Evidence map›Paper›PMID 34663435›Full record

ArticleTrials2021

Protocol: A multi-modal, physician-centered intervention to improve guideline-concordant prostate cancer imaging.

Danil V Makarov, Shannon Ciprut, Matthew Kelly, Dawn Walter, Michele G Shedlin, Ronald Scott Braithwaite, Craig T Tenner, Heather T Gold, Steven Zeliadt, Scott E Sherman

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03445559 (A Multi-modal, Physician-centered Intervention to Improve Guideline-concordant Prostate Cancer Imaging), which is not on this map. Not yet cited in PubMed.

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

NCT03445559 naactive not recruitingnot on this map

A Multi-modal, Physician-centered Intervention to Improve Guideline-concordant Prostate Cancer Imaging

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2018 to 2027Enrolled58ConditionsProstate CancerArmsClinical Order Check, Academic Detailing, Audit and Feedback
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Danil V MakarovDepartment of Urology, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA.
Shannon CiprutDepartment of Urology, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA.
Matthew KellyDepartment of Urology, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA. matthew.kelly@nyulangone.org.ORCID http://orcid.org/0000-0001-6907-310X
Dawn WalterDepartment of Urology, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA.
Michele G ShedlinNYU Rory Meyers College of Nursing, New York, NY, USA.
Ronald Scott BraithwaiteDepartment of Population Health, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA.
Craig T TennerVA New York Harbor Healthcare System, New York, USA.
Heather T GoldDepartment of Population Health, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA.
Steven ZeliadtHealth Services Research and Development, Department of Veterans Affairs Medical Center, Seattle, WA, USA.
Scott E ShermanDepartment of Urology, New York University School of Medicine, 227 E 30th St, 617 L, New York, NY, 10016, USA.

Funding

A multi-modal, physician-centered intervention to improve guideline-concordant prostate cancer imagingI01HX002038 · VA · VA NEW YORK HARBOR HLTHCARE/SYS/BROOKLYN · PI MAKAROV, DANIL V. · 2018 to 2022
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Health Services Research and Development 15-356HSRD VA I01 HX002038
6 · The paper itself

Abstract

backgroundAlmost half of Veterans with localized prostate cancer receive inappropriate, wasteful staging imaging. Our team has explored the barriers and facilitators of guideline-concordant prostate cancer imaging and found that (1) patients with newly diagnosed prostate cancer have little concern for radiographic staging but rather focus on treatment and (2) physicians trust imaging guidelines but are apt to follow their own intuition, fear medico-legal consequences, and succumb to influence from imaging-avid colleagues. We used a theory-based approach to design a multi-level intervention strategy to promote guideline-concordant imaging to stage incident prostate cancer.

methodsWe designed the Prostate Cancer Imaging Stewardship (PCIS) intervention: a multi-site, stepped wedge, cluster-randomized trial to determine the effect of a physician-focused behavioral intervention on Veterans Health Administration (VHA) prostate cancer imaging use. The multi-level intervention, developed according to the Theoretical Domains Framework (TDF) and Behavior Change Wheel, combines traditional physician behavior change methods with novel methods of communication and data collection. The intervention consists of three components: (1) a system of audit and feedback to clinicians informing individual clinicians and their sites about how their behavior compares to their peers' and to published guidelines, (2) a program of academic detailing with the goal to educate providers about prostate cancer imaging, and (3) a CPRS Clinical Order Check for potentially guideline-discordant imaging orders. The intervention will be introduced to 10 participating geographically distributed study sites. DISCUSSION: This study is a significant contribution to implementation science, providing VHA an opportunity to ensure delivery of high-quality care at the lowest cost using a theory-based approach. The study is ongoing. Preliminary data collection and recruitment have started; analysis has yet to be performed.

trial registrationCliniclTrials.gov NCT03445559. Prospectively registered on February 26, 2018.

Indexed as

PhysiciansProstatic NeoplasmsDiagnostic ImagingFeedbackHumansMaleRandomized Controlled Trials as TopicTrustGuidelinesImplementationProstate cancerStaging imaging

Identifiers

PMID34663435
PMCPMC8522153

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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.