Journal of General Internal Medicine

, Volume 19, Issue 4, pp 316–323

Communication factors in the follow-up of abnormal mammograms

  • Eric G. Poon
  • Jennifer S. Haas
  • Ann Louise Puopolo
  • Tejal K. Gandhi
  • Elisabeth Burdick
  • David W. Bates
  • Troyen A. Brennan
Original Articles


OBJECTIVE: To identify the communication factors that are significantly associated with appropriate short-term follow-up of abnormal mammograms.

DESIGN: Prospective longitudinal study involving medical record review and patient survey.

SETTING: Ten academically affiliated ambulatory medical practices in the Boston metropolitan area.

PARTICIPANTS: One hundred twenty-six women with abnormal mammograms requiring short-term (6 months) follow-up imaging.

MEASUREMENTS: Proportion of women in the study who received appropriate follow-up care.

RESULTS: Eighty-one (64%) of the women with abnormal mammograms requiring short-term follow-up imaging received the appropriate follow-up care. After adjusting for patients’ age and insurance status, 2 communication factors were found to be independently associated with the delivery of appropriate follow-up care: 1) physicians’ documentation of a follow-up plan in the medical record (adjusted odds ratio, 2.79; 95% confidence interval, 1.11 to 6.98; P=.029); and 2) patients’ understanding of the need for follow-up (adjusted odds ratio, 3.86; 95% confidence interval, 1.50 to 9.96; P=.006). None of the patients’ clinical or psychological characteristics were associated with the delivery of appropriate follow-up care.

CONCLUSIONS: Follow-up care for women with abnormal mammograms requiring short-term follow-up imaging is suboptimal. Documentation of the follow-up plan by the physician and understanding of the follow-up plan by the patient are important factors that are correlated with the receipt of appropriate follow-up care for these women. Interventions designed to improve the quality of result follow-up in the outpatient setting should address these issues in patient-doctor communication.

Key words

test result follow-up abnormal mammogram patient-doctor communication patient safety quality improvement 


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Copyright information

© Society of General Internal Medicine 2004

Authors and Affiliations

  • Eric G. Poon
    • 1
  • Jennifer S. Haas
    • 1
  • Ann Louise Puopolo
    • 1
  • Tejal K. Gandhi
    • 1
  • Elisabeth Burdick
    • 1
  • David W. Bates
    • 1
    • 2
  • Troyen A. Brennan
    • 1
    • 2
  1. 1.the Division of General Medicine and Primary Care, Department of MedicineBrigham and Women’s HospitalBoston
  2. 2.Department of Health Policy and ManagementHarvard School of Public HealthBoston

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