Evidence map›Paper›PMID 28800760›Full record

ArticleBMC health services research2017

Perceptions of patients and providers on myocardial perfusion imaging for asymptomatic patients, choosing wisely, and professional liability.

Kristopher P Kline, Leslee Shaw, Rebecca J Beyth, Jared Plumb, Linda Nguyen, Tianyao Huo, David E Winchester

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kristopher P KlineDepartment of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
Leslee ShawDepartment of Medicine, Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
Rebecca J BeythGeriatric Research Education and Clinical Centers, Malcom Randall VA Medical Center, and University of Florida Department of Medicine, Gainesville, FL, USA.
Jared PlumbDepartment of Medicine, College of Medicine, Division of Cardiovascular Medicine, University of Florida, 1600 SW Archer Road, PO Box 100277, Gainesville, FL, 32610-0277, USA.
Linda NguyenCollege of Medicine, University of Florida, Gainesville, FL, USA.
Tianyao HuoCardiology Section, Medical Service, Malcom Randall VA Medical Center, Gainesville, FL, USA.
David E WinchesterDepartment of Medicine, College of Medicine, Division of Cardiovascular Medicine, University of Florida, 1600 SW Archer Road, PO Box 100277, Gainesville, FL, 32610-0277, USA. david.winchester@medicine.ufl.edu.

Funding

Using social networks to map and evaluate team science across CTSA hubsUL1TR001427 · NCATS · UNIVERSITY OF FLORIDA · PI MITCHELL, DUANE A. · 2015 to 2024
$37.2M
STUDENTS IN HEALTH PROFESSIONAL SCHOOLST35HL007489 · NHLBI · UNIVERSITY OF FLORIDA · PI Scott A Berceli, Robert Maile · 1985 to 2026
$2.4M
NCATS NIH HHS UL1 TR001427NHLBI NIH HHS T35 HL007489
6 · The paper itself

Abstract

backgroundDespite efforts by professional societies to reduce low value care, many reports indicate that unnecessary tests, such as nuclear myocardial perfusion imaging (MPI), are commonly used in contemporary practice. The degree to which lack of awareness and professional liability concerns drive these behaviors warrants further study. We sought to investigate patient and provider perceptions about MPI in asymptomatic patients, the Choosing Wisely (CW) campaign, and professional liability concerns.

methodsWe administered an anonymous, paper-based survey with both discrete and open-response queries to subjects in multiple outpatient settings at our facilities. The survey was completed by 456 respondents including 342 patients and 114 physicians and advanced practice providers between May and August 2014. Our outcome was to compare patient and provider perceptions about MPI in asymptomatic patients and related factors.

resultsPatients were more likely than providers to report that MPI was justified for asymptomatic patients (e.g. asymptomatic with family history of heart disease 75% versus 9.2%, p < 0.0001). In free responses to the question "What would be an inappropriate reason for MPI?" many responses echoed the goals of CW (for example, "If you don't have symptoms", "If the test is too risky", "For screening or in asymptomatic patients"). A minority of providers were aware of CW while even fewer patients were aware (37.2% versus 2.7%, p < 0.0001). Over one third of providers (38.9%) admitted to ordering MPI out of concern for professional liability including 48.3% of VA affiliated providers.

conclusionsWhile some patients and providers are aware of the low value of MPI in patients without symptoms, others are enthusiastic to use it for a variety of scenarios. Concerns about professional liability likely contribute, even in the VA setting. Awareness of the Choosing Wisely campaign is low in both groups.

Indexed as

Attitude of Health PersonnelAttitude to HealthMyocardial Perfusion ImagingPhysiciansUnnecessary ProceduresAgedFemaleHumansLiability, LegalMaleMiddle AgedSurveys and QuestionnairesAppropriate use criteriaChoosing wiselyMedical liabilityMyocardial perfusion imaging

Identifiers

PMID28800760
PMCPMC5553740

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.