Abstract：
Background: Provider uncertainty about the appropriate guideline-concordant evaluation of endometrial cancer (EC) symptoms may be a factor in racial inequities in EC. To evaluate the relationship between EC knowledge and reported practice patterns in a nationally representative survey of first-line providers for initial EC symptoms. Materials and Methods: This was a mailed cross-sectional survey of physicians and nurse practitioners from professional organization roster of providers from Obstetrics and Gynecology (OBGYN), Family Medicine, Internal Medicine, and Emergency Medicine. It queried demographics, practice characteristics, EC knowledge, and guideline-concordant practice patterns via three case vignettes. Regions of low response were retargeted to ensure strong representation among providers caring for Black women patients. EC knowledge was analyzed via a composite score (range: -3 to 10, with higher scores representing more EC knowledge), and adjusted prevalence ratios (PRs) used to test the association between knowledge and reported practice patterns. Results: Among 531 returned surveys (response rate = 38%), OBGYN had highest (53%) frequency of >6 (median) EC knowledge score, and Emergency Medicine had the lowest (15%) (p < 0.001). Nonguideline-concordant practice patterns were reported in 14%, 41%, and 35% of the three EC cases presented. Providers with knowledge >6, (n = 205) were significantly more likely to report guideline-concordant care on case vignettes (PR 1.28-1.36). Conclusions: In a national survey of multi-specialty backgrounds, there were basic knowledge gaps about EC and EC risk factors among providers, and a sizeable proportion reported nonguideline concordant practices. These findings indicate the importance of targeted education and training for first-line providers, as EC incidence rises.
摘要：
简介：提供者对子宫内膜癌（EC）症状的适当指南一致评估的不确定性可能是导致EC种族不平等的一个因素。在针对初始EC症状的一线提供者的全国代表性调查中，评估EC知识与报告的实践模式之间的关系。材料和方法：这是来自妇产科（OBGYN）的专业组织提供者名册的医师和护士从业人员的邮寄横断面调查，家庭医学,内科,和急诊医学。它查询了人口统计，实践特点,EC知识，通过三个案例小插曲和指南一致的实践模式。对低反应区域进行了重新定位，以确保照顾黑人女性患者的提供者具有强大的代表性。通过综合得分（范围：-3到10，得分越高代表更多的EC知识）分析EC知识，和调整后的患病率比（PRs）用于测试知识和报告的实践模式之间的关联。结果：在531项返回的调查中（回复率=38%），OBGYN的最高（53％）频率>6（中位数）EC知识得分，急诊医学最低(15%)(p<0.001)。有14%的人报告了非指南一致的实践模式，41%,在三个EC病例中，有35％出现。知识>6的提供者（n=205）更有可能报告病例小插曲的指南一致护理（PR1.28-1.36）。结论：在一项全国多专业背景调查中，提供者之间关于EC和EC风险因素的基本知识存在差距，和相当大比例的报告的非指南一致的做法。这些发现表明了对一线提供者进行有针对性的教育和培训的重要性,随着EC发病率的上升。
