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Screening Mammography in Clinical Practice: A Complex Activity

Screening Mammography in Clinical Practice: A Complex Activity Abstract The burgeoning literature regarding screening mammography at times seems to ignore, and yet, by its volume, indirectly acknowledges, the complexity of this activity. Consider briefly the sequence of behaviors healthy women and their physicians may follow. A woman initiates a health care encounter with (possibly only partially or unconsciously recognized) or without signs of breast disease. The physician may perform a breast examination and may take a spectrum of actions concerning mammographyfrom limited discussion to promptly arranging for the study. At a site other than the physician's office, at another time, mammograms are performed. An immediate (possibly) and final written report of findings are sent to the ordering physician by the radiologist. The physician acts on the findings, including informing the woman. The woman acts on the reported findings. When one considers the myriad of factors that might influence the repeated regular and successful completion of this abbreviated cascade of References 1. Shapiro S, Venet W, Strax P, et al, eds. Periodic Screening for Breast Cancer . Baltimore, Md: Johns Hopkins Press; 1988. 2. Tabar L, Fagerberg CJG, Gad A, et al. Reduction in mortality from breast cancer after mass screening with mammography . Lancet. 1985;1:829-832.Crossref 3. Anderson I, Aspegren K, Janzon L, et al. Mammographic screening and mortality from breast cancer: the Malmo Mammographic Screening Trial . BMJ. 1988;297:943-948.Crossref 4. Verbeek ALM, Hendricks JNCL, Nollan PR, et al. Reduction of breast cancer mortality through mass screening with modem mammography: first results of the Nijmegen Project 1975-1981 . Lancet. 1984;1:1222-1224.Crossref 5. Collete HJA, Day ME, Rombach JJ, et al. Evaluation of screening for breast cancer in a non-randomized study (The DOM Project) by means of a case-control study . Lancet. 1984;1:1224-1226.Crossref 6. American Cancer Society. Summary of Current Guidelines for the Cancer-Related Checkup: Recommendations . New York, NY: American Cancer Society; 1988. 7. Canadian Task Force on the Periodic Health Examination. The periodic health examination . Can Med Assoc J. 1989;141:205. 8. Report of the US Preventive Services Task Force: Guide to Clinical Preventive Services . Baltimore, Md: Williams & Wilkins; 1989. 9. Eddy DM. The challenge . JAMA. 1990;263:287-290.Crossref 10. Eddy DM. Practice policies—What are they? JAMA. 1990;263:877-880.Crossref 11. Eddy DM. Practice policies: Where do they come from? JAMA. 1990;263:1265-1275.Crossref 12. Eddy DM. Guidelines for policy statements: the explicit approach . JAMA. 1990;263:2239-2243.Crossref 13. Eddy DM. Designing a practice policy: standards, guidelines, and options . JAMA. 1990;263:3077-3084.Crossref 14. American Cancer Society. Survey of physician attitudes and practices in early cancer detection . CA. 1985;35:197-213. 