Who defaults from colposcopy? A multi-centre, population-based, prospective cohort study of predictors of non-attendance for follow-up among women with low-grade abnormal cervical cytology

Sharp, Linda; Cotton, Seonaidh; Thornton, Alison J.; Gray, Nicola; Cruickshank, Margaret; Whynes, David K.; Duncan, Ian D.; Hammond, R. H.; Smart, Louise; Little, Julian

doi:10.1016/j.ejogrb.2012.08.001

Cited by 26 publications

(27 citation statements)

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“…The six-week assessment was conducted in a sub-group of the study population, and women who did not attend for colposcopy or a first surveillance smear were not included. Default from colposcopy was higher than for cytological surveillance (6.7% vs 2.4%) [39], [40]. If raised anxiety was associated with default, as has been previously suggested [41], this would mean that we would have tended to underestimate the prevalence of anxiety to a greater extent in the colposcopy, than in the cytology, arm.…”

Section: Discussionmentioning

confidence: 80%

Psychosocial Impact of Alternative Management Policies for Low-Grade Cervical Abnormalities: Results from the TOMBOLA Randomised Controlled Trial

et al. 2013

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BackgroundLarge numbers of women who participate in cervical screening require follow-up for minor cytological abnormalities. Little is known about the psychological consequences of alternative management policies for these women. We compared, over 30-months, psychosocial outcomes of two policies: cytological surveillance (repeat cervical cytology tests in primary care) and a hospital-based colposcopy examination.MethodsWomen attending for a routine cytology test within the UK NHS Cervical Screening Programmes were eligible to participate. 3399 women, aged 20–59 years, with low-grade abnormal cytology, were randomised to cytological surveillance (six-monthly tests; n = 1703) or initial colposcopy with biopsies and/or subsequent treatment based on colposcopic and histological findings (n = 1696). At 12, 18, 24 and 30-months post-recruitment, women completed the Hospital Anxiety and Depression Scale (HADS). A subgroup (n = 2354) completed the Impact of Event Scale (IES) six weeks after the colposcopy episode or first surveillance cytology test. Primary outcomes were percentages over the entire follow-up period of significant depression (≥8) and significant anxiety (≥11; “30-month percentages”). Secondary outcomes were point prevalences of significant depression, significant anxiety and procedure-related distress (≥9). Outcomes were compared between arms by calculating fully-adjusted odds ratios (ORs) for initial colposcopy versus cytological surveillance.ResultsThere was no significant difference in 30-month percentages of significant depression (OR = 0.99, 95% CI 0.80–1.21) or anxiety (OR = 0.97, 95% CI 0.81–1.16) between arms. At the six-week assessment, anxiety and distress, but not depression, were significantly less common in the initial colposcopy arm (anxiety: 7.9% vs 13.4%; OR = 0.55, 95% CI 0.38–0.81; distress: 30.6% vs 39.3%, OR = 0.67 95% CI 0.54–0.84). Neither anxiety nor depression differed between arms at subsequent time-points.ConclusionsThere was no difference in the longer-term psychosocial impact of management policies based on cytological surveillance or initial colposcopy. Policy-makers, clinicians, and women themselves can be reassured that neither management policy has a significantly greater psychosocial cost.Trial RegistrationControlled-Trials.com ISRCTN 34841617

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Section: Discussionmentioning

confidence: 80%

Psychosocial Impact of Alternative Management Policies for Low-Grade Cervical Abnormalities: Results from the TOMBOLA Randomised Controlled Trial

et al. 2013

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“…Socioeconomic deprivation, as defined by not being in paid employment, has been found to be associated with nonattendance at hospital out-patient clinics. 18 This could have been the case for crucial endocrine and ophthalmic follow-up appointments for those TAO subjects of lower social grade or higher levels of deprivation. These patients may also have presented later to medical care or had higher rates of nonadherence with treatment modalities.…”

Section: Discussionmentioning

confidence: 99%

Are Ethnicity, Social Grade, and Social Deprivation Associated With Severity of Thyroid-Associated Ophthalmopathy?

Edmunds

Huntbach

Durrani³

2014

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose:Previous studies have extensively investigated the pathophysiology, genetics, and lifestyle risk factors of thyroid-associated ophthalmopathy (TAO). The aim of this study was to investigate the independent contribution of ethnic origin, social grade, and level of social deprivation to TAO severity in a large, multiethnic, and urban population.Methods:Retrospective case note review of all TAO patients seen at Birmingham and Midland Eye Centre, United Kingdom over a 14-year period. Ethnicity (White, Asian, or Black) was recorded, and residence postcode was used to determine social grade (National Readership Survey classification) and level of social deprivation (Index of Multiple Deprivation 2007). TAO severity was defined by European Group on Graves’ Orbitopathy criteria. Moderate-to-severe: necessity for TAO treatment with oral or intravenous steroid, long-term immunosuppressants, or orbital radiotherapy. Sight-threatening: presence of dysthyroid optic neuropathy (DON) or need for urgent orbital decompression surgery. Multivariable logistic regression was performed to measure the independent influence of ethnicity, social grade, and social deprivation on indicators of severe TAO.Results:Lower social grade was significantly associated with increased odds ratio (OR) of TAO patients having severe TAO, including treatment with oral (OR: 2.3 (95% CI 1.1–5.1) p = 0.03) and intravenous steroid (OR: 2.6 (95% CI 1.0–7.0) p = 0.04) and DON (OR: 4.0 (95% CI 1.2–12.7) p = 0.02), compared with those of highest social grade. Similar results were observed for social deprivation. Ethnicity had no independent association with any measure of TAO severity.Conclusions:In this cohort, lower social grade and higher social deprivation, but not ethnicity, had independent, statistically significant association with more severe TAO.

