Effectiveness and Outcomes in Health Care Proceedings of an Invitational Conference (1990) / Chapter Skim
Currently Skimming:
20 Effectiveness Research and Changing Physician Practice Patterns
20 Effectiveness Research and Changing Physician Practice Patterns
Pages 173-178
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 173... ...
EFFECTS OF RESEARCH ON MEDICAL PRACTICE The relationship between a specified research result and changes in medical practice is very complex. Diffusion, which is a term for the adoption of new medical technology, also applies to altered ways of using technology, such as might result from an effectiveness study.
|
From page 174... ...
First, what is the baseline pattern of using the technology? Is there a trend among practicing physicians that is due to factors unrelated to the research results?
|
From page 175... ...
They measured TABLE 1 RAND Study of NIH Consensus Conferences Condition Selected Recommendations Breast cancer Standard is total mastectomy with axillary dissection in Stage 1 or 2 Breast cancer An estrogen receptor assay should be performed on each primary tumor Cesarean section A trial of labor in low-risk women with a previous C-section Unstable angina Unstable angina patients should have a coronary angiogram on their first hospital admission for the condition SOURCE: Adapted from Kosecoff et al.
|
From page 176... ...
There was no trend toward increased compliance with the recommendation to perform total mastectomy with axillary dissection in Stage I and Stage II breast cancer. The RAND investigators studied compliance with a recommendation to test for estrogen receptors in breast cancer.
|
From page 177... ...
Their recommendations should be based on research results, with clear delineation of the logic leading from the research findings to the recommendations. If the professional societies are to play this central role, they should spend some time working together on a common approach to developing guidelines.
|
From page 178... ...
It will take a decade or more for the Effectiveness Initiative to achieve research results that physicians can use to change the way that they practice medicine. These research findings will not have their intended impact unless there is an intensive effort to understand the factors that influence physicians to change.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.