Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial
Identifieur interne : 006549 ( Main/Merge ); précédent : 006548; suivant : 006550Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial
Auteurs : Kinta Beaver [Royaume-Uni] ; Debbie Tysver-Robinson ; Malcolm Campbell ; Mary Twomey ; Susan Williamson ; Andrew Hindley ; Shabbir Susnerwala ; Graham Dunn [Royaume-Uni] ; Karen LukerSource :
- BMJ [ 0959-8138 ] ; 2009.
Abstract
Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.
Url:
- https://api.istex.fr/document/5D55A63106DF0A493D9213657BB9FBE9C232E231/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628299
DOI: 10.1136/bmj.a3147
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code="subField">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Dunn, Graham" sort="Dunn, Graham" uniqKey="Dunn G" first="Graham" last="Dunn">Graham Dunn</name><affiliation wicri:level="3"><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><wicri:orgArea>Health Methodology Research Group, University of Manchester</wicri:orgArea></affiliation></author><author><name sortKey="Luker, Karen" sort="Luker, Karen" uniqKey="Luker K" first="Karen" last="Luker">Karen Luker</name><affiliation><wicri:noCountry code="subField">9PL</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2009">2009</date><biblScope unit="volume">338</biblScope></imprint><idno type="ISSN">0959-8138</idno></series><idno type="istex">5D55A63106DF0A493D9213657BB9FBE9C232E231</idno><idno type="DOI">10.1136/bmj.a3147</idno><idno type="href">bmj-338-bmj-a3147.pdf</idno><idno type="ArticleID">beak584029</idno><idno type="PMID">19147478</idno><idno type="local">bmj;338/jan14_2/a3147</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.</div></front></TEI><double doi="10.1136/bmj.a3147"><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</title><author><name sortKey="Beaver, Kinta" sort="Beaver, Kinta" uniqKey="Beaver K" first="Kinta" last="Beaver">Kinta Beaver</name></author><author><name sortKey="Tysver Robinson, Debbie" sort="Tysver Robinson, Debbie" uniqKey="Tysver Robinson D" first="Debbie" last="Tysver-Robinson">Debbie Tysver-Robinson</name></author><author><name sortKey="Campbell, Malcolm" sort="Campbell, Malcolm" uniqKey="Campbell M" first="Malcolm" last="Campbell">Malcolm Campbell</name></author><author><name sortKey="Twomey, Mary" sort="Twomey, Mary" uniqKey="Twomey M" first="Mary" last="Twomey">Mary Twomey</name></author><author><name sortKey="Williamson, Susan" sort="Williamson, Susan" uniqKey="Williamson S" first="Susan" last="Williamson">Susan Williamson</name></author><author><name sortKey="Hindley, Andrew" sort="Hindley, Andrew" uniqKey="Hindley A" first="Andrew" last="Hindley">Andrew Hindley</name></author><author><name sortKey="Susnerwala, Shabbir" sort="Susnerwala, Shabbir" uniqKey="Susnerwala S" first="Shabbir" last="Susnerwala">Shabbir Susnerwala</name></author><author><name sortKey="Dunn, Graham" sort="Dunn, Graham" uniqKey="Dunn G" first="Graham" last="Dunn">Graham Dunn</name></author><author><name sortKey="Luker, Karen" sort="Luker, Karen" uniqKey="Luker K" first="Karen" last="Luker">Karen Luker</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:5D55A63106DF0A493D9213657BB9FBE9C232E231</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1136/bmj.a3147</idno><idno type="url">https://api.istex.fr/document/5D55A63106DF0A493D9213657BB9FBE9C232E231/fulltext/pdf</idno><idno 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last="Tysver-Robinson">Debbie Tysver-Robinson</name><affiliation><wicri:noCountry code="subField">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Campbell, Malcolm" sort="Campbell, Malcolm" uniqKey="Campbell M" first="Malcolm" last="Campbell">Malcolm Campbell</name><affiliation><wicri:noCountry code="subField">9PL</wicri:noCountry></affiliation></author><author><name sortKey="Twomey, Mary" sort="Twomey, Mary" uniqKey="Twomey M" first="Mary" last="Twomey">Mary Twomey</name><affiliation><wicri:noCountry code="subField">9PL</wicri:noCountry></affiliation></author><author><name sortKey="Williamson, Susan" sort="Williamson, Susan" uniqKey="Williamson S" first="Susan" last="Williamson">Susan Williamson</name><affiliation><wicri:noCountry code="subField">9PL</wicri:noCountry></affiliation></author><author><name sortKey="Hindley, Andrew" sort="Hindley, Andrew" uniqKey="Hindley A" first="Andrew" last="Hindley">Andrew Hindley</name><affiliation><wicri:noCountry code="subField">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Susnerwala, Shabbir" sort="Susnerwala, Shabbir" uniqKey="Susnerwala S" first="Shabbir" last="Susnerwala">Shabbir Susnerwala</name><affiliation><wicri:noCountry code="subField">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Dunn, Graham" sort="Dunn, Graham" uniqKey="Dunn G" first="Graham" last="Dunn">Graham Dunn</name><affiliation wicri:level="3"><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><wicri:orgArea>Health