'Choosing Wisely' culture among Brazilian cardiologists. (1st March 2018)
- Record Type:
- Journal Article
- Title:
- 'Choosing Wisely' culture among Brazilian cardiologists. (1st March 2018)
- Main Title:
- 'Choosing Wisely' culture among Brazilian cardiologists
- Authors:
- Correia, Luis C L
Barcellos, Guilherme B
Calixto, Vitor
Volschan, André
Barreto-Filho, José A S
Lopes, Renato D
Rassi, Anis
Levinson, Wendy
de Paola, Angelo A V - Abstract:
- Abstract: Objective: (i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful care. Design: Cross-sectional study. Setting: Brazilian Society of Cardiology. Participants: Cardiologists who agree to fill a web questionary. Intervention: A task force of 12 Brazilian cardiologists prepared a list of 13 'do not do' recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation. Main Outcome Measurement: Score average for supporting recommendations. Results: Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was 'do not perform routine percutaneous coronary intervention in asymptomatic individuals' (mean score = 8.0 ± 2.9) while the one with the lowest support was 'do not use an intra-aortic balloon pump in infarction with cardiogenic shock' (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7–8 (moderate support) followed by 6 recommendations with an average of 5–7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support. Conclusions: (i) The support of BrazilianAbstract: Objective: (i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful care. Design: Cross-sectional study. Setting: Brazilian Society of Cardiology. Participants: Cardiologists who agree to fill a web questionary. Intervention: A task force of 12 Brazilian cardiologists prepared a list of 13 'do not do' recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation. Main Outcome Measurement: Score average for supporting recommendations. Results: Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was 'do not perform routine percutaneous coronary intervention in asymptomatic individuals' (mean score = 8.0 ± 2.9) while the one with the lowest support was 'do not use an intra-aortic balloon pump in infarction with cardiogenic shock' (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7–8 (moderate support) followed by 6 recommendations with an average of 5–7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support. Conclusions: (i) The support of Brazilian cardiologists for the 'Choosing Wisely' concept is modest to moderate, and (ii) older generations and enthusiasm towards the procedure one performs may be factors against the 'Choosing Wisely' philosophy. … (more)
- Is Part Of:
- International journal for quality in health care. Volume 30:Number 6(2018:Aug.)
- Journal:
- International journal for quality in health care
- Issue:
- Volume 30:Number 6(2018:Aug.)
- Issue Display:
- Volume 30, Issue 6 (2018)
- Year:
- 2018
- Volume:
- 30
- Issue:
- 6
- Issue Sort Value:
- 2018-0030-0006-0000
- Page Start:
- 437
- Page End:
- 442
- Publication Date:
- 2018-03-01
- Subjects:
- patient-centred care -- shared decision-making -- appropriateness -- under-use -- over-use -- patient safety -- decision analysis
Medical care -- Quality control -- Periodicals
362.1068 - Journal URLs:
- http://intqhc.oxfordjournals.org/ ↗
http://ukcatalogue.oup.com/ ↗ - DOI:
- 10.1093/intqhc/mzy028 ↗
- Languages:
- English
- ISSNs:
- 1353-4505
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 4542.510500
British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 12304.xml