Improving discussion of surgical treatment options for patients with breast cancer: local medical opinion leaders versus audit and performance feedback
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.
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Guadagnoli 2000 found no differences for breast cancer treatment (adjusted RD = -2%; no P value reported).
“Guadagnoli 2000 found no differences for breast cancer treatment (adjusted RD = ‐2%; no P value reported).”
From Audit and feedback: effects on professional practice and healthcare outcomes (2012) · cites this paper as Guadagnoli 2000
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- Authors
- Guadagnoli, E., Soumerai, S. B., Gurwitz, J. H., Borbas, C., Shapiro, C. L., Weeks, J. C., & Morris, N.
- Affiliations
- Harvard University (US)
- University of Massachusetts Chan Medical School (US)
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- Dana-Farber Cancer Institute (US)
- Venue
- Breast Cancer Research and Treatment
- Published
- 2000-05
- Volume
- 61
- Issue
- 2
- Pages
- 171-175
- ISSN
- 0167-6806 (ISSN-L)
- 1573-7217
- OpenAlex
- W2082391887
- Cited by
- 45
- References
- 13
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 4 · 2016: 1 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 1
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Breast Cancer Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- National Institutes of Health (5r01ca059408-03, 5r01ca057755-03)
- National Cancer Institute (CA 59408, CA57755)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- breast cancer, surgical treatment options, shared decision-making, performance feedback, audit and feedback, peer influence, clinical teaching, early breast cancer
- MeSH terms
- Adult, Aged, Cancer Care Facilities, Communication, Feedback, Female, Hospital Bed Capacity, Hospitals, University, Hospitals, Urban, Humans, Informed Consent, Mastectomy, Medical Audit, Middle Aged, Minnesota, Patient Education as Topic, Peer Group, Physician-Patient Relations, General Surgery, Task Performance and Analysis, Truth Disclosure, Mastectomy, Segmental
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