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Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations
BACKGROUND: It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations. The primary aim of this study is to determine the proportion of Choosing Wisely recommendations targeting income-generating trea...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6844045/ https://www.ncbi.nlm.nih.gov/pubmed/31707993 http://dx.doi.org/10.1186/s12913-019-4576-1 |
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author | Zadro, Joshua R. Farey, John Harris, Ian A. Maher, Christopher G. |
author_facet | Zadro, Joshua R. Farey, John Harris, Ian A. Maher, Christopher G. |
author_sort | Zadro, Joshua R. |
collection | PubMed |
description | BACKGROUND: It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations. The primary aim of this study is to determine the proportion of Choosing Wisely recommendations targeting income-generating treatments, and whether recommendations from professional societies on income-generating treatments are more likely to target members or non-members. The secondary aim is to determine the prevalence of qualified statements, and whether qualified statements are more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. METHODS: We performed a content analysis of all Choosing Wisely recommendations, with data extracted from Choosing Wisely websites. Two researchers coded recommendations as test or treatment-based, for or against a procedure, containing qualified statements, income-generating and applying to members. Disagreements were resolved by discussion or consultation with a third researcher. A Chi-squared test evaluated whether society recommendations on income-generating treatments were more likely to target members or non-members; and whether qualified statements were more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. RESULTS: We found 1293 Choosing Wisely recommendations (48.3% tests and 48.6% treatments). Ninety-eight treatment recommendations targeted income-generating treatments (17.8%), and recommendations on income-generating treatments were less likely to target members compared to non-members (15.6% vs. 40.4%, p < 0.001). Nearly half of all recommendations were qualified (41.9%), with a similar proportion of recommendations targeting income-generating and non-income-generating treatments that apply to members containing qualified statements (49.4% vs. 42.0%, p = 0.23). CONCLUSIONS: Many societies provide Choosing Wisely recommendations that minimise impact on their own members. Only 20% of treatment recommendations target income-generating treatments, and of these recommendations mostly target non-members. Many recommendations are also qualified. Increasing the number of recommendations from societies that are unqualified and target member clinicians responsible for de-implementation of low-value and costly treatments should be a priority. |
format | Online Article Text |
id | pubmed-6844045 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-68440452019-11-15 Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations Zadro, Joshua R. Farey, John Harris, Ian A. Maher, Christopher G. BMC Health Serv Res Research Article BACKGROUND: It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations. The primary aim of this study is to determine the proportion of Choosing Wisely recommendations targeting income-generating treatments, and whether recommendations from professional societies on income-generating treatments are more likely to target members or non-members. The secondary aim is to determine the prevalence of qualified statements, and whether qualified statements are more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. METHODS: We performed a content analysis of all Choosing Wisely recommendations, with data extracted from Choosing Wisely websites. Two researchers coded recommendations as test or treatment-based, for or against a procedure, containing qualified statements, income-generating and applying to members. Disagreements were resolved by discussion or consultation with a third researcher. A Chi-squared test evaluated whether society recommendations on income-generating treatments were more likely to target members or non-members; and whether qualified statements were more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. RESULTS: We found 1293 Choosing Wisely recommendations (48.3% tests and 48.6% treatments). Ninety-eight treatment recommendations targeted income-generating treatments (17.8%), and recommendations on income-generating treatments were less likely to target members compared to non-members (15.6% vs. 40.4%, p < 0.001). Nearly half of all recommendations were qualified (41.9%), with a similar proportion of recommendations targeting income-generating and non-income-generating treatments that apply to members containing qualified statements (49.4% vs. 42.0%, p = 0.23). CONCLUSIONS: Many societies provide Choosing Wisely recommendations that minimise impact on their own members. Only 20% of treatment recommendations target income-generating treatments, and of these recommendations mostly target non-members. Many recommendations are also qualified. Increasing the number of recommendations from societies that are unqualified and target member clinicians responsible for de-implementation of low-value and costly treatments should be a priority. BioMed Central 2019-11-11 /pmc/articles/PMC6844045/ /pubmed/31707993 http://dx.doi.org/10.1186/s12913-019-4576-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Zadro, Joshua R. Farey, John Harris, Ian A. Maher, Christopher G. Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations |
title | Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations |
title_full | Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations |
title_fullStr | Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations |
title_full_unstemmed | Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations |
title_short | Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations |
title_sort | do choosing wisely recommendations about low-value care target income-generating treatments provided by members? a content analysis of 1293 recommendations |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6844045/ https://www.ncbi.nlm.nih.gov/pubmed/31707993 http://dx.doi.org/10.1186/s12913-019-4576-1 |
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