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DeImplementing Ineffective and Low-Value Clinical Practices: Research and Practice Opportunities in Community
Wynne E Norton1, Worta McCaskill-Stevens2, David A Chambers1
1Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
JNCI Cancer Spectrum
|April 16, 2021
Summary
Deimplementing low-value cancer care practices requires research. The National Cancer Institute Community Oncology Research Program (NCORP) offers a robust infrastructure for studying deimplementation strategies nationwide.
Area of Science:
- Oncology
- Health Services Research
- Implementation Science
Background:
- Growing concern regarding the delivery of ineffective or low-value clinical practices within cancer care.
- A critical need exists for research focused on the effective deimplementation of such practices.
Purpose of the Study:
- To highlight the National Cancer Institute Community Oncology Research Program (NCORP) as an ideal infrastructure for deimplementation research.
- To outline multilevel issues influencing deimplementation and propose strategies.
- To identify optimal study designs for deimplementation trials within real-world settings.
Main Methods:
- Commentary and proposal based on the structure and objectives of the NCORP network.
- Description of multilevel factors impacting deimplementation.
- Elaboration on study designs suitable for deimplementation research.
Main Results:
- NCORP is uniquely positioned to conduct rigorous, real-world deimplementation research due to its extensive network of diverse community oncology sites.
- Multilevel issues affecting deimplementation are identified as key considerations for strategy development.
- Optimal study designs for testing deimplementation strategies are discussed.
Conclusions:
- The NCORP network provides a valuable infrastructure for advancing deimplementation research in cancer care.
- Conducting deimplementation trials within NCORP can lead to significant improvements in cancer care delivery nationwide.
- This approach facilitates evidence-based practice change for millions of patients.
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