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‘Choosing Wisely’ culture among Brazilian cardiologists
Abstract Objective (i) To describe how aligned the ‘Choosing Wisely’ concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians’ preference for avoiding wasteful care. Design Cross-sectional study. Setting Brazilian Society of Cardiology. Partici...
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| Published in: | International journal for quality in health care 2018-07, Vol.30 (6), p.437-442 |
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| container_end_page | 442 |
| container_issue | 6 |
| container_start_page | 437 |
| container_title | International journal for quality in health care |
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| creator | CORREIA, LUIS C. L. BARCELLOS, GUILHERME B. CALIXTO, VITOR VOLSCHAN, ANDRÉ BARRETO-FILHO, JOSÉ A. S. LOPES, RENATO D. RASSI, ANIS LEVINSON, WENDY DE PAOLA, ANGELO A. V. |
| description | Abstract
Objective
(i) To describe how aligned the ‘Choosing Wisely’ concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians’ preference for avoiding wasteful care.
Design
Cross-sectional study.
Setting
Brazilian Society of Cardiology.
Participants
Cardiologists who agree to fill a web questionary.
Intervention
A task force of 12 Brazilian cardiologists prepared a list of 13 ‘do not do’ recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation.
Main Outcome Measurement
Score average for supporting recommendations.
Results
Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was ‘do not perform routine percutaneous coronary intervention in asymptomatic individuals’ (mean score = 8.0 ± 2.9) while the one with the lowest support was ‘do not use an intra-aortic balloon pump in infarction with cardiogenic shock’ (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7–8 (moderate support) followed by 6 recommendations with an average of 5–7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support.
Conclusions
(i) The support of Brazilian cardiologists for the ‘Choosing Wisely’ concept is modest to moderate, and (ii) older generations and enthusiasm towards the procedure one performs may be factors against the ‘Choosing Wisely’ philosophy. |
| doi_str_mv | 10.1093/intqhc/mzy028 |
| format | article |
| fullrecord | <record><control><sourceid>jstor_TOX</sourceid><recordid>TN_cdi_proquest_miscellaneous_2011275358</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>48519896</jstor_id><oup_id>10.1093/intqhc/mzy028</oup_id><sourcerecordid>48519896</sourcerecordid><originalsourceid>FETCH-LOGICAL-c387t-aebbd6d39521e072ee28b32e4a6c320f7eec1a22af8db892f63f05fa8195de1f3</originalsourceid><addsrcrecordid>eNqFkLtOwzAUhi0EoqUwMoIysoT6EjuOmKDiJlViATFGjnPSukri1k6GdupjwOv1SQhKgZHpHJ3_03-kD6Fzgq8JTtjY1M1qrsfVZo2pPEBDEokoZCKOD7udcRZGHPMBOvF-gTERjItjNKAJx6JLh-hmt_2YzK31pp4F78ZDud5tPwPdlk3rIFCV7e53Tm1MaVQdaOVyY0s7M77xp-ioUKWHs_0cobeH-9fJUzh9eXye3E5DzWTchAqyLBc5SzglgGMKQGXGKERKaEZxEQNooihVhcwzmdBCsALzQkmS8BxIwUboqu9dOrtqwTdpZbyGslQ12NanFBNCY8647NCwR7Wz3jso0qUzlXLrlOD021fa-0p7Xx1_ua9uswryX_pH0N9v2y7_7bro0YVvrPuFI8lJIhPBvgDO3oLC</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2011275358</pqid></control><display><type>article</type><title>‘Choosing Wisely’ culture among Brazilian cardiologists</title><source>Oxford Journals Open Access Collection</source><creator>CORREIA, LUIS C. L. ; BARCELLOS, GUILHERME B. ; CALIXTO, VITOR ; VOLSCHAN, ANDRÉ ; BARRETO-FILHO, JOSÉ A. S. ; LOPES, RENATO D. ; RASSI, ANIS ; LEVINSON, WENDY ; DE PAOLA, ANGELO A. V.</creator><creatorcontrib>CORREIA, LUIS C. L. ; BARCELLOS, GUILHERME B. ; CALIXTO, VITOR ; VOLSCHAN, ANDRÉ ; BARRETO-FILHO, JOSÉ A. S. ; LOPES, RENATO D. ; RASSI, ANIS ; LEVINSON, WENDY ; DE PAOLA, ANGELO A. V.</creatorcontrib><description>Abstract
Objective
(i) To describe how aligned the ‘Choosing Wisely’ concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians’ preference for avoiding wasteful care.
Design
Cross-sectional study.
Setting
Brazilian Society of Cardiology.
Participants
Cardiologists who agree to fill a web questionary.
Intervention
A task force of 12 Brazilian cardiologists prepared a list of 13 ‘do not do’ recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation.
Main Outcome Measurement
Score average for supporting recommendations.
