ArticleJournal of general internal medicine2012
Medical center characteristics associated with PSA screening in elderly veterans with limited life expectancy.
Article in Journal of general internal medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 28 citations in OpenAlex.
- Variation in Low-Value Service Use Across Veterans Affairs Facilities.Journal of general internal medicine · 2023Article
- Use of the prostate-specific antigen (PSA) test in the United States for men age ≥65, 1999-2015: Implications for practice interventions.Cancer reports (Hoboken, N.J.) · 2021Article
- Comparison by Race of Conservative Management for Low-Risk and Intermediate-Risk Prostate Cancers in Veterans From 2004 to 2018.JAMA network open · 2020Article
- Evaluation of Low-Value Diagnostic Testing for 4 Common Conditions in the Veterans Health Administration.JAMA network open · 2020Article
- How Do Older Adults Consider Age, Life Expectancy, Quality of Life, and Physician Recommendations When Making Cancer Screening Decisions? Results from a National Survey Using a Discrete Choice Experiment.Medical decision making : an international journal of the Society for Medical Decision Making · 2019Article
- Unrelated Death After Colorectal Cancer Screening: Implications for Improving Colonoscopy Referrals.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2019Article
- Communicating About Stopping Cancer Screening: Comparing Clinicians' and Older Adults' Perspectives.The Gerontologist · 2019Article
- Influence of Age, Health, and Function on Cancer Screening in Older Adults with Limited Life Expectancy.Journal of general internal medicine · 2019Article
- Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI.Cancer medicine · 2018Article
- Article
- The Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer.Journal of the National Cancer Institute · 2017Article
- Older Adults' Views and Communication Preferences About Cancer Screening Cessation.JAMA internal medicine · 2017Article
- Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy.JAMA internal medicine · 2016Article
- The impact of technology diffusion on treatment for prostate cancer.Medical care · 2013Article
- Response to the U.S. Preventative Services Task Force decision on prostate cancer screening.Current urology reports · 2013Article
- Limited PSA testing in indigent men in South Texas: an appropriate care or missing a prevention opportunity?Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2012Article
- 80 is the new 60: implications of irrational exuberance regarding longevity on prostate cancer treatment decisions.Journal of general internal medicine · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundAlthough guidelines recommend against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, screening is common.
objectiveWe sought to identify medical center characteristics associated with screening in this population. DESIGN/
participantsWe conducted a prospective study of 622,262 screen-eligible men aged 70+ seen at 104 VA medical centers in 2003. MAIN MEASURES: Primary outcome was the percentage of men at each center who received PSA screening in 2003, based on VA data and Medicare claims. Men were stratified into life expectancy groups ranging from favorable (age 70-79 with Charlson score = 0) to limited (age 85+ with Charlson score ≥1 or age 70+ with Charlson score ≥4). Medical center characteristics were obtained from the 1999-2000 VA Survey of Primary Care Practices and publicly available VA data sources. KEY
resultsAmong 123,223 (20%) men with limited life expectancy, 45% received PSA screening in 2003. Across 104 VAs, the PSA screening rate among men with limited life expectancy ranged from 25-79% (median 43%). Higher screening was associated with the following center characteristics: no academic affiliation (50% vs. 43%, adjusted RR = 1.14, 95% CI 1.04-1.25), a ratio of midlevel providers to physicians ≥3:4 (55% vs. 45%, adjusted RR = 1.20, 95% CI 1.09-1.32) and location in the South (49% vs. 39% in the West, adjusted RR = 1.25, 95% CI 1.12-1.40). Use of incentives and high scores on performance measures were not independently associated with screening. Within centers, the percentages of men screened with limited and favorable life expectancies were highly correlated (r = 0.90).
conclusionsSubstantial practice variation exists for PSA screening in older men with limited life expectancy across VAs. The high center-specific correlation of screening among men with limited and favorable life expectancies indicates that PSA screening is poorly targeted according to life expectancy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.