Evidence map›Paper›PMID 39903984›Full record

ArticleAmerican journal of surgery2025

Overcoming inertia: Provider perspectives on de-implementation strategies in preoperative testing.

Erin Kim, Alexis G Antunez, Devak Nanua, Valerie Gavrila, Anthony Cuttitta, Lesly A Dossett

Abstract read
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In one paragraph

Article in American journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

6 authors.

Erin KimUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Alexis G AntunezDepartment of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Devak NanuaUniversity of Michigan Medical School, Ann Arbor, MI, USA.
Valerie GavrilaUniversity of Michigan, Michigan Program on Value Enhancement, Ann Arbor, MI, USA.
Anthony CuttittaUniversity of Michigan, Michigan Program on Value Enhancement, Ann Arbor, MI, USA.
Lesly A DossettDepartment of Surgery, University of Michigan, Ann Arbor, MI, USA. Electronic address: ldossett@med.umich.edu.

Funding

SHORT-TERM TRAINING IN HEALTH PROF SCHOOLST35HL007690 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI FLAHERTY, KEVIN R · 1990 to 2024
$3.3M
AHRQ HHS R01 HS029306NHLBI NIH HHS T35 HL007690
6 · The paper itself

Abstract

backgroundRoutine preoperative testing for low-risk surgeries is often unnecessary and may result in preventable harm. While de-implementation strategies have reduced the frequency and proportion of unnecessary preoperative tests, the reach of the strategies and the provider-level adoption remain unclear. Understanding stakeholders' perspective on these strategies is essential for widespread de-implementation.

methodsInterviews were conducted with 18 anesthesiologists, surgeons, and physician assistants at a single academic institution. Thematic analysis was guided by the RE-AIM framework, and persistent barriers were assessed using the Consolidated Framework for Implementation Research.

resultsDe-implementation strategies achieved high reach, with educational meetings emerging as the most effective strategy. Workflow variations significantly influenced adoption and implementation, with regular meetings and data sharing identified as facilitators for maintenance. Barriers were identified in the individual characteristics, inner setting, and outer setting levels.

conclusionsTailored de-implementation strategies are essential to overcoming provider- and institution-level barriers and to sustain guideline-concordant care.

Indexed as

Attitude of Health PersonnelPreoperative CareUnnecessary ProceduresAnesthesiologistsFemaleHumansInterviews as TopicMalePhysician AssistantsQualitative ResearchSurgeons

Identifiers

PMID39903984
PMCPMC11893224

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