15. Bergner M, Allison CJ, Dieter P, et al. Early detection and control of cancer in clinical practice . Arch Intern Med. 1990;150:431-436.Crossref 16. McPhee SJ, Richard RJ, Solkowitz SM. Performance of cancer screening in a university general internal medicine practice: comparison with the 1980 American Cancer Society guidelines . J Gen Intern Med. 1986;1:275-281.Crossref 17. Battista RM. Adult cancer prevention in primary care: patterns of practice in Quebec . Am J Public Health. 1983;73:1036-1039.Crossref 18. Zapka JG, Stottard AM, Costanza ME, Greene HL. Breast cancer screening by mammography: utilization and associated factors . Am J Public Health. 1989;79:1499-1502.Crossref 19. Becker MH, Janz NK. Practicing health promotion: the doctor's dilemma . Ann Intern Med. 1990;113:419-422.Crossref 20. Sibley JC, Sackett DL, Neufeld V, et al. A randomized trial of continuing medical education . N Engl J Med. 1982;306:511-515.Crossref 21. Tierney WM, Hui SL, MacDonald CJ. Delayed feedback of physician performance versus immediate reminders to perform preventive care . Med Care. 1986;24:659-666.Crossref 22. McPhee SJ, Bird JA, Jenkins CNH. Promotion of cancer screening: a randomized, controlled trial of three interventions . Arch Intern Med. 1989;149:1866-1872.Crossref 23. MacDonald CJ, Sui LH, Smith DM, et al. Reminders to physicians from an introspective computer medical record: a two-year randomized trial . Ann Intern Med. 1984;100:130-138.Crossref 24. Green LW, Eriksen MP, Schot EL. Preventive practices by physicians: behavioral determinants and potential interventions . Am J Prev Med. 1988;4( (suppl) ):101-107. 25. Ajzen I, Fishbein M. Understanding Attitudes and Predicting Social Behavior . Englewood Cliffs, NJ: Prentice-Hall; 1980. 26. Greer AL. The two cultures of biomedicine: can there be consensus? JAMA. 1987;258:2739-2740.Crossref 27. Greer AL. The state of the art versus the state of science: the diffusion of new medical technologies into practice . Int J Tech Assess Health Care. 1988;4:5-26.Crossref 28. Hill MH, Levine DM, Whelton PK. Awareness, use, and impact of the 1984 Joint National Committee Report on High Blood Pressure . Am J Public Health. 1988;78:1190-1194.Crossref 29. Wechsler H, Levine S, Idelson RK, et al. The physician's role in health promotion: a survey of primary care practitioners . N Engl J Med. 1983;308:97-100.Crossref 30. Montano DE, Manders DB, Phillips WR. Family physician beliefs about cancer screening: development of a survey instrument . J Fam Pract. 1990;30:313-319. 31. Clementz GL, Aldag JC, Gladfelter TT, Barclay AM, Brooks HF. A randomized study of cancer screening in a family practice setting using a recall model . J Fam Pract. 1990;30:537-541. 32. Taplin SH. Breast cancer screening: a curious problem in primary care . J Fam Pract. 1989;29:247-248. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Screening Mammography in Clinical Practice: A Complex Activity

