richardson, L.C. & Royalty, J. & Howe, W. & Helsel, W. & Kammerer, W. & Benard, V.B., 2010. "Timeliness of breast cancer diagnosis and initiation of treatment in the national breast and cervical cancer early detection program, 1996-2005," American Journal of Public Health, American Public Health Association, vol. 100(9), pages 1769-1776.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rekhter, Natalia & Ermasova, Natalia, 2021. "Culture of prevention and early disease detection of cancer in Russia," Social Science & Medicine, Elsevier, vol. 277(C).
    2. Shelley White-Means & Jill Dapremont & Barbara D Davis & Tronlyn Thompson, 2020. "Who Can Help Us on This Journey? African American Woman with Breast Cancer: Living in a City with Extreme Health Disparities," IJERPH, MDPI, vol. 17(4), pages 1-12, February.
    3. Dateng Li & Jing Cao & Song Zhang, 2020. "Power analysis for cluster randomized trials with multiple binary co‐primary endpoints," Biometrics, The International Biometric Society, vol. 76(4), pages 1064-1074, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0074542. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.