Methodology Research Group, University of Manchester</wicri:orgArea></affiliation></author><author><name sortKey="Luker, Karen" sort="Luker, Karen" uniqKey="Luker K" first="Karen" last="Luker">Karen Luker</name><affiliation><wicri:noCountry code="subField">9PL</wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">BMJ</title><title level="j" type="abbrev">BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1468-5833</idno><imprint><publisher>British Medical Journal Publishing Group</publisher><date type="published" when="2009">2009</date><biblScope unit="volume">338</biblScope></imprint><idno type="ISSN">0959-8138</idno></series><idno type="istex">5D55A63106DF0A493D9213657BB9FBE9C232E231</idno><idno type="DOI">10.1136/bmj.a3147</idno><idno type="href">bmj-338-bmj-a3147.pdf</idno><idno type="ArticleID">beak584029</idno><idno type="PMID">19147478</idno><idno type="local">bmj;338/jan14_2/a3147</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0959-8138</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer. Design A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months. Setting Outpatient clinics in two NHS hospital trusts in the north west of England Participants 374 women treated for breast cancer who were at low to moderate risk of recurrence. Interventions Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy). Main outcome measures Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease. Results The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group v 39.0 (10-152) days in telephone group; P=0.228). Conclusions Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics. Trial registration National Cancer Research Institute 1477.</div></front></TEI></ISTEX><PMC><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</title><author><name sortKey="Beaver, Kinta" sort="Beaver, Kinta" uniqKey="Beaver K" first="Kinta" last="Beaver">Kinta Beaver</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Tysver Robinson, Debbie" sort="Tysver Robinson, Debbie" uniqKey="Tysver Robinson D" first="Debbie" last="Tysver-Robinson">Debbie Tysver-Robinson</name><affiliation><nlm:aff id="aff2">Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, Lancashire</nlm:aff><wicri:noCountry code="subfield">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Campbell, Malcolm" sort="Campbell, Malcolm" uniqKey="Campbell M" first="Malcolm" last="Campbell">Malcolm Campbell</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Twomey, Mary" sort="Twomey, Mary" uniqKey="Twomey M" first="Mary" last="Twomey">Mary Twomey</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Williamson, Susan" sort="Williamson, Susan" uniqKey="Williamson S" first="Susan" last="Williamson">Susan Williamson</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Hindley, Andrew" sort="Hindley, Andrew" uniqKey="Hindley A" first="Andrew" last="Hindley">Andrew Hindley</name><affiliation><nlm:aff id="aff3">Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</nlm:aff><wicri:noCountry code="subfield">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Susnerwala, Shabbir" sort="Susnerwala, Shabbir" uniqKey="Susnerwala S" first="Shabbir" last="Susnerwala">Shabbir Susnerwala</name><affiliation><nlm:aff id="aff3">Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</nlm:aff><wicri:noCountry code="subfield">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Dunn, Graham" sort="Dunn, Graham" uniqKey="Dunn G" first="Graham" last="Dunn">Graham Dunn</name><affiliation wicri:level="3"><nlm:aff id="aff4">Health Methodology Research Group, University of Manchester, Manchester</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><wicri:orgArea>Health Methodology Research Group, University of Manchester</wicri:orgArea></affiliation></author><author><name sortKey="Luker, Karen" sort="Luker, Karen" uniqKey="Luker K" first="Karen" last="Luker">Karen Luker</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19147478</idno><idno type="pmc">2628299</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628299</idno><idno type="RBID">PMC:2628299</idno><idno type="doi">10.1136/bmj.a3147</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">000715</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000715</idno><idno type="wicri:Area/Pmc/Curation">000715</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000715</idno><idno type="wicri:Area/Pmc/Checkpoint">003780</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003780</idno><idno type="wicri:Area/Ncbi/Merge">003163</idno><idno type="wicri:Area/Ncbi/Curation">003163</idno><idno type="wicri:Area/Ncbi/Checkpoint">003163</idno><idno type="wicri:doubleKey">0959-8138:2009:Beaver K:comparing:hospital:and</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparing hospital and telephone follow-up after treatment for breast cancer: randomised equivalence trial</title><author><name sortKey="Beaver, Kinta" sort="Beaver, Kinta" uniqKey="Beaver