Results
Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was ‘do not perform routine percutaneous coronary intervention in asymptomatic individuals’ (mean score = 8.0 ± 2.9) while the one with the lowest support was ‘do not use an intra-aortic balloon pump in infarction with cardiogenic shock’ (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7–8 (moderate support) followed by 6 recommendations with an average of 5–7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support.
Conclusions
(i) The support of Brazilian cardiologists for the ‘Choosing Wisely’ concept is modest to moderate, and (ii) older generations and enthusiasm towards the procedure one performs may be factors against the ‘Choosing Wisely’ philosophy.</description><identifier>ISSN: 1353-4505</identifier><identifier>EISSN: 1464-3677</identifier><identifier>DOI: 10.1093/intqhc/mzy028</identifier><identifier>PMID: 29506135</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Brazil ; Cardiologists ; Cardiology - standards ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - therapy ; Cross-Sectional Studies ; Diagnostic Techniques, Cardiovascular - statistics & numerical data ; Female ; Health Services Misuse - prevention & control ; Humans ; Male ; Middle Aged ; Societies, Medical ; Surveys and Questionnaires ; Unnecessary Procedures</subject><ispartof>International journal for quality in health care, 2018-07, Vol.30 (6), p.437-442</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-aebbd6d39521e072ee28b32e4a6c320f7eec1a22af8db892f63f05fa8195de1f3</citedby><cites>FETCH-LOGICAL-c387t-aebbd6d39521e072ee28b32e4a6c320f7eec1a22af8db892f63f05fa8195de1f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48519896$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48519896$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,1598,27901,27902,58213,58446</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/intqhc/mzy028$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29506135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CORREIA, LUIS C. L.</creatorcontrib><creatorcontrib>BARCELLOS, GUILHERME B.</creatorcontrib><creatorcontrib>CALIXTO, VITOR</creatorcontrib><creatorcontrib>VOLSCHAN, ANDRÉ</creatorcontrib><creatorcontrib>BARRETO-FILHO, JOSÉ A. S.</creatorcontrib><creatorcontrib>LOPES, RENATO D.</creatorcontrib><creatorcontrib>RASSI, ANIS</creatorcontrib><creatorcontrib>LEVINSON, WENDY</creatorcontrib><creatorcontrib>DE PAOLA, ANGELO A. V.</creatorcontrib><title>‘Choosing Wisely’ culture among Brazilian cardiologists</title><title>International journal for quality in health care</title><addtitle>Int J Qual Health Care</addtitle><description>Abstract
Objective
(i) To describe how aligned the ‘Choosing Wisely’ concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians’ preference for avoiding wasteful care.
Design
Cross-sectional study.
Setting
Brazilian Society of Cardiology.
Participants
Cardiologists who agree to fill a web questionary.
Intervention
A task force of 12 Brazilian cardiologists prepared a list of 13 ‘do not do’ recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation.
Main Outcome Measurement
Score average for supporting recommendations.
Results
Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was ‘do not perform routine percutaneous coronary intervention in asymptomatic individuals’ (mean score = 8.0 ± 2.9) while the one with the lowest support was ‘do not use an intra-aortic balloon pump in infarction with cardiogenic shock’ (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7–8 (moderate support) followed by 6 recommendations with an average of 5–7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support.
Conclusions
(i) The support of Brazilian cardiologists for the ‘Choosing Wisely’ concept is modest to moderate, and (ii) older generations and enthusiasm towards the procedure one performs may be factors against the ‘Choosing Wisely’ philosophy.</description><subject>Adult</subject><subject>Brazil</subject><subject>Cardiologists</subject><subject>Cardiology - standards</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - therapy</subject><subject>Cross-Sectional Studies</subject><subject>Diagnostic Techniques, Cardiovascular - statistics & numerical data</subject><subject>Female</subject><subject>Health Services Misuse - prevention & control</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Societies, Medical</subject><subject>Surveys and Questionnaires</subject><subject>Unnecessary Procedures</subject><issn>1353-4505</issn><issn>1464-3677</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqFkLtOwzAUhi0EoqUwMoIysoT6EjuOmKDiJlViATFGjnPSukri1k6GdupjwOv1SQhKgZHpHJ3_03-kD6Fzgq8JTtjY1M1qrsfVZo2pPEBDEokoZCKOD7udcRZGHPMBOvF-gTERjItjNKAJx6JLh-hmt_2YzK31pp4F78ZDud5tPwPdlk3rIFCV7e53Tm1MaVQdaOVyY0s7M77xp-ioUKWHs_0cobeH-9fJUzh9eXye3E5DzWTchAqyLBc5SzglgGMKQGXGKERKaEZxEQNooihVhcwzmdBCsALzQkmS8BxIwUboqu9dOrtqwTdpZbyGslQ12NanFBNCY8647NCwR7Wz3jso0qUzlXLrlOD021fa-0p7Xx1_ua9uswryX_pH0N9v2y7_7bro0YVvrPuFI8lJIhPBvgDO3oLC</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>CORREIA, LUIS C. L.