Research Topics
| R H FletcherSummaryAffiliation: Harvard University Country: USA Publications
Research Grants
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Detail Information
Publications
Rationale for combining different screening strategiesRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA
Gastrointest Endosc Clin N Am 12:53-63. 2002....- Systematic review: the relationship between clinical experience and quality of health careNiteesh K Choudhry
Harvard Medical School and Harvard Pilgrim Health Care, Brigham and Women s Hospital, Boston, Massachusetts, USA
Ann Intern Med 142:260-73. 2005..However, evidence suggests that there is an inverse relationship between the number of years that a physician has been in practice and the quality of care that the physician provides... - Comparison of a brush-sampling fecal immunochemical test for hemoglobin with a sensitive guaiac-based fecal occult blood test in detection of colorectal neoplasiaRobert H Fletcher
Cancer 109:1925-6; author reply 1926. 2007 
A multilevel intervention to promote colorectal cancer screening among community health center patients: results of a pilot studyKaren E Lasser
Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA
BMC Fam Pract 10:37. 2009..Patient navigation has been shown to increase breast and cervical cancer screening rates, but few studies have looked at the potential of patient navigation to increase colorectal cancer screening rates...- Barriers to colorectal cancer screening in community health centers: a qualitative studyKaren E Lasser
Department of Medicine, Cambridge Health Alliance Harvard Medical School, Cambridge, MA, USA
BMC Fam Pract 9:15. 2008..The purpose of this study was to describe barriers to/facilitators of colorectal cancer screening among diverse patients served by community health centers... - Vitamins for chronic disease prevention in adults: clinical applicationsRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School Harvard Pilgrim Health Care, 133 Brookline Ave, Sixth Floor, Boston, MA 02215, USA
JAMA 287:3127-9. 2002.... - Screening patients with a family history of colorectal cancerRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School, Harvard Pilgrim Health Care, and Harvard Vanguard Medical Associates, Boston, MA, USA
J Gen Intern Med 22:508-13. 2007..To compare screening practices and beliefs in patients with and without a clinically important family history... - Adverts in medical journals: caveat lectorRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA
Lancet 361:10-1. 2003 - The quality of colonoscopy services--responsibilities of referring clinicians: a consensus statement of the Quality Assurance Task Group, National Colorectal Cancer RoundtableRobert H Fletcher
Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA
J Gen Intern Med 25:1230-4. 2010..Information on quality indicators will be increasingly available with quality improvement efforts within the colonoscopy community and growth in the use of electronic medical records... - Screening for colorectal cancer: the business caseRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA
Am J Manag Care 8:531-8. 2002..We believe that colorectal cancer screening programs are integral to any organization purporting to provide high-quality care. Organizations without such programs should give them high priority for implementation... - Evaluation of interventionsRobert H Fletcher
Department of Ambulatory Care and Prevention, 133 Brookline Avenue, 6th Floor, Boston, MA 02215, USA
J Clin Epidemiol 55:1183-90. 2002..When trials disagree, resolution may be found not by from more trials but also from critical appraisal of individual trials, weighing the totality of the evidence, and Bayesian reasoning... - Personalized screening for colorectal cancerRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA
Med Care 46:S5-9. 2008 - The diagnosis of colorectal cancer in patients with symptoms: finding a needle in a haystackRobert H Fletcher
Harvard Medical School, Boston, Massachusetts, USA
BMC Med 7:18. 2009.... - Successful colorectal cancer screening starts with primary careRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA, USA
Rev Gastroenterol Disord 2:S27-34. 2002..Newer tests, such as virtual colonoscopy and stool-based DNA tests, will help if they offer greater sensitivity, specificity, or patient acceptability than current screening options... - The longitudinal primary care clerkship at Harvard Medical SchoolA S Peters
Department of Ambulatory Care and Prevention, Harvard Medical School, 126 Brookline Avenue, Boston, MA 02215, USA
Acad Med 76:484-8. 2001..Other medical schools are beginning to develop longitudinal clerkships to ensure that students have essential educational experiences that are difficult to achieve in block, hospital-based clerkships... - Patient and physician reminders to promote colorectal cancer screening: a randomized controlled trialThomas D Sequist
Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA
Arch Intern Med 169:364-71. 2009..Screening reduces colorectal cancer mortality, but effective screening tests remain underused. Systematic reminders to patients and physicians could increase screening rates.. - Measuring access to effective care among elderly medicare enrollees in managed and Fee-for-Service care: a retrospective cohort studyM B Barton
Department of Ambulatory Care and Prevention Harvard Medical School and Harvard Pilgrim Health Care Boston MA, USA
BMC Health Serv Res 1:11. 2001..Our aim was to compare access to effective care among elderly Medicare patients in a Staff Model and Group Model HMO and in Fee-for-Service (FFS) care... 