K" first="Kinta" last="Beaver">Kinta Beaver</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Tysver Robinson, Debbie" sort="Tysver Robinson, Debbie" uniqKey="Tysver Robinson D" first="Debbie" last="Tysver-Robinson">Debbie Tysver-Robinson</name><affiliation><nlm:aff id="aff2">Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust, Blackpool, Lancashire</nlm:aff><wicri:noCountry code="subfield">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Campbell, Malcolm" sort="Campbell, Malcolm" uniqKey="Campbell M" first="Malcolm" last="Campbell">Malcolm Campbell</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Twomey, Mary" sort="Twomey, Mary" uniqKey="Twomey M" first="Mary" last="Twomey">Mary Twomey</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Williamson, Susan" sort="Williamson, Susan" uniqKey="Williamson S" first="Susan" last="Williamson">Susan Williamson</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Hindley, Andrew" sort="Hindley, Andrew" uniqKey="Hindley A" first="Andrew" last="Hindley">Andrew Hindley</name><affiliation><nlm:aff id="aff3">Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</nlm:aff><wicri:noCountry code="subfield">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Susnerwala, Shabbir" sort="Susnerwala, Shabbir" uniqKey="Susnerwala S" first="Shabbir" last="Susnerwala">Shabbir Susnerwala</name><affiliation><nlm:aff id="aff3">Rosemere Cancer Centre, Royal Preston Hospital, Preston, Lancashire</nlm:aff><wicri:noCountry code="subfield">Lancashire</wicri:noCountry></affiliation></author><author><name sortKey="Dunn, Graham" sort="Dunn, Graham" uniqKey="Dunn G" first="Graham" last="Dunn">Graham Dunn</name><affiliation wicri:level="3"><nlm:aff id="aff4">Health Methodology Research Group, University of Manchester, Manchester</nlm:aff><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><wicri:orgArea>Health Methodology Research Group, University of Manchester</wicri:orgArea></affiliation></author><author><name sortKey="Luker, Karen" sort="Luker, Karen" uniqKey="Luker K" first="Karen" last="Luker">Karen Luker</name><affiliation wicri:level="4"><nlm:aff id="aff1">School of Nursing, Midwifery and Social Work, University of Manchester, Manchester M13 9PL</nlm:aff><orgName type="university">Université de Manchester</orgName><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="nation">Angleterre</region><region nuts="2" type="region">Grand Manchester</region></placeName></affiliation></author></analytic><series><title level="j">The BMJ</title><idno type="ISSN">0959-8138</idno><idno type="eISSN">1756-1833</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Objective</bold> To compare traditional hospital follow-up with telephone follow-up by specialist nurses after treatment for breast cancer.</p><p><bold>Design</bold> A two centre randomised equivalence trial in which women remained in the study for a mean of 24 months.</p><p><bold>Setting</bold> Outpatient clinics in two NHS hospital trusts in the north west of England</p><p><bold>Participants</bold> 374 women treated for breast cancer who were at low to moderate risk of recurrence.</p><p><bold>Interventions</bold> Participants were randomised to traditional hospital follow-up (consultation, clinical examination, and mammography as per hospital policy) or telephone follow-up by specialist nurses (consultation with structured intervention and mammography according to hospital policy).</p><p><bold>Main outcome measures</bold> Psychological morbidity (state-trait anxiety inventory, general health questionnaire (GHQ-12)), participants’ needs for information, participants’ satisfaction, clinical investigations ordered, and time to detection of recurrent disease.</p><p><bold>Results</bold> The 95% confidence interval for difference in mean state-trait scores adjusted for treatment received (−3.33 to 2.07) was within the predefined equivalence region (−3.5 to 3.5). The women in the telephone group were no more anxious as a result of foregoing clinic examinations and face-to-face consultations and reported higher levels of satisfaction than those attending hospital clinics (intention to treat P<0.001). The numbers of clinical investigations ordered did not differ between groups. Recurrences were few (4.5%), with no differences between groups for time to detection (median 60.5 (range 37-131) days in hospital group <italic>v</italic> 39.0 (10-152) days in telephone group; P=0.228).</p><p><bold>Conclusions</bold> Telephone follow-up was well received by participants, with no physical or psychological disadvantage. It is suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics.</p><p><bold>Trial registration</bold> National Cancer Research Institute 1477.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI></PMC></double></record>Pour manipuler ce document sous Unix (Dilib)
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