一个移动应用程序,以提高对结肠直肠癌筛查和息肉切除术后监测指南的依从性。

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
María A Casas, Francisco Schlottmann, Leandro Steinberg, Xavier Bessa, Anna Serradesanferm, Angels Pozo, Sonia Torres, Antoni Castells, Francesc Balaguer, Jaume Grau, Lisandro Pereyra, María Pellisé
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引用次数: 0

摘要

背景:尽管在预防和早期发现方面取得了重大进展,但结直肠癌(CRC)是全球癌症死亡的主要原因。不充分遵守指南和/或缺乏对指南的了解已被证明会妨碍适当的筛查和监测建议,并妨碍有效的筛查规划。目的:根据最近更新的指南,评估旨在优化CRC筛查和监测的移动应用程序的实施和现实影响。方法:由一组专家创建一个包含人机工程学算法的移动应用程序,整合所有相关指南信息。数据是在2023年2月至2024年5月期间从使用该应用程序的加泰罗尼亚医疗保健专业人员那里收集的。分析了用户特征、咨询类型和患者数据,以评估应用程序的实施、使用模式以及对CRC筛查和监测结果的影响。结果:共记录了12481次咨询;3,054例(24.4%)筛查和9,427例(75.6%)息肉切除术后监测咨询。在研究期间,专业人士越来越频繁地使用这款应用(保留率为72%)。在筛查咨询中,2082例(68.2%)患者被分类为平均风险,建议使用粪便隐血试验(FOBT)代替结肠镜检查。在监测咨询中,根据结肠镜检查阴性指数或存在低风险息肉的4748名(50%)患者,该应用程序建议推迟后续结肠镜检查,改为使用FOBT。推荐3224例(34.1%)患者进行标准3年结肠镜检查,749例(7.9%)患者进行1年结肠镜检查的强化监测。结论:CRC筛查和监测移动应用程序在医疗保健专业人员中得到了显著的接受和采用。在使用该应用程序的帮助下,正确实施更新的指南可以显着减少不必要的筛查和息肉切除术后结肠镜检查的数量,并有助于识别需要加强监测的高风险患者。临床试验:不适用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A mobile app to improve adherence to colorectal cancer screening and post polypectomy surveillance guidelines.

Background: Despite significant advances in prevention and early detection, colorectal cancer (CRC) is a leading cause of cancer mortality worldwide. Inadequate adherence and/or lack of knowledge of guidelines have shown to prevent adequate screening and surveillance recommendations and hinder effective screening programs.

Objective: Evaluate the implementation and real-world impact of a mobile app designed to optimize CRC screening and surveillance in accordance to recently updated guidelines.

Methods: A mobile app including ergonomic algorithms integrating all pertinent guideline information was created by a group of experts. Data were collected from Catalonia healthcare professionals using the app between February 2023 and May 2024. Users' characteristics, consultation types, and patient data were analyzed to assess app's implementation, usage patterns, and impact on CRC screening and surveillance outcomes.

Results: A total of 12,481 consultations were recorded; 3,054 (24.4%) screening and 9,427 (75.6%) post-polypectomy surveillance consultations. The app was increasingly and repeatedly used by professionals during the study period (72% retention rate). Among screening consultations, 2,082 (68.2%) patients were classified as average risk, suggesting the use of fecal occult blood test (FOBT) instead of colonoscopy. Among surveillance consultations, the app advised deferring follow-up colonoscopies and using FOBT instead in 4,748 (50%) patients based on negative index colonoscopy or the presence of low-risk polyps. Standard surveillance with colonoscopy at 3 years was recommended for 3,224 (34.1%) patients and intensive surveillance, requiring a colonoscopy at 1 year, was indicated for 749 (7.9%) patients.

Conclusions: A CRC screening and surveillance mobile app showed remarkable acceptance and uptake among healthcare professionals. Proper implementation of updated guidelines aided by the use of the app could significantly reduce the number of unnecessary screening and post-polypectomy surveillance colonoscopies, as well as help identifying high risk patients who require intensive surveillance.

Clinical trial: Not applicable.

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来源期刊
BMC Gastroenterology
BMC Gastroenterology 医学-胃肠肝病学
CiteScore
4.20
自引率
0.00%
发文量
465
审稿时长
6 months
期刊介绍: BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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