Preferences of Community Physicians for Cancer Screening Guidelines

Czaja, Ronald; McFall, Stephanie L.; Warnecke, Richard B.; Ford, Leslie G.; Kaluzny, Arnold D.

doi:10.7326/0003-4819-120-7-199404010-00012

Cited by 73 publications

(25 citation statements)

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“…Readmission rates and costs of care did not meaningfully vary with physician age. Taken together, our findings suggest that differences in practice patterns or process measures of quality between physicians with varying years of experience reported in previous studies1 2 3 4 37 might have a meaningful impact on patient outcomes.…”

Section: Discussionsupporting

confidence: 62%

Physician age and outcomes in elderly patients in hospital in the US: observational study

Tsugawa

Newhouse

Zaslavsky

et al. 2017

BMJ

150

121

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Objectives To investigate whether outcomes of patients who were admitted to hospital differ between those treated by younger and older physicians. Design Observational study. Setting US acute care hospitals. Participants 20% random sample of Medicare fee-for-service beneficiaries aged ≥65 admitted to hospital with a medical condition in 2011-14 and treated by hospitalist physicians to whom they were assigned based on scheduled work shifts. To assess the generalizability of findings, analyses also included patients treated by general internists including both hospitalists and non-hospitalists. Main outcome measures 30 day mortality and readmissions and costs of care. Results 736 537 admissions managed by 18 854 hospitalist physicians (median age 41) were included. Patients’ characteristics were similar across physician ages. After adjustment for characteristics of patients and physicians and hospital fixed effects (effectively comparing physicians within the same hospital), patients’ adjusted 30 day mortality rates were 10.8% for physicians aged <40 (95% confidence interval 10.7% to 10.9%), 11.1% for physicians aged 40-49 (11.0% to 11.3%), 11.3% for physicians aged 50-59 (11.1% to 11.5%), and 12.1% for physicians aged ≥60 (11.6% to 12.5%). Among physicians with a high volume of patients, however, there was no association between physician age and patient mortality. Readmissions did not vary with physician age, while costs of care were slightly higher among older physicians. Similar patterns were observed among general internists and in several sensitivity analyses. Conclusions Within the same hospital, patients treated by older physicians had higher mortality than patients cared for by younger physicians, except those physicians treating high volumes of patients.

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Section: Discussionsupporting

confidence: 62%

Physician age and outcomes in elderly patients in hospital in the US: observational study

Tsugawa

Newhouse

Zaslavsky

et al. 2017

BMJ

150

121

View full text Add to dashboard Cite

show abstract

“…However, a few studies examining physician adherence to various current practice guidelines found that those who were more recently trained were more likely to adhere to the guidelines than those who had been out of training for more years. [15][16][17][18] It is possible that there is a similar inverse effect for the pharmacists we surveyed of years out of training with adherence to current recommendations regarding DDDs. However, there are no data specifically focusing on factors that influence practice patterns of pharmacists.…”

Section: Discussionmentioning

confidence: 92%

Factors Associated With Dispensing Dosage Delivery Devices

Wojewoda¹,

Chou²

2017

The Journal of Pediatric Pharmacology and Therapeutics

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OBJECTIVES A potential cause of medication errors in children is imprecise measurements, particularly using household spoons. There are no regulations requiring dispensing dose delivery devices (DDDs) with liquid prescription medications. Local, regional, and national pharmacy practice patterns are largely unknown. This study sought to determine how frequently devices are provided with prescription pediatric liquid medications with instructions for their use at pharmacies in Bronx, New York, and to examine which pharmacy and pharmacist characteristics are associated with reported practices.METHODS All pharmacies in Bronx, New York, were identified using an online telephone directory. A telephone survey was administered to the senior-level pharmacist that elicited availability of DDDs, whether pharmacy policy regarding dispensing devices existed, the pharmacist's personal practice of dispensing devices, and years in practice. RESULTSIn total, 268 pharmacies were contacted; 214 had free DDDs (79.9%) most of the time, 97.8% had them available to buy, and 160 (59.7%) had no policy regarding dispensing devices. Overall, 199 pharmacists (74.3%) routinely dispensed devices, and 195 (73.3%) demonstrated the use of devices. However, 94 pharmacists (35.3%) recommended using a household spoon to measure correct doses at least some of the time. Pharmacists were less likely to give devices as their years in practice increased.CONCLUSIONS In our study, many Bronx pharmacies had no policy regarding dispensing DDDs for prescription liquid medications, and dispensing practices varied among pharmacists based on years in practice. If similar trends are found in other areas, standardizing pharmacy policy and pharmacists' practices may decrease morbidity in children due to medication measurement errors.ABBREVIATIONS DDD, dosage delivery devices

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“…With respect to the cancer-screening guidelines recommended by the American Cancer Society (31) or by the National Cancer Institute (32) (e.g. flexible sigmoidoscopy for persons older than 50 years), the protocol followed ultimately depends on the specific communityof physicians (33). While a screening method using sigmoidoscopy can prevent deaths by colorectal cancer (34)(35)(36), up to 40%of colorectal neoplasms maygo undetected (37).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Detection of Colorectal Neoplasia Using an Immnochemical Occult Blood Test in Symptomatic Referred Patients. Comparison of Retrospective and Prospective Studies.

et al. 2000

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Objective In this study the sensitivity and specificity of immunochemical tests for colorectal neoplasia were evaluated in retrospective and prospective studies. Methods Four types of fecal blood tests -a chemical test (Hemoccult II) and three different immunochemical tests including a test which detects hemoglobin and transferrin-were performedin the retrospective study. In the prospective study the test for hemoglobin and transferrin was used for all patients that underwent total colonoscopy. Patients One hundred seven patients with colorectal neoplasia, 57 with gastroduodenal bleeding, and 62 with normal digestive tracts were examinedretrospectively. One thousand two hundred and ninety-eight nonspecifically symptomatic patients whose endoscopic examination was negative for hemorrhagic lesions in the upper digestive tract were examined prospectively.Results In the retrospective study, sensitivities for the detection of colorectal cancers and adenomaswith diameters^10 mmusing the tests which detect hemoglobin and transferrin were 98%and 89%, respectively. These were the highest sensitivity among the four tests. The specificity of this test was 97%, which was higher than that of the Hemoccult II test. In the prospective study, the sensitivities of the tests for hemoglobin and transferrin for the detection of colorectal cancers and adenomaswith diameters^10 mmwere 79%and 33%, respectively. The specificity was 95%.Conclusions The test for hemoglobin and transferrin showed the highest sensitivity and specificity for colorectal neoplasia in the retrospective study. The sensitivity and specificity of this test were not so high in the prospective study, but they may be clinically applicable in the evaluation of patients with various nonspecific symptoms. (Internal Medicine 39: 701-706, 2000)

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Preferences of Community Physicians for Cancer Screening Guidelines

Cited by 73 publications

References 0 publications

Physician age and outcomes in elderly patients in hospital in the US: observational study

Physician age and outcomes in elderly patients in hospital in the US: observational study

Factors Associated With Dispensing Dosage Delivery Devices

Accuracy of Detection of Colorectal Neoplasia Using an Immnochemical Occult Blood Test in Symptomatic Referred Patients. Comparison of Retrospective and Prospective Studies.

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