Table 2. Primary and Secondary Outcomes of 120-Day and 240-Day Follow-Up.
| Patient population (N = 11 980)a | Absolute difference among proportions (95% CI)a | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| EHR reminders, outreach, and navigation | EHR reminders and outreach | EHR reminders | Usual care | EHR reminders, outreach, and navigation vs usual care | EHR reminders and outreach vs usual care | EHR reminders vs usual care | EHR reminders, outreach, and navigation vs EHR reminders | EHR reminders and outreach vs EHR reminders | EHR reminders, outreach, and navigation vs EHR reminders and outreach | |
| Primary outcome | ||||||||||
| Intention-to-treat population, No. (%) | 3455 (28.8) | 2569 (21.4) | 3254 (27.2) | 2702 (22.6) | ||||||
| Completed follow-up within 120 d of study enrollment | ||||||||||
| Unadjusted, No. (%) | 1062 (30.7) | 831 (32.3) | 796 (24.5) | 672 (24.9) | 5.8 (3.6 to 8.1) | 7.4 (5.0 to 9.9) | −0.4 (−2.6 to 1.8) | 6.2 (4.1 to 8.4) | 7.8 (5.6 to 10.2) | −1.6 (−4.0 to 0.8) |
| Adjusted %b | 31.4 | 31.0 | 22.7 | 22.9 | 8.5 (4.8 to 12.0) | 8.1 (4.5 to 11.7) | −0.2 (−3.5 to 3.0) | 8.7 (5.1 to 12.2) | 8.3 (4.8 to 11.9) | 0.4 (−3.6 to 4.2) |
| Secondary outcomes | ||||||||||
| Completed follow-up within 240 d of study enrollmentc | ||||||||||
| Unadjusted, No. (%) | 1470 (42.5) | 1122 (43.7) | 1170 (36.0) | 955 (35.3) | 7.2 (4.8 to 9.6) | 8.4 (5.7 to 11.0) | 0.7 (−1.8 to 3.1) | 6.5 (4.3 to 8.9) | 7.7 (5.2 to 10.2) | −1.2 (−3.7 to 1.4) |
| Adjusted %b | 43.8 | 42.6 | 34.7 | 34.1 | 9.7 (5.4 to 14.2) | 8.5 (4.1 to 13.0) | 0.6 (−3.5 to 4.9) | 9.1 (4.7 to 13.5) | 7.9 (3.5 to 12.3) | 1.2 (−3.3 to 5.9) |
| As-treated populationd | 2094 (25.6) | 1855 (22.7) | 2348 (28.7) | 1883 (23.0) | ||||||
| Completed follow-up within 120 d of study enrollment | ||||||||||
| Unadjusted, No. (%) | 786 (37.5) | 649 (35.0) | 597 (25.4) | 453 (24.1) | 13.4 (10.6 to 16.3) | 10.9 (8.0 to 13.8) | 1.3 (−1.2 to 4.0) | 12.1 (9.4 to 14.8) | 9.6 (6.8 to 12.4) | 2.5 (−0.5 to 5.6) |
| Adjusted %b | 38.9 | 33.7 | 23.6 | 22.6 | 16.3 (12.3 to 20.4) | 11.1 (7.2 to 15.0) | 1.0 (−2.4 to 4.5) | 15.3 (11.3 to 19.3) | 10.1 (6.2 to 13.9) | 5.2 (0.8 to 9.6) |
| Completed follow-up within 240 d of study enrollment | ||||||||||
| Unadjusted, No. (%) | 1095 (52.3) | 895 (48.2) | 900 (38.3) | 691 (36.7) | 15.6 (12.5 to 18.6) | 11.5 (8.4 to 14.7) | 1.6 (−1.3 to 4.6) | 14.0 (11.1 to 16.9) | 9.9 (6.9 to 12.9) | 4.1 (0.9 to 7.2) |
| Adjusted %b | 52.2 | 46.9 | 37.3 | 35.9 | 18.3 (13.0 to 23.4) | 11.0 (5.8 to 16.2) | 1.4 (−3.6 to 6.3) | 16.9 (11.7 to 22.0) | 9.6 (4.5 to 14.8) | 7.3 (1.8 to 12.7) |
Abbreviation: EHR, electronic health record.
The comparisons overall yielded P<.001, which was derived from the adjusted model.
Mixed logistic regression models (SAS Proc GLIMMIX) were used with the patient as the unit of analysis and included indicator variables for the 3 intervention groups (EHR reminders, outreach, and navigation group, the EHR reminders and outreach group, and the EHR reminders group) as the primary exposure. Random effects were used for practices and physicians. Fixed effects were used for cancer type, study site, enrollment period, and the enrollment period × study site interaction. In addition, the primary adjusted models also included covariates for the risk level of the abnormal test results (eg, low, medium, or high), marital status, having a primary care visit within the past year, race, and ethnicity. The adjusted percentages were calculated using marginal standardization.
Data are for the intention-to-treat population.
Excluded those included in the intention-to-treat population (additional details appear in the eMethods in Supplement 2).