Measures of Appropriateness and Value for Breast Surgeons and Their Patients: The American Society of Breast Surgeons Choosing Wisely ® Initiative
| Autor: | Starr Koslow Mautner, Oluwadamilola M. Fayanju, Michelle Sowden, Joshua Froman, Lisa Bailey, Caprice C. Greenberg, Lee G. Wilke, Robert Buras, Jennifer Gass, Tiffany S. Berry, Jeffrey Landercasper, Roshni Rao, Barbara Wexelman, Amy C. Degnim, Judy A. Tjoe, Steven L. Chen, Helen Krontiras |
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| Jazyk: | angličtina |
| Předmět: |
Reoperation
medicine.medical_specialty Pathology Neoplasm Residual Delphi Technique medicine.medical_treatment Decision Making Alternative medicine Delphi method MEDLINE Breast Neoplasms Breast Oncology Health Services Misuse Mastectomy Segmental 03 medical and health sciences 0302 clinical medicine Breast cancer Health care medicine Humans Genetic Testing 030212 general & internal medicine Patient participation Societies Medical Quality Indicators Health Care business.industry Margins of Excision medicine.disease Magnetic Resonance Imaging Prophylactic Mastectomy Surgical Oncology Oncology 030220 oncology & carcinogenesis Family medicine Lymph Node Excision Female Professional association Surgery Patient Participation business Mastectomy |
| Zdroj: | Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| DOI: | 10.1245/s10434-016-5327-8 |
| Popis: | Background Current breast cancer care is based on high-level evidence from randomized, controlled trials. Despite these data, there continues to be variability of breast cancer care, including overutilization of some tests and operations. To reduce overutilization, the American Board of Internal Medicine Choosing Wisely® Campaign recommends that professional organizations provide patients and providers with a list of care practices that may not be necessary. Shared decision making regarding these services is encouraged. Methods The Patient Safety and Quality Committee of the American Society of Breast Surgeons (ASBrS) solicited candidate measures for the Choosing Wisely® Campaign. The resulting list of “appropriateness” measures of care was ranked by a modified Delphi appropriateness methodology. The highest-ranked measures were submitted to and later approved by the ASBrS Board of Directors. They are listed below. Results (1) Don’t routinely order breast magnetic resonance imaging in new breast cancer patients. (2) Don’t routinely excise all the lymph nodes beneath the arm in patients having lumpectomy for breast cancer. (3) Don’t routinely order specialized tumor gene testing in all new breast cancer patients. (4) Don’t routinely reoperate on patients with invasive cancer if the cancer is close to the edge of the excised lumpectomy tissue. (5) Don’t routinely perform a double mastectomy in patients who have a single breast with cancer. Conclusions The ASBrS list for the Choosing Wisely® campaign is easily accessible to breast cancer patients online. These measures provide surgeons and their patients with a starting point for shared decision making regarding potentially unnecessary testing and operations. |
| Databáze: | OpenAIRE |
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