Improving discussion of surgical treatment options for patients with breast cancer: local medical opinion leaders versus audit and performance feedback.
Guadagnoli, Edward ; Soumerai, Stephen B. ; Gurwitz, Jerry H. ; Borbas, Catherine ; Shapiro, Charles L. ; Weeks, Jane C. ; Morris, Nora
Citations
Student Authors
Faculty Advisor
Academic Program
UMass Chan Affiliations
Document Type
Publication Date
Keywords
Aged
Cancer Care Facilities
Communication
Feedback
Female
General Surgery
Hospital Bed Capacity
Hospitals, University
Hospitals, Urban
Humans
Informed Consent
Mastectomy
Mastectomy, Segmental
Medical Audit
Middle Aged
Minnesota
Patient Education as Topic
Peer Group
Physician-Patient Relations
Task Performance and Analysis
Truth Disclosure
Health Services Research
Medicine and Health Sciences
Subject Area
Embargo Expiration Date
Link to Full Text
Abstract
We studied whether a hospital intervention utilizing medical opinion leaders and performance feedback reduced the proportion of women who reported that surgeons did not discuss options prior to surgery for early stage breast cancer. Opinion leaders provided clinical education to their peers using a variety of strategies and were selected for their ability to influence their peers. Performance feedback involved distributing performance reports that contained data on the outcomes of interest as well as on other treatment patterns. Twenty-eight hospitals in Minnesota were randomized to the intervention or to a control group that received performance feedback only. The proportion of patients at intervention hospitals who said that their surgeon did not discuss options decreased significantly (p < 0.001) from 33% to 17%, but a similar decrease was observed among control hospitals. Using medical opinion leaders to intervene in hospitals appeared as effective as performance feedback.
Source
Breast Cancer Res Treat. 2000 May;61(2):171-5.