Evidence map›Paper›PMID 28817780›Full record

ArticleThe American journal of managed care2017

US internists' awareness and use of overtreatment guidelines: a national survey.

Kira L Ryskina, Eric S Holmboe, Elizabeth Bernabeo, Rachel M Werner, Judy A Shea, Judith A Long

Abstract read
In one paragraph

Article in The American journal of managed care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Kira L Ryskina12-30 12th Fl, Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104. E-mail: ryskina@mail.med.upenn.edu.
Eric S Holmboe
Elizabeth Bernabeo
Rachel M Werner
Judy A Shea
Judith A Long

Funding

UNDERSTANDING THE ROLE OF PHYSICIAN INTEGRATION WITHIN NURSING HOMES IN POST-ACUTE CARE OUTCOMESK08AG052572 · NIA · UNIVERSITY OF PENNSYLVANIA · PI RYSKINA, KIRA L · 2016 to 2020
$821k
NIA NIH HHS K08 AG052572
6 · The paper itself

Abstract

objectivesTo assess physician views and perceived adoption of overtreatment guidelines and measure whether adoption of these guidelines influenced the recommendation of a targeted service. STUDY

designA cross-sectional survey mailed from July 2014 to January 2015 to 902 internists who completed residency between 2003 and 2013, randomly selected from the American Medical Association Masterfile.

methodsPoisson regression was used to model the rate of recommending a targeted service included in the guidelines, based on the level of guideline adoption.

resultsA total of 456 physicians responded (51% response rate). Most expressed familiarity with overtreatment guidelines (88.5%), a comfort level with discussing these guidelines with patients (79.9%), and described overtreatment guidelines as a useful tool in their practice (81.6%). Physicians in the highest tertile of guideline adoption reported double-digit rates of recommending antibiotics for sinusitis (29.7%), mammogram at end of life (16.5%), and electrocardiogram testing for asymptomatic patients (11.0%). Physicians in the bottom tertile of guideline adoption reported lower rates of recommending x rays (-12.0%; 95% confidence interval [CI], -19.4% to -4.5%; P = .002), magnetic resonance imaging for lower back pain (-4.8%; 95% CI, -8.1% to -1.5%; P = .004), and cardiac testing for asymptomatic patients (-10.2%; 95% CI, -18.9% to -1.5%; P = .02).

conclusionsUS internal medicine physicians who completed residency between 2003 and 2013 reported high levels of adoption of overtreatment guidelines. Physicians who reported the highest levels of guideline adoption reported recommending services targeted by these guidelines in their practice.

Indexed as

AdultAttitude of Health PersonnelCross-Sectional StudiesFemaleGuideline AdherenceHumansInternal MedicineMaleMedical OveruseMiddle AgedPhysicians, Primary CarePractice Guidelines as TopicPractice Patterns, Physicians'United States

Identifiers

PMID28817780
PMCPMC5823021

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Registered trials

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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.