Charlotte M Carlson

Publications (2)22.92 Total impact

• Article: Lack of follow-up after fecal occult blood testing in older adults: inappropriate screening or failure to follow up?

  Charlotte M Carlson, Katharine A Kirby, Michele A Casadei, Melissa R Partin, Christine E Kistler, Louise C Walter
  [show abstract] [hide abstract]
  ABSTRACT: It is unclear whether lack of follow-up after screening fecal occult blood testing (FOBT) in older adults is due to screening patients whose comorbidity or preferences do not permit follow-up vs failure to complete follow-up in healthy patients. A prospective cohort study of 2410 patients 70 years or older screened with FOBT was conducted at 4 Veteran Affairs (VA) medical centers from January 1 to December 31, 2001. The main outcome measure was receipt of follow-up within 1 year of FOBT based on national VA and Medicare data. For patients with positive FOBT results, age and Charlson comorbidity scores were evaluated as potential predictors of receiving a complete colon evaluation (colonoscopy or sigmoidoscopy plus barium enema), and medical records were reviewed to determine reasons for lack of follow-up. A total of 212 patients (9%) had positive FOBT results; 42% received a complete colon evaluation within 1 year. Age and comorbidity were not associated with receipt of a complete follow-up, which was similar among patients 70 to 74 years old with a Charlson score of 0 compared with patients 80 years or older with a Charlson score of 1 or higher (48% vs 41%; P=.28). The VA site, number of positive FOBT cards, and number of VA outpatient visits were predictors. Of 122 patients who did not receive a complete follow-up within 1 year, 38% had documentation that comorbidity or preferences did not permit follow-up, and over the next 5 years 76% never received a complete follow-up. While follow-up after positive FOBT results was low regardless of age or comorbidity, screening patients in whom complete evaluation would not be pursued substantially contributes to lack of follow-up. Efforts to improve follow-up should address the full chain of decision making, including decisions to screen and decisions to follow up.
  Archives of internal medicine 10/2010; 171(3):249-56. · 11.46 Impact Factor
• Source

  Available from: archinte.ama-assn.org

  Article: Lack of Follow-up After Fecal Occult Blood Testing in Older AdultsInappropriate Screening or Failure to Follow Up?Lack of Follow-up After FOBT in Older Adults

  Charlotte M. Carlson, Katharine A. Kirby, Michele A. Casadei, Melissa R. Partin, Christine E. Kistler, Louise C. Walter
  Archives of Internal Medicine 171(3):249-256. · 11.46 Impact Factor