Communication factors in the follow-up of abnormal mammograms
Open accessAbstract
Objective To identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms.Design Prospective longitudinal study involving medical record review and patient survey.Setting Ten academically affiliated ambulatory medical practices in the Boston metropolitan area.Participants One hundred twenty-six women with abnormal mammograms requiring short-term (6 months) follow-up imaging.Measurements Proportion of women in the study who received appropriate follow-up care.Results Eighty-one (64%) of the women with abnormal mammograms requiring short-term follow-up imaging received the appropriate follow-up care. After adjusting for patients' age and insurance status, 2 communication factors were found to be independently associated with the delivery of appropriate follow-up care: 1). physicians' documentation of a follow-up plan in the medical record (adjusted odds ratio, 2.79; 95% confidence interval, 1.11 to 6.98; P =.029); and 2). patients' understanding of the need for follow-up (adjusted odds ratio, 3.86; 95% confidence interval, 1.50 to 9.96; P =.006). None of the patients' clinical or psychological characteristics were associated with the delivery of appropriate follow-up care.Conclusions Follow-up care for women with abnormal mammograms requiring short-term follow-up imaging is suboptimal. Documentation of the follow-up plan by the physician and understanding of the follow-up plan by the patient are important factors that are correlated with the receipt of appropriate follow-up care for these women. Interventions designed to improve the quality of result follow-up in the outpatient setting should address these issues in patient-doctor communication.
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Missed laboratory results or delayed recognition of results creates a significant potential for outpatient diagnostic errors, adverse events, and liability claims.
“missed laboratory results or delayed recognition of results leads to a significant potential for outpatient diagnostic errors, adverse events and liability claims.”
From Notification of Abnormal Lab Test Results in an Electronic Medical Record: Do Any Safety Concerns Remain? (2010) · cites this paper as [12]
Communication breakdowns are an increasingly recognized preventable factor in medical mishaps.
“Communication breakdowns are an increasingly recognized preventable factor in medical mishaps, and emerging data suggest a high prevalence of communication breakdowns among physicians, patients, and important members of the health care team who assist with the diagnostic process.21,25–32”
From Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology (2008) · cites this paper as [30]
In a study of abnormal mammograms, over a third of the women studied did not receive appropriate follow-up.
“For example, in a study of abnormal mammograms, over a third of the women studied did not receive appropriate follow-up.30”
From Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology (2008) · cites this paper as [30]
Emerging data suggest a high prevalence of communication breakdowns among physicians, patients, and important members of the health care team who assist with the diagnostic process.
“Communication breakdowns are an increasingly recognized preventable factor in medical mishaps, and emerging data suggest a high prevalence of communication breakdowns among physicians, patients, and important members of the health care team who assist with the diagnostic process.21,25–32”
From Reducing Diagnostic Errors through Effective Communication: Harnessing the Power of Information Technology (2008) · cites this paper as [30]
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References 92 · Cited by 138
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- Authors
- Poon, E. G., Haas, J. S., Puopolo, A. L., Gandhi, T. K., Burdick, E., Bates, D. W., & Brennan, T. A.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Poon, Eric G.
- Venue
- Journal of General Internal Medicine
- Published
- 2004-04
- Volume
- 19
- Issue
- 4
- Pages
- 316-323
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC1492194
- OpenAlex
- W2063328474
- Cited by
- 138
- References
- 92
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 2 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 8 · 2014: 8 · 2013: 7 · 2012: 1
- FWCI
- 23.51
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- mammographic abnormalities, follow-up care, patient-doctor communication, physician documentation, follow-up plan, patient understanding, quality of care, breast cancer screening, outpatient care
- MeSH terms
- Breast Diseases, Breast Neoplasms, Communication, Continuity of Patient Care, Female, Humans, Mammography, Middle Aged, Physician-Patient Relations, Primary Health Care, Prospective Studies, Quality of Health Care, Insurance Coverage
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