Evidence map›Paper›PMID 30291742›Full record

Observational studyJournal of the American Geriatrics Society2019

Exnovation of Low Value Care: A Decade of Prostate-Specific Antigen Screening Practices.

Julie Bynum, Honor Passow, Donald Carmichael, Jonathan Skinner

Abstract readObservational Study
In one paragraph

Observational study in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Review
  5. Article
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

4 authors.

Julie BynumDepartment of Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.
Honor PassowDartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
Donald CarmichaelDartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.
Jonathan SkinnerDartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire.

Funding

UNDERSTANDING AND IMPROVING EPISODE-BASED HOSPITAL CAREP01AG019783 · NIA · DARTMOUTH COLLEGE · PI Leila S. Agha · 2001 to 2026
$52.9M
Technology Diffusion, Health Outcomes, and Healthcare ExpendituresU01AG046830 · NIA · DARTMOUTH COLLEGE · PI SKINNER, JONATHAN S · 2013 to 2017
$4.5M
NIA NIH HHS P01 AG019783NIA NIH HHS U01 AG046830
6 · The paper itself

Abstract

objectivesTo examine prostate-specific antigen (PSA) screening practice change in subgroups of men defined in guidelines and in various regions and to identify factors associated with change in screening practices.

designObservational study using serial cross-sections, 2003 to 2013.

settingNational fee-for-service Medicare.

participantsMen aged 68 and older eligible for prostate cancer screening. MEASUREMENTS: National PSA screening practices in men aged 68 and older from 2003 to 2013 and change in regional screening rates in men aged 75 and older.

resultsThe PSA screening rate in men aged 68 and older was 17.2% in 2003, 22.3% in 2008, and 18.6% in 2013 (p < .001 for all differences); rates ended slightly lower than rates in 2003 only in men 80 and older. Racial disparities in screening became less pronounced over this period. In men aged 75 and older, change in regional screening rates varied widely, with absolute rates growing by 15 per 100 enrollees in some areas and declining by the same amount in others. Areas with high social capital, a measure associated with diffusion of new ideas, were more likely to decline; malpractice intensity and managed care penetration had no effect.

conclusionStudying Medicare enrollees over time, we found little reduction in PSA screening and even increases according to race and in some regions. The heterogeneous changes across regions suggest that consistent reduction in the use of low-value care may require change strategies that go beyond evidence and guidelines to include monitoring and feedback on performance. J Am Geriatr Soc 67:29-36, 2019.

Indexed as

AgedAged, 80 and overCross-Sectional StudiesEarly Detection of CancerFee-for-Service PlansHumansMaleMedicareProcedures and Techniques UtilizationProstate-Specific AntigenProstatic NeoplasmsUnited StatesProstate-Specific Antigenlow-value careMedicareprostate cancer screening

Identifiers

PMID30291742
PMCPMC6322964

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.