Adjuvant chemotherapy for stage III colon cancer: do physicians agree about the importance of patient age and comorbidity?Nancy L Keating
Division of General Internal Medicine and the Department of Surgery and Center for Surgery and Public Health, Brigham and Women s Hospital, USA
J Clin Oncol 26:2532-7. 2008..We surveyed cancer physicians to understand how patients' age and comorbidity influence adjuvant chemotherapy recommendations and whether physician or practice characteristics also affect these recommendations...- Teaching care management in a longitudinal primary care clerkshipAntoinette S Peters
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Office of Educational Development, Harvard Medical School, Boston, Massachusetts 02115, USA
Teach Learn Med 17:322-7. 2005.... - Preparing faculty to teach managing care competencies: lessons learned from a national faculty development programMaryjoan D Ladden
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA 02215, USA
Fam Med 36:S115-20. 2004..Backlash against managed care has created a skeptical educational environment. Many faculty feel unprepared to teach the competencies in clinical settings... - Vitamins for chronic disease prevention in adults: scientific reviewKathleen M Fairfield
Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Channing Laboratory, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, USA
JAMA 287:3116-26. 2002..Although vitamin deficiency is encountered infrequently in developed countries, inadequate intake of several vitamins is associated with chronic disease... - How do precepting physicians select patients for teaching medical students in the ambulatory primary care setting?Steven R Simon
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, 133 Brookline Avenue, 6th Floor, Boston, MA 02215, USA
J Gen Intern Med 18:730-5. 2003..To study how clinical preceptors select patients for medical student teaching in ambulatory care and to explore key factors they consider in the selection process... - Variations in surgeon treatment recommendations for lobectomy in early-stage non-small-cell lung cancer by patient age and comorbiditySelwyn O Rogers
Department of Surgery and Center for Surgery and Public Health, Brigham and Women s Hospital, Boston, MA, USA
Ann Surg Oncol 17:1581-8. 2010..We surveyed surgeons to understand how their recommendations for lobectomy were influenced by age, the presence and severity of smoking-related lung disease, or by characteristics of the surgeons and their practices... - Familial risk and colorectal cancer screening health beliefs and attitudes in an insured populationRichard C Palmer
Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA
Prev Med 45:336-41. 2007..To examine the relationship between health beliefs and attitudes toward colorectal cancer screening, strength of family history risk, and being appropriately screened for colorectal cancer... - Implementation of a cancer prevention program for working class, multiethnic populationsRebecca Lobb
Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care, Boston, MA 02215, USA
Prev Med 38:766-76. 2004..Healthy Directions-Health Centers was designed to address social contextual factors relevant to cancer prevention interventions for working class, multi-ethnic populations... - The effect of medical student teaching on patient satisfaction in a managed care settingS R Simon
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA
J Gen Intern Med 15:457-61. 2000..Concerns about patient satisfaction should not prevent managed care organizations from participating in primary care education... - Practice guidelines and the practice of medicine: is it the end of clinical judgment and expertise?R H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA 02215, USA
Schweiz Med Wochenschr 128:1883-8. 1998..Although guidelines may point out the best research evidence to guide the care of average patients, they are not a substitute for clinical judgment, which should be applied to each individual patient... - Interpretation of diagnostic testsR H Fletcher
Harvard Medical School, Department of Ambulatory Care and Prevention, Boston, MA 02215, USA robert
Indian J Pediatr 67:49-53. 2000..Describing test performance in terms of likelihood ratios facilitates this process. Readers should be able to critique published studies of diagnostic tests which are still far from perfect... - Faculty training in general internal medicine: a survey of graduates from a research-intensive fellowship programS R Simon
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA
Acad Med 74:1253-5. 1999..To determine the fellowship experiences and career activities of the graduates of a research-intensive general internal medicine fellowship program... - Evaluation of a faculty development program in managing careAntoinette S Peters
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02215, USA
