||5R01CA072570-04 Interpret this number
||Harvard Pilgrim Health Care, Inc.
||Decreasing Adverse Effects of False Positive Mammograms
DESCRIPTION: False-positive mammogram readings, which account for more than
10 percent of all screening mammograms, cause long-lasting anxiety in women
and are associated with low adherence to subsequent screening mammogram
recommendations. The investigators propose a study to evaluate two
strategies to reduce adverse psychosocial effects of false-positive
mammograms in community women members of a large health maintenance
organization in a Northeast urban area. A psychoeducational intervention,
consisting of a videotape presentation and a pamphlet to explain the concept
of a false-positive mammogram reading and how to cope with it will be
developed and given to women at the time of their screening mammograms in
eight radiology practices. It will be evaluated, along with a radiology
system intervention to provide on-site readings and immediate follow-up
investigations to women with abnormal readings. A factorial design, with
four study groups will be used: Control, Education, Immediate Follow-up,
and Both. Levels of anxiety and concern about breast cancer and
mammography, adherence to subsequent screening mammography, health-care
utilization in the 12 months after screening mammography, and daily
functioning will be assessed in the women in each group, by telephone
interviews at two weeks and three months after the screening mammogram, and
by medical record review. Differences among the four groups will be sought,
using the Impact of Event Scale and the Hopkins Symptom Checklist for levels
of anxiety, and short-form General Health Survey for daily function.
Psychological effects will be plotted over time, and effect modifiers will
be sought to determine if the interventions affect women differentially.
Feasibility and cost of both interventions will be determined and
cost-effectiveness analyses will be performed. Because of high levels of
anxiety about breast cancer and breast cancer screening among women in
general, in a secondary study, the investigators will determine the same set
of outcomes in two groups of women with normal mammogram readings: Control
and Education. The study will determine whether simple strategies alleviate
adverse psychosocial effects of an important breast cancer screening
procedure that more than 25 million American women receive each year.
The Effect Of Immediate Reading Of Screening Mammograms On Medical Care Utilization And Costs After False-positive Mammograms
, Neumann P.J.
, Fletcher S.W.
, Barton M.B.
Health Services Research, 2007 Aug; 42(4), p. 1464-82.
Decreasing Women's Anxieties After Abnormal Mammograms: A Controlled Trial
, Morley D.S.
, Moore S.
, Allen J.D.
, Kleinman K.P.
, Emmons K.M.
, Fletcher S.W.
Journal Of The National Cancer Institute, 2004-04-07 00:00:00.0; 96(7), p. 529-38.