Clinician-Level Variation in Three Measures Representing Overuse Based on the American Geriatrics Society Choosing Wisely Statement.

Journal of General Internal Medicine
Theresa A RoweStephen D Persell

Abstract

The extent of clinician-level variation in the overuse of testing or treatment in older adults is not well understood. To examine clinician-level variation for three new measures of potentially inappropriate use of medical services in older adults. Retrospective analysis of overall means and clinician-level variation in performance on three new measures. Adults aged 65 years and older who had office visits with outpatient primary or immediate care clinicians within a single academic medical center health system between July 1, 2016, and June 30, 2017. Two electronic clinical quality measures representing potentially inappropriate use of medical services in older adults: prostate-specific antigen testing against guidelines (PSA) in men aged 76 and older; urinalysis or urine culture for non-specific reasons in women aged 65 and older; and one intermediate outcome measure: hemoglobin A1c less than 7.0 in adults aged 75 and older with diabetes mellitus treated with insulin or oral hypoglycemic medication. Sixty-nine clinicians and 2009 patients contributed observations to the PSA measure, 144 clinicians and 5933 patients contributed to the urinalysis/urine culture measure, and 42 clinicians and 665 patients contributed to the diabe...Continue Reading

References

Jul 4, 2002·Journal of the National Cancer Institute·Ruth EtzioniEric J Feuer
Feb 17, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Lindsay E NicolleUNKNOWN American Geriatric Society
Mar 16, 2007·Journal of General Internal Medicine·J B McKinlayK L Lutfey
Jul 18, 2012·Annals of Internal Medicine·Virginia A Moyer, UNKNOWN U.S. Preventive Services Task Force
Aug 14, 2012·Journal of the American Geriatrics Society·Thomas E Finucane
Oct 31, 2012·Annals of Internal Medicine·David W BakerUNKNOWN American College of Physicians Performance Measurement Committee
Apr 18, 2013·Journal of the American Geriatrics Society·Lesley B GordonLeonard A Mermel
Oct 17, 2013·JAMA : the Journal of the American Medical Association·Elizabeth JaramilloJames S Goodwin
Feb 27, 2014·JAMA : the Journal of the American Medical Association·Lona Mody, Manisha Juthani-Mehta
Apr 10, 2014·American Journal of Infection Control·Barbara W TrautnerAanand D Naik
Jan 2, 2015·BMJ Quality & Safety·Wendy LevinsonUNKNOWN Choosing Wisely International Working Group
Jan 13, 2015·JAMA Internal Medicine·Kasia J LipskaMichael A Steinman
Jul 29, 2015·Journal of General Internal Medicine·Alai TanJames S Goodwin
Sep 23, 2016·JAMA Internal Medicine·Daniel J MorganDeborah Korenstein
Oct 4, 2017·JAMA Internal Medicine·Daniel J MorganDeborah Korenstein
Apr 11, 2018·Journal of the American Geriatrics Society·Suzanne V ArnoldMikhail Kosiborod
Dec 7, 2018·JAMA Internal Medicine·Aaron L SchwartzJ Michael McWilliams
Dec 19, 2018·Diabetes Care·UNKNOWN American Diabetes Association
Mar 25, 2019·The Journal of Clinical Endocrinology and Metabolism·Derek LeRoithAlan J Sinclair

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