Acceptability and implementation potential of a health literacy intervention to increase colorectal cancer screening in deprived areas: A qualitative study of patients and general practitioners participating in a cluster randomized controlled trial

by Alix Boirot, Maria Claudia Addamiano, Clémence Casanova, Niamh M. Redmond, Géraldine Cazorla, Michel Rotily, Anne-Marie Schott-Petelaz, Christian Balamou, Zineb Doukhi, Myriam Kaou, Françoise Couranjou, Julien Mancini, Cyrille Delpierre, Marie-Anne Durand, Aurore Lamouroux

Background

Colorectal cancer (CCR) is one of the leading causes of death worldwide. Early detection remains a highly effective strategy for curing this disease. In France, despite a free organised screening programme for people aged between 50 and 74, participation rates remain suboptimal. Socioeconomic position and health literacy levels exacerbate the situation, with the lowest screening rates observed in the most socially disadvantaged areas. This study assessed patients’ and General Practitioners’ (GP) views on the acceptability of an intervention to increase screening uptake using a simple brochure and video on the importance and process of CCR screening.

Method

We conducted a cross-sectional qualitative study using semi-structured interviews with patients (n = 24) and GPs (n = 22) who used or participated in the DECODE project intervention. The interviews were conducted by telephone or videoconference and analysed thematically using Nvivo software and dual independent coding.

Results

95% of GPs expressed a clear preference for the video over the brochure. Patients had varied results with 50% preferring the video, as it demonstrated how to do the test, versus the brochure. The humorous and de-dramatising aspects of the video were the two key factors highlighted by interviewees. However, support from healthcare staff (GPs, nurses, etc.) is still essential, in supporting patients in prevention. This presents a challenge for GPs, who are frequently constrained by time limitations during consultations.

Conclusion

Our findings emphasize the need to tailor promotional materials for both patients and healthcare professionals to improve CCR screening uptake, balancing digital efficiency with maintaining core human relationships in healthcare. Such intervention can be integrated into different workflows. The addition of video into national CRC screening programs might also help. Targeting CRC screening interventions at provider-patient interactions, ensuring they are tailored, accessible, and engaging, is key to reducing disparities.

Music and sedation relieve intraoperative stress: A randomized controlled trial

by Kaoru Yamashita, Toshiro Kibe, Akari Uto, Shusei Yoshimine, Minako Uchino, Mitsutaka Sugimura

Trial registration

UMIN Clinical Trials Registry, UMIN 000054970

Deep generative abnormal lesion emphasization validated by nine radiologists and 1000 chest X-rays with lung nodules

by Shouhei Hanaoka, Yukihiro Nomura, Naoto Hayashi, Issei Sato, Soichiro Miki, Takeharu Yoshikawa, Hisaichi Shibata, Takahiro Nakao, Tomomi Takenaga, Hiroaki Koyama, Shinichi Cho, Noriko Kanemaru, Kotaro Fujimoto, Naoya Sakamoto, Tomoya Nishiyama, Hirotaka Matsuzaki, Nobutake Yamamichi, Osamu Abe

A general-purpose method of emphasizing abnormal lesions in chest radiographs, named EGGPALE (Extrapolative, Generative and General-Purpose Abnormal Lesion Emphasizer), is presented. The proposed EGGPALE method is composed of a flow-based generative model and L-infinity-distance-based extrapolation in a latent space. The flow-based model is trained using only normal chest radiographs, and an invertible mapping function from the image space to the latent space is determined. In the latent space, a given unseen image is extrapolated so that the image point moves away from the normal chest X-ray hyperplane. Finally, the moved point is mapped back to the image space and the corresponding emphasized image is created. The proposed method was evaluated by an image interpretation experiment with nine radiologists and 1,000 chest radiographs, of which positive suspected lung cancer cases and negative cases were validated by computed tomography examinations. The sensitivity of EGGPALE-processed images showed +0.0559 average improvement compared with that of the original images, with -0.0192 deterioration of average specificity. The area under the receiver operating characteristic curve of the ensemble of nine radiologists showed a statistically significant improvement. From these results, the feasibility of EGGPALE for enhancing abnormal lesions was validated. Our code is available at https://github.com/utrad-ical/Eggpale.