T H Wagner1. 1. School of Public Health, University of California, Berkeley 94720-7360, USA.
Abstract
BACKGROUND: Researchers have tried to increase mammography screening rates by using patient-oriented reminders. This paper compares the effectiveness of mailed patient reminders at increasing mammography screening. METHODS: Sixteen published articles met the inclusion criteria and were included in the meta-analysis. To assess the association between reminders and mammography screening, the Mantel-Haenszel odds ratio (OR) was calculated. RESULTS: Among U.S. studies in which controls did not receive any type of reminder, women who received reminders were approximately 50% more likely to get a mammogram (OR 1.48; chi(2)MH(1) = 38.27, P < .001). In addition, tailored letters were found to be more effective than generic reminders (OR 1.87; chi(2)MH(1) = 4.70, P < .05). Combining cost and effectiveness data allowed for estimates of cost per woman screened, which ranged from $0.96 to $5.88. CONCLUSIONS: Patient reminders are effective at increasing mammography screening. More research is needed to assess (1) the cost-effectiveness of patient reminders and (2) their effectiveness across race, education, income, and type of insurance.
BACKGROUND: Researchers have tried to increase mammography screening rates by using patient-oriented reminders. This paper compares the effectiveness of mailed patient reminders at increasing mammography screening. METHODS: Sixteen published articles met the inclusion criteria and were included in the meta-analysis. To assess the association between reminders and mammography screening, the Mantel-Haenszel odds ratio (OR) was calculated. RESULTS: Among U.S. studies in which controls did not receive any type of reminder, women who received reminders were approximately 50% more likely to get a mammogram (OR 1.48; chi(2)MH(1) = 38.27, P < .001). In addition, tailored letters were found to be more effective than generic reminders (OR 1.87; chi(2)MH(1) = 4.70, P < .05). Combining cost and effectiveness data allowed for estimates of cost per woman screened, which ranged from $0.96 to $5.88. CONCLUSIONS:Patient reminders are effective at increasing mammography screening. More research is needed to assess (1) the cost-effectiveness of patient reminders and (2) their effectiveness across race, education, income, and type of insurance.
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