Failure of automated Telephone outreach to improve colorectal cancer screening

January 01, 0001

Failure of automated Telephone outreach to improve colorectal cancer screening

Automated telephone outreach with speech recognition (ATO-SR) is used extensively by health plans. These US authors randomly allocated 40,000 health plan members to ATO-SR and 40,000 to usual care, of whom 10,432 and 10,506 in the intervention and usual care groups, respectively, had not been previously screened and were therefore eligible for analysis. The intervention was a single interactive outreach call using speech recognition to engage participants in conversation about the importance of CRC screening and options for and barriers to screening. The intervention directed participants to contact their primary care provider to schedule screening.

They found: "The incidence of any CRC screening was 30.6% in the intervention group and 30.4% in the usual care group. After adjustment for available covariates, there remained no intervention effect (adjusted OR 1.01). A total of 21.4% of members in the intervention group and 20.3% in the usual care group underwent colonoscopy. In multivariate analysis, there was a small intervention effect on colonoscopy."

The authors concluded: "This study showed that ATO-SR failed to improve rates of CRC screening. Future studies should examine approaches that combine efforts to target patients and their health care providers to overcome the barriers to CRC screening."

It is helpful to demonstrate that this kind of intervention does or does not work. Back to the drawing board in this case.

For the full abstract, click here.

Arch Intern Med 170(3):264-270, 8 February 2010
© 2010 to the American Medical Association
Failure of Automated Telephone Outreach With Speech Recognition to Improve Colorectal Cancer Screening-A Randomized Controlled Trial. Steven R. Simon, Fang Zhang, Stephen B. Soumerai,et al. Correspondence to Dr. Simon:

Category: D. Digestive, HSR Health Services Research. Keywords: colon cancer screening, telephone, colonoscopy, health services research, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 23 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.