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400010043002
Publisher site
See Article on Publisher Site

Abstract

Abstract The burgeoning literature regarding screening mammography at times seems to ignore, and yet, by its volume, indirectly acknowledges, the complexity of this activity. Consider briefly the sequence of behaviors healthy women and their physicians may follow. A woman initiates a health care encounter with (possibly only partially or unconsciously recognized) or without signs of breast disease. The physician may perform a breast examination and may take a spectrum of actions concerning mammographyfrom limited discussion to promptly arranging for the study. At a site other than the physician's office, at another time, mammograms are performed. An immediate (possibly) and final written report of findings are sent to the ordering physician by the radiologist. The physician acts on the findings, including informing the woman. The woman acts on the reported findings. When one considers the myriad of factors that might influence the repeated regular and successful completion of this abbreviated cascade of References 1. Shapiro S, Venet W, Strax P, et al, eds. Periodic Screening for Breast Cancer . Baltimore, Md: Johns Hopkins Press; 1988. 2. Tabar L, Fagerberg CJG, Gad A, et al. Reduction in mortality from breast cancer after mass screening with mammography . Lancet. 1985;1:829-832.Crossref 3. Anderson I, Aspegren K, Janzon L, et al. Mammographic screening and mortality from breast cancer: the Malmo Mammographic Screening Trial . BMJ. 1988;297:943-948.Crossref 4. Verbeek ALM, Hendricks JNCL, Nollan PR, et al. Reduction of breast cancer mortality through mass screening with modem mammography: first results of the Nijmegen Project 1975-1981 . Lancet. 1984;1:1222-1224.Crossref 5. Collete HJA, Day ME, Rombach JJ, et al. Evaluation of screening for breast cancer in a non-randomized study (The DOM Project) by means of a case-control study . Lancet. 1984;1:1224-1226.Crossref 6. American Cancer Society. Summary of Current Guidelines for the Cancer-Related Checkup: Recommendations . New York, NY: American Cancer Society; 1988. 7. Canadian Task Force on the Periodic Health Examination. The periodic health examination . Can Med Assoc J. 1989;141:205. 8. Report of the US Preventive Services Task Force: Guide to Clinical Preventive Services . Baltimore, Md: Williams & Wilkins; 1989. 9. Eddy DM. The challenge . JAMA. 1990;263:287-290.Crossref 10. Eddy DM. Practice policies—What are they? JAMA. 1990;263:877-880.Crossref 11. Eddy DM. Practice policies: Where do they come from? JAMA. 1990;263:1265-1275.Crossref 12. Eddy DM. Guidelines for policy statements: the explicit approach . JAMA. 1990;263:2239-2243.Crossref 13. Eddy DM. Designing a practice policy: standards, guidelines, and options . JAMA. 1990;263:3077-3084.Crossref 14. American Cancer Society. Survey of physician attitudes and practices in early cancer detection . CA. 1985;35:197-213. 15. Bergner M, Allison CJ, Dieter P, et al. Early detection and control of cancer in clinical practice . Arch Intern Med. 1990;150:431-436.Crossref 16. McPhee SJ, Richard RJ, Solkowitz SM. Performance of cancer screening in a university general internal medicine practice: comparison with the 1980 American Cancer Society guidelines . J Gen Intern Med. 1986;1:275-281.Crossref 17. Battista RM. Adult cancer prevention in primary care: patterns of practice in Quebec . Am J Public Health. 1983;73:1036-1039.Crossref 18. Zapka JG, Stottard AM, Costanza ME, Greene HL. Breast cancer screening by mammography: utilization and associated factors . Am J Public Health. 1989;79:1499-1502.Crossref 19. Becker MH, Janz NK. Practicing health promotion: the doctor's dilemma . Ann Intern Med. 1990;113:419-422.Crossref 20. Sibley JC, Sackett DL, Neufeld V, et al. A randomized trial of continuing medical education . N Engl J Med. 1982;306:511-515.Crossref 21. Tierney WM, Hui SL, MacDonald CJ. Delayed feedback of physician performance versus immediate reminders to perform preventive care . Med Care. 1986;24:659-666.Crossref 22. McPhee SJ, Bird JA, Jenkins CNH. Promotion of cancer screening: a randomized, controlled trial of three interventions . Arch Intern Med. 1989;149:1866-1872.Crossref 23. MacDonald CJ, Sui LH, Smith DM, et al. Reminders to physicians from an introspective computer medical record: a two-year randomized trial . Ann Intern Med. 1984;100:130-138.Crossref 24. Green LW, Eriksen MP, Schot EL. Preventive practices by physicians: behavioral determinants and potential interventions . Am J Prev Med. 1988;4( (suppl) ):101-107. 25. Ajzen I, Fishbein M. Understanding Attitudes and Predicting Social Behavior . Englewood Cliffs, NJ: Prentice-Hall; 1980. 26. Greer AL. The two cultures of biomedicine: can there be consensus? JAMA. 1987;258:2739-2740.Crossref 27. Greer AL. The state of the art versus the state of science: the diffusion of new medical technologies into practice . Int J Tech Assess Health Care. 1988;4:5-26.Crossref 28. Hill MH, Levine DM, Whelton PK. Awareness, use, and impact of the 1984 Joint National Committee Report on High Blood Pressure . Am J Public Health. 1988;78:1190-1194.Crossref 29. Wechsler H, Levine S, Idelson RK, et al. The physician's role in health promotion: a survey of primary care practitioners . N Engl J Med. 1983;308:97-100.Crossref 30. Montano DE, Manders DB, Phillips WR. Family physician beliefs about cancer screening: development of a survey instrument . J Fam Pract. 1990;30:313-319. 31. Clementz GL, Aldag JC, Gladfelter TT, Barclay AM, Brooks HF. A randomized study of cancer screening in a family practice setting using a recall model . J Fam Pract. 1990;30:537-541. 32. Taplin SH. Breast cancer screening: a curious problem in primary care . J Fam Pract. 1989;29:247-248.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1991

References