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Related Experiment Videos

Changing practice patterns in the management of primary breast cancer: Consensus Development Program.

J Kosecoff1, D E Kanouse, R H Brook

  • 1Behavioral Sciences Department, RAND Corporation, Santa Monica, CA 90406-2138.

Health Services Research
|December 1, 1990
PubMed
Summary

National Institutes of Health breast cancer treatment guidelines did not change physician practices or improve care quality. Further improvements are needed in breast cancer diagnosis and treatment protocols.

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Area of Science:

  • Oncology
  • Health Services Research

Background:

  • Recent advancements in breast cancer treatment efficacy necessitate updated clinical guidelines.
  • The National Institutes of Health convened a consensus conference on breast cancer treatment.

Purpose of the Study:

  • To assess the impact of the National Institutes of Health consensus conference on clinical practice patterns.
  • To evaluate the quality of care for breast cancer patients.

Main Methods:

  • Retrospective analysis of medical records from 573 breast cancer patients across ten hospitals in Washington State.
  • Examination of adherence to consensus recommendations and quality of care indicators.

Main Results:

  • No significant changes observed in the adoption of total mastectomy with axillary dissection or two-step surgical procedures post-conference.

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  • Limited improvement in preoperative staging (4%) and postoperative staging (29%) rates.
  • Minimal change in the utilization of sentinel laboratory tests over time.

    • Conclusions:

    • Consensus recommendations do not automatically translate into changes in physician behavior.
    • Significant gaps remain in the quality of breast cancer diagnosis and treatment, requiring further attention and intervention.