Communicating results of diagnostic mammography: what do patients think?

RATIONALE AND OBJECTIVES: The purpose of this study was to investigate women's preferences for who (radiologist or referring physician) should communicate the results of diagnostic mammography. MATERIALS AND METHODS: Data from 153 women presenting to two sites for diagnostic mammography between February and June 1995 were collected with a 24-item, self-administered, closed-ended survey. For both normal and abnormal hypothetical results, contingency tables with chi2 tests and multiple logistic regression were used to determine the association, if any, between women's characteristics and their preferences. RESULTS: Women undergoing diagnostic mammography preferred that their radiologists disclose their normal (90%) and abnormal (88%) mammogram results to them immediately after their examination, rather than have their referring physicians disclose results at a later time. In the case of normal findings, women whose regular physicians were specialists were less likely to want to hear first from their radiologists (odds ratio [OR] = 0.06; 95% confidence interval [CI] = 0.01, 0.77; P = .03), but women who were nervous about learning their results were more likely to want to hear first from their radiologists (OR = 4.5; 95% CI = 1.2, 17.3; P = .03). CONCLUSION: Radiologists may want to consider assessing women's preferences for who communicates their mammogram results, as most women in this study preferred to hear these results from their radiologists rather than waiting to hear from their referring physicians.

The Boston AIDS Survival Score (BASS): a multidimensional AIDS severity instrument.

OBJECTIVES: This study developed a new acquired immunodeficiency syndrome (AIDS) severity system by including diagnostic, physiological, functional, and sociodemographic factors predictive of survival. METHODS: Three-hundred five persons with AIDS in Boston were interviewed; their medical records were reviewed and vital status ascertained. RESULTS: Overall median (+/- SD) survival for the cohort from the first interview until death was 560 +/- 14.4 days. The best model for predicting survival, the Boston AIDS Survival Score, included the Justice score (stage 2 relative hazard [RH] = 1.25, 95% confidence interval [CI] = 0.80, 1.96; stage 3 RH = 1.76, 95% CI = 1.15, 2.70), a newly developed opportunistic disease score (Boston Opportunistic Disease Survival Score; stage 2 RH = 1.35, 95% CI = 0.90, 2.02; stage 3 RH = 2.10, 95% CI = 1.38, 3.18), and measures of activities of daily living (any intermediate limitations, RH = 1.84, 95% CI = 1.05, 3.21; any basic limitations, RH = 2.60, 95% CI = 1.44, 4.69). This model had substantially greater predictive power (R2 = .17, C statistic = .68) than the Justice score alone (R2 = .09, C statistic = .61). CONCLUSIONS: Incorporating data on clinically important events and functional status into a physiologically based system can improve the prediction of survival with AIDS.