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A Statewide Intervention Improves Appropriate Imaging in Localized Prostate Cancer
The Journal of Urology
|November 28, 2016
Summary
A statewide quality improvement initiative reduced unnecessary bone scans and CT imaging for prostate cancer staging. This intervention improved appropriate imaging utilization, particularly for low-risk patients, leading to significant practice pattern changes.
Area of Science:
- Urology
- Radiology
- Health Services Research
Background:
- Prostate cancer staging often involves imaging like bone scans and CT.
- Inappropriate imaging can lead to increased costs and patient burden.
- Standardized criteria can guide appropriate utilization.
Purpose of the Study:
- To implement and evaluate a statewide intervention to optimize imaging utilization for newly diagnosed prostate cancer.
- To reduce unnecessary bone scan and computerized tomography (CT) use in prostate cancer staging.
Main Methods:
- A quality improvement collaborative (MUSIC) developed imaging appropriateness criteria.
- Multidimensional interventions were deployed across 42 diverse practices.
- Imaging utilization rates were measured before (2012-2013) and after (2015) the intervention.
Main Results:
- Use of unnecessary bone scans decreased from 11.0% to 6.5% (p <0.0001).
- Use of unnecessary CT scans decreased from 14.7% to 7.7% (p <0.0001).
- Inter-practice variability in imaging use significantly decreased.
Conclusions:
- A statewide intervention effectively reduced the use of inappropriate bone scans and CT imaging in prostate cancer staging.
- The intervention demonstrated success in improving appropriate imaging utilization, especially for low-risk patients.
- Quality improvement collaboratives can drive significant changes in clinical practice patterns.
