| Title |
Cervical Cancer Screening Guideline Adherence Before and After Guideline Changes in Pennsylvania Medicaid
|
|---|---|
| Published in |
Obstetrics & Gynecology, January 2017
|
| DOI | 10.1097/aog.0000000000001804 |
| Pubmed ID | |
| Authors |
Natasha Parekh, Julie M. Donohue, Aiju Men, Jennifer Corbelli, Marian Jarlenski |
| Abstract |
To assess changes in cervical cancer screening after the 2009 American College of Obstetricians and Gynecologists' guideline change and to determine predictors associated with underscreening and overscreening among Medicaid-enrolled women. We performed an observational cohort study of Pennsylvania Medicaid claims from 2007 to 2013. We evaluated guideline adherence of 18- to 64-year-old continuously enrolled women before and after the 2009 guideline change. To define adherence, we categorized intervals between Pap tests as longer than (underscreening), within (appropriate screening), or shorter than (overscreening) guideline-recommended intervals (±6-month). We stratified results by age and assessed predictors of underscreening and overscreening through logistic regression. Among 29,650 women, appropriate cervical cancer screening significantly decreased after the guideline change (from 45% [95% confidence interval (CI) 44-46%] to 11% [95% CI 11-12%] among 17,360 younger than 30 year olds and from 27% [95% CI 26-28%] to 6% [95% CI 6-7%] among 12,290 women 30 years old or older). Overscreening significantly increased (from 6% [95% CI 5-6%] to 67% [95% CI 66-68%] in those younger than 30 years old and from 54% [95% CI 52-55%] to 65% [95% CI 64-67%] in those 30 years old or older), whereas underscreening significantly increased only in those 30 years old or older (from 20% [95% CI 19-21%] to 29% [95% CI 27-30%]). Pap tests after guideline change, pregnancy, Managed Care enrollment (in those younger than 30 years old), and black race (in those younger than 30 years old) were associated with underscreening. Pap tests after guideline change, more visits, more sexually transmitted infection testing, and white race (in those 30 years old or older) were associated with overscreening. We observed high rates of cervical cancer overscreening and underscreening and low rates of appropriate screening after the guideline change. Interventions should target both underscreening and overscreening to address these separate yet significant issues. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 1 | 33% |
| United States | 1 | 33% |
| United Kingdom | 1 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 67% |
| Science communicators (journalists, bloggers, editors) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 36 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 3 | 8% |
| Student > Postgraduate | 3 | 8% |
| Professor > Associate Professor | 3 | 8% |
| Student > Master | 3 | 8% |
| Student > Doctoral Student | 2 | 6% |
| Other | 8 | 22% |
| Unknown | 14 | 39% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 22% |
| Nursing and Health Professions | 4 | 11% |
| Philosophy | 1 | 3% |
| Biochemistry, Genetics and Molecular Biology | 1 | 3% |
| Agricultural and Biological Sciences | 1 | 3% |
| Other | 6 | 17% |
| Unknown | 15 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 33. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 February 2017.
All research outputs
#1,196,986
of 25,374,917 outputs
Outputs from Obstetrics & Gynecology
#872
of 8,949 outputs
Outputs of similar age
#24,609
of 421,660 outputs
Outputs of similar age from Obstetrics & Gynecology
#17
of 96 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 8,949 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 22.0. This one has done particularly well, scoring higher than 90% of its peers.
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We're also able to compare this research output to 96 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.