Acad Med 77:1121-7. 2002..To evaluate a faculty development program that teaches quality improvement and cost-effectiveness... - Failure of automated telephone outreach with speech recognition to improve colorectal cancer screening: a randomized controlled trialSteven R Simon
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA
Arch Intern Med 170:264-70. 2010..Automated telephone outreach with speech recognition (ATO-SR) is used extensively by health plans. Whether ATO-SR can increase rates of colorectal cancer (CRC) screening is unknown... - Understanding cancer treatment and outcomes: the Cancer Care Outcomes Research and Surveillance ConsortiumJohn Z Ayanian
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
J Clin Oncol 22:2992-6. 2004 - "Spin" in scientific writing: scientific mischief and legal jeopardyRobert H Fletcher
Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA, USA
Med Law 26:511-25. 2007..We therefore suggest some actions that editors can take to foster a more trustworthy evidence base both for the care of patients and for legal decisions... - Is patient cost-sharing the best way to protect the medical commons?Robert H Fletcher
Ann Intern Med 149:435; author reply 435-6. 2008 - Promoting early detection tests for colorectal carcinoma and adenomatous polyps: a framework for action: the strategic plan of the National Colorectal Cancer RoundtableBernard Levin
Division of Cancer Prevention, The University of Texas M D Anderson Cancer Center, Houston, Texas 77030, USA
Cancer 95:1618-28. 2002.... - Pearls and pitfalls in patient care: need to revive traditional clinical valuesAmi Schattner
Hebrew University and Hadassah Medical School, Kaplan Medical Center, Jerusalem, Israel
Am J Med Sci 327:79-85. 2004.... - Barriers to endoscopic colorectal cancer screening: are women different from men?Francis A Farraye
Section of Gastroenterology, Boston Medical Center, Massachusetts 02118, USA
Am J Gastroenterol 99:341-9. 2004..The goals of this study were to compare women and men's understanding of screening flexible sigmoidoscopy (FS) and to identify predictors of endoscopic colorectal cancer (CRC) screening... - Impact of intervention dose on cancer-related health behaviors among working-class, multiethnic, community health center patientsKimberly A Kaphingst
National Human Genome Research Institute, Social and Behavioral Research Branch, 2 Center Drive, MSC 0249, Building 2, Room 4E30, Bethesda, MD 20892, USA
Am J Health Promot 21:262-6. 2007..DESIGN. Analysis of intervention condition participant data from a randomized controlled trial... - Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and the US Multi-Society Task Force on Colorectal CancerDouglas K Rex
Indiana University School of Medicine, Indianapolis, Indiana, USA
Gastroenterology 130:1865-71. 2006.... - Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer SocietySidney J Winawer
Memorial Sloan Kettering Cancer Center, New York, New York, USA
Gastroenterology 130:1872-85. 2006..It has been shown that the first screening colonoscopy and polypectomy produces the greatest effects on reducing the incidence of colorectal cancer in patients with adenomatous polyps... - Screening sigmoidoscopy-- how often and how good?Robert H Fletcher
JAMA 290:106-8. 2003 - Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer SocietySidney J Winawer
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
CA Cancer J Clin 56:143-59; quiz 184-5. 2006..It has been shown that the first screening colonoscopy and polypectomy produces the greatest effects on reducing the incidence of colorectal cancer in patients with adenomatous polyps... - Colorectal cancer screening on stronger footingRobert H Fletcher
N Engl J Med 359:1285-7. 2008 - Guidelines for colonoscopy surveillance after cancer resection: a consensus update by the American Cancer Society and US Multi-Society Task Force on Colorectal CancerDouglas K Rex
Indiana University School of Medicine, Indianapolis, IN, USA
CA Cancer J Clin 56:160-7; quiz 185-6. 2006.... - Improving colorectal cancer screening in primary care practice: innovative strategies and future directionsCarrie N Klabunde
Health Services and Economics Branch, Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, EPN 4005, 6130 Executive Boulevard, Bethesda, MD 20892 7344, USA
J Gen Intern Med 22:1195-205. 2007..Active engagement and support of practices are essential for the enormous potential of CRC screening to be realized... - Extracolonic findings with computed tomographic colonography: asset or liability?Robert H Fletcher
Arch Intern Med 168:685-6. 2008
Research Grants
- Screening and Family History Colorectal CancerRobert Fletcher; Fiscal Year: 2004..This developmental research will raise hypotheses about the causes of failure to recognize FH and begin timely screening and suggest potential solutions to be tested in subsequent research. ..