Table 4.
Trials to Expedite Follow-up Testing
| Reference | Design | Intervention(s) | Control or Limited Intervention(s) | Intervention n (control n), Duration, Race/Ethnicity | Health Insurance, Income | Setting | Results | Quality Score (out of 27) |
|---|---|---|---|---|---|---|---|---|
| Manfredi et al. 1990 | CCT | Nurse instructions on making referral appointments; stamped, pre-addressed form patients returned upon referral completion; mailed reminder notes; telephone reminders. | Usual care. | 69 (95), 16 months, 69.5% black. | 48.2% uninsured in control group, 61.3% uninsured in intervention group, income not reported. | Four urban Department of Health neighborhood health centers. | Referral completion: Intervention (84.1%), control (54.7%), (CI 14.8, 44.0). | 13 |
| Bressler et al. 1993 | CCT | Breast cancer screening and breast self-exam education, clinical breast exam and referral for mammogram when indicated, tracking of those referred for biopsy. | Usual care. | 164 (335), 4 years, 83-86% black, 8% white, 4-5% Hispanic, 2-4% Other. | Insurance not stated, patients had “low income”. | Outpatient general medicine clinic at large county hospital. | Proportion diagnosed with early stage breast cancer: intervention (25%), control (6%), (p = .001). | 17 |
| Lacey et al. 1993 | CCT | Nurse and outreach worker directed education, screening, referral, and tracking/follow-up. | Usual care. | 100 (270) 18 months 99% black. | Patients were “primarily uninsured,” income not reported, 75% unemployed. | Urban community-based health center with a breast screening clinic. | Diagnostic appointment rates: intervention (92%), control (72%), (p < .001). | 16 |
| Freeman, Muth, and Kemer 1995 | CCT | Navigator assistance with follow-up appointments, obtaining financial and medical clearance for surgical procedures, retrieving lost test results, language translation when necessary. | Usual care. | 131 (493), 27 months, 64% black, 26% Hispanic, 10% white. | ~20% Medicaid, ~40% no insurance, patients had “low income.” | Primary care clinic in a major community hospital. | Biopsy completion: intervention (85.7%), control (56.5%), (not significant). Biopsy completion within 4 weeks: intervention (71.4%), control (38.5%), (p = .047). | 17 |
| Ell et al. 2002 | CCT | Stepped care appointment reminders, reinforcing telephone calls, assistance with logistical barriers, systems navigation, social work assessment +/- counseling +/- referral to psychosocial oncology +/- mental health services. | Usual care. | 605 (476), 12 months, 71% Hispanic, 18% black, 11% Other. | 17% without insurance at one location, 78% without insurance at other location, income not reported. | Large public and private urban screening, diagnostic, and treatment-referral centers in Los Angeles and New York. | Follow-up appointment adherence in Los Angeles; intervention (93%), control (72%), (p = .001). Follow-up appointment adherence in New York: intervention (90% ), control (69%), (p = .001) Diagnostic resolution within 240 days for American College of Radiology Score of 3: interventions vs. control (89% vs. 67%, p = .008) in Los Angeles and (75% vs. 49%, p = .001) in New York | 19 |