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“…A idade foi inversamente relacionada à probabilidade de no-show de um agendamento (quanto maior a idade do paciente, menor a probabilidade), ou seja, os pacientes adultos mais jovens são mais propensos a perder seus compromissos Goldman et al, 1982;Ross et al, 1995;Majeroni et al, 1996;Weingarten et al, 1997;Dyer et al, 1998;Hamilton et al, 2002;Cashman et al, 2004;Coodin et al, 2004;Karter et al, 2004;Lee et al, 2005;Adeponle et al, 2007;Chariatte et al, 2007;Dreiher et al, 2008b;Siminoff et al, 2008;Bofill et al, 2011;Carlsen et al, 2011;Pillai et al, 2012;Sharp et al, 2012;Traeger et al, 2012;Cronin et al, 2013…”

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“…Para Huang e Hanauer (2016), os pacientes hispânicos foram os mais propensos a comparecerem e os afro-americanos menos. Os pacientes de grupos raciais minoritários (incluindo o afro-americano) eram mais propensos ao não comparecimento do que brancosMargolis et al, 1993;Majeroni et al, 1996;Mugavero et al, 2007;Traeger et al, 2012;Miller et al, 2015;Samuels et al, 2015;Partin et al, 2016).No Reino Unido, houve também diferenças no não comparecimento associada à etnia, onde o afro descendente tem tendência de faltar mais do que o brancoKempny et al, 2016).ParaGrunebaum et al (1996),,Gordon et al (2010),Sharp et al (2012),Pillai et al (2012),Guay et al (2014),Samuels et al (2015) a etnia não foi um fator significativo.Para,Kavanagh et al (1991),,Bofill et al (2011,Barksdale et al (2014), Lotfi e Torres (2014),,Whiting et al (2015), a raça não é significativa Siminoff et al (2008),Kazarian et al (2008),. não encontraram significância nem para etnia nem para a raça.…”

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Revisão Sistemática Da Literatura Sobre No-Show Em Agendamento De Consultas

DANTAS¹

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A Deus por me permitir chegar até aqui com muita fé e perseverança, por me dar forças e iluminar meus caminhos.Aos meus pais, Francisco e Vilma, agradeço por todo apoio, educação, carinho, amor, torcida e confiança. Sem eles nada disso teria sido possível.Aos meus irmãos, André e Sílvia, pelo companheirismo e apoio em todos os momentos. À Igor, pela ajuda, incentivo e por estar sempre ao meu lado nessa jornada. Obrigada por tudo.Aos orientadores Fernando Cyrino e Silvio Hamacher, por todo suporte, atenção, correções, incentivos e oportunidades durante o desenvolvimento da dissertação. Obrigada por todos os ensinamentos.Aos professores do DEI/PUC-Rio por todo conhecimento compartilhado e pelas oportunidades de aprendizado.Aos meus colegas e amigos da PUC-Rio, obrigada por dividirem as dúvidas, experiências e por tornar toda essa trajetória um pouco mais fácil.À CAPES e à PUC-Rio, pelos auxílios concedidos e pelo excelente ambiente, materiais e professores disponíveis, sem os quais este trabalho não teria sido possível.A todos aqueles que, de alguma forma, contribuíram para este trabalho, meu muito obrigada. PUC-Rio -Certificação Digital Nº 1512274/CA Palavras-chavesNo-shows; agendamentos; sistemas de saúde; análise estatística; revisão sistemática. PUC-Rio -Certificação Digital Nº 1512274/CA Abstract Dantas, Leila Figueiredo; Oliveira, Fernando Luiz Cyrino (Advisor); Hamacher, Sílvio (Co-Advisor). Systematic literature review on no-show in appointment scheduling. Rio de Janeiro, 2016. 89p.The failure to attend to scheduled appointments ("no-show") has a significant impact on healthcare systems. Despite the growing of scientific research on the factors that influence no-show, there is not a current summary of the state of art in this area, and systematic review covering all medical fields. In order to fill this gap, this dissertation has the intention to conduct a systematic literature review with three goals: (i) to summarize the characteristics of the studies according to methodology, country, clinical specialty, dependents variables, and no-show rates;(ii) to gather and integrate the results of the factors that significantly affect the nonattendance rates; (iii) to compare this analysis with previous researches. The literature indicates that the no-show does not happens randomly, and to understand the characteristics related to missed appointments is important to improve attendance, allowing the use of this information in scheduling practices. Using the Scopus database, 724 articles were reviewed and 105 selected for analysis. The average no-show rate was 23%, and it is most common in patients: younger, low socioeconomic level, greater distance from home to the clinic, with public health insurance or no insurance, and attended by less experienced provider. The most significant factors are high lead time and high rates of previously missed appointment.

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Who defaults from colposcopy? A multi-centre, population-based, prospective cohort study of predictors of non-attendance for follow-up among women with low-grade abnormal cervical cytology

Cited by 26 publications

References 35 publications

Psychosocial Impact of Alternative Management Policies for Low-Grade Cervical Abnormalities: Results from the TOMBOLA Randomised Controlled Trial

Psychosocial Impact of Alternative Management Policies for Low-Grade Cervical Abnormalities: Results from the TOMBOLA Randomised Controlled Trial

Are Ethnicity, Social Grade, and Social Deprivation Associated With Severity of Thyroid-Associated Ophthalmopathy?

Revisão Sistemática Da Literatura Sobre No-Show Em Agendamento De Consultas

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