The role of physician reminders in faecal occult blood testing for colorectal cancer screening

Figures & data

Table I. Inclusion criteria.

• All studies comparing physician reminders with no reminders

• All studies related to colorectal cancer screening

• All studies looking at FOB or endoscopic surveillance

• Trials on patients of any age and sex eligible for colorectal cancer screening

• Trials in all languages

Table II. Modified quality score for randomized controlled trials, Jadad et al. (27) Chalmers et al. (26).

Quality variables	Sequist et al. (38)	Vinker et al. (37)	Ornstein et al. (40)	Becker et al. (36)	Weingarten et al. (39)
Was the study described as randomized such as using the words randomly, random, and randomization? (0,1)	1	1	1	1	1
Was randomization described and appropriate? (−1,0,1)	1	0	0	0	1
Was the study described as double blind? (0,1)	1	0	0	1	0
Was method of blinding appropriate? (−1,0,1)	1	0	0	1	0
Was there a description of withdrawals and dropouts? (0,1)	0	0	0	0	0
Inclusion criteria	1	1	1	1	1
Exclusion criteria	1	0	1	1	0
Study period given	1	0	1	1	1
Appropriate statistical analysis	1	1	1	1	0
Hard end points	1	1	1	1	1
Sample size calculation	0	0	0	0	0
Baseline comparable	1	0	0	1	1
Any missing post intervention data	0	0	0	0	0
Allocation concealment	0	0	0	0	0
Analysis by intention to treat	1	1	0	0	0

Papers with higher scores were considered to be of higher quality.

Figure 1. Flow chart of literature search.

Table III. Excluded trials.

Trial (Ref.)	Reason for exclusion
Williams 1998 (29)	No specific data on number of patients undergoing FOB testing
Frame et al., 1994 (34)	No individual data available
McPhee et al., 1991 (32)	Use of combined performance scores for each physician and not individual patients, unclear whether the same data as previous study
Fordham et al., 1990 (35)	Data on practices rather than individual patient uptake
McPhee et al., 1989 (31)	Use of combined performance scores for each physician and not individual patients
Turner et al., 1989 (30)	No individual data given on FOB testing
McDonald 1984 (33)	No individual data. Physician randomization

Table IV. Reminder protocols for trials.

Trial	Year (ref.)	Intervention	n	Randomization type	Age (mean)	Gender	Setting	Reminder type	Method of uptake measurement	F/Up (months)
Sequist et al.	2009(38)	ReminderNo reminder	1091210948	Cluster	50–80(60)	57% women	Primary care	Electronic	Electronic & medical record	1515
Vinker et al.	2002(37)	ReminderNo reminder	753913	Cluster	50–75(61)	52.2% women	Primary care	Note in patient file	Not stated	1212
Ornstein et al.	1991(40)	ReminderNo reminder	818618	Cluster	22–57(40)	62% women	Primary care	Memo. in patient file	Not stated	1212
Becker et al.	1989(36)	ReminderNo reminder	103117	IndividualIndividual	40–60(53)	64.1% women	Hospital and primary care	Memo. attached to patient notes	Chart/notes review	1212
Weingarten et al.	1989(39)	ReminderNo reminder	5550		Adults	Not stated	Community health centre	Electronic list	Data recorded in notes	3030

F/Up, average time after the intervention before reviewing the notes to see what the uptake had been for FOB testing.

Figure 2. FOB uptake (Risk difference in %).

Table V. Outcome variables.

Trial	Year (ref.)	Type	n	FOB	% Uptake
Sequist et al.	2009(38)	ReminderNo reminder	1091210948	25052499	23.022.8
Vinker et al.	2002(37)	ReminderNo reminder	753913	12412	16.51.3
Ornstein et al.	1991(40)	ReminderNo reminder	818618	190116	23.218.8
Becker et al.	1989(36)	ReminderNo reminder	103117	127	11.76.0
Weingarten et al.	1989(39)	ReminderNo reminder	5550	3124	56.448.0

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