</creator><creator>BARCELLOS, GUILHERME B.</creator><creator>CALIXTO, VITOR</creator><creator>VOLSCHAN, ANDRÉ</creator><creator>BARRETO-FILHO, JOSÉ A. S.</creator><creator>LOPES, RENATO D.</creator><creator>RASSI, ANIS</creator><creator>LEVINSON, WENDY</creator><creator>DE PAOLA, ANGELO A. V.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180701</creationdate><title>‘Choosing Wisely’ culture among Brazilian cardiologists</title><author>CORREIA, LUIS C. L. ; BARCELLOS, GUILHERME B. ; CALIXTO, VITOR ; VOLSCHAN, ANDRÉ ; BARRETO-FILHO, JOSÉ A. S. ; LOPES, RENATO D. ; RASSI, ANIS ; LEVINSON, WENDY ; DE PAOLA, ANGELO A. V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-aebbd6d39521e072ee28b32e4a6c320f7eec1a22af8db892f63f05fa8195de1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Brazil</topic><topic>Cardiologists</topic><topic>Cardiology - standards</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - therapy</topic><topic>Cross-Sectional Studies</topic><topic>Diagnostic Techniques, Cardiovascular - statistics & numerical data</topic><topic>Female</topic><topic>Health Services Misuse - prevention & control</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Societies, Medical</topic><topic>Surveys and Questionnaires</topic><topic>Unnecessary Procedures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CORREIA, LUIS C. L.</creatorcontrib><creatorcontrib>BARCELLOS, GUILHERME B.</creatorcontrib><creatorcontrib>CALIXTO, VITOR</creatorcontrib><creatorcontrib>VOLSCHAN, ANDRÉ</creatorcontrib><creatorcontrib>BARRETO-FILHO, JOSÉ A. S.</creatorcontrib><creatorcontrib>LOPES, RENATO D.</creatorcontrib><creatorcontrib>RASSI, ANIS</creatorcontrib><creatorcontrib>LEVINSON, WENDY</creatorcontrib><creatorcontrib>DE PAOLA, ANGELO A. V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal for quality in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>CORREIA, LUIS C. L.</au><au>BARCELLOS, GUILHERME B.</au><au>CALIXTO, VITOR</au><au>VOLSCHAN, ANDRÉ</au><au>BARRETO-FILHO, JOSÉ A. S.</au><au>LOPES, RENATO D.</au><au>RASSI, ANIS</au><au>LEVINSON, WENDY</au><au>DE PAOLA, ANGELO A. V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>‘Choosing Wisely’ culture among Brazilian cardiologists</atitle><jtitle>International journal for quality in health care</jtitle><addtitle>Int J Qual Health Care</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>30</volume><issue>6</issue><spage>437</spage><epage>442</epage><pages>437-442</pages><issn>1353-4505</issn><eissn>1464-3677</eissn><abstract>Abstract
Objective
(i) To describe how aligned the ‘Choosing Wisely’ concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians’ preference for avoiding wasteful care.
Design
Cross-sectional study.
Setting
Brazilian Society of Cardiology.
Participants
Cardiologists who agree to fill a web questionary.
Intervention
A task force of 12 Brazilian cardiologists prepared a list of 13 ‘do not do’ recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation.
Main Outcome Measurement
Score average for supporting recommendations.
Results
Of 14 579 Brazilian cardiologists, 621 (4.3%) answered the questionnaire. The top recommendation was ‘do not perform routine percutaneous coronary intervention in asymptomatic individuals’ (mean score = 8.0 ± 2.9) while the one with the lowest support was ‘do not use an intra-aortic balloon pump in infarction with cardiogenic shock’ (5.8 ± 3.2). None of the 13 recommendations presented a mean grade >9 (strong support); 7 recommendations averaged 7–8 (moderate support) followed by 6 recommendations with an average of 5–7 (modest support). Multivariate analysis independently identified predictors of the score attributed to the top recommendation; being an interventionist and time since graduation were both negatively associated with support.
Conclusions
(i) The support of Brazilian cardiologists for the ‘Choosing Wisely’ concept is modest to moderate, and (ii) older generations and enthusiasm towards the procedure one performs may be factors against the ‘Choosing Wisely’ philosophy.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29506135</pmid><doi>10.1093/intqhc/mzy028</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1353-4505 |
| ispartof | International journal for quality in health care, 2018-07, Vol.30 (6), p.437-442 |
| issn | 1353-4505 1464-3677 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2011275358 |
| source | Oxford Journals Open Access Collection |
| subjects | Adult Brazil Cardiologists Cardiology - standards Cardiovascular Diseases - diagnosis Cardiovascular Diseases - therapy Cross-Sectional Studies Diagnostic Techniques, Cardiovascular - statistics & numerical data Female Health Services Misuse - prevention & control Humans Male Middle Aged Societies, Medical Surveys and Questionnaires Unnecessary Procedures |
| title | ‘Choosing Wisely’ culture among Brazilian cardiologists |
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