Breast Cancer Research and Treatment

, Volume 61, Issue 2, pp 171–175

Improving discussion of surgical treatment options for patients with breast cancer: local medical opinion leaders versus audit and performance feedback

  • Edward Guadagnoli
  • Stephen B. Soumerai
  • Jerry H. Gurwitz
  • Catherine Borbas
  • Charles L. Shapiro
  • Jane C. Weeks
  • Nora Morris
Article

DOI: 10.1023/A:1006475012861

Cite this article as:
Guadagnoli, E., Soumerai, S.B., Gurwitz, J.H. et al. Breast Cancer Res Treat (2000) 61: 171. doi:10.1023/A:1006475012861

Abstract

We studied whether a hospital intervention utilizing medical opinion leaders and performance feedback reduced the proportion of women who reported that surgeons did not discuss options prior to surgery for early stage breast cancer. Opinion leaders provided clinical education to their peers using a variety of strategies and were selected for their ability to influence their peers. Performance feedback involved distributing performance reports that contained data on the outcomes of interest as well as on other treatment patterns. Twenty-eight hospitals in Minnesota were randomized to the intervention or to a control group that received performance feedback only. The proportion of patients at intervention hospitals who said that their surgeon did not discuss options decreased significantly (p<0.001) from 33% to 17%, but a similar decrease was observed among control hospitals. Using medical opinion leaders to intervene in hospitals appeared as effective as performance feedback.

breast cancer breast conserving surgery hospital practices mastectomy physician behavior 

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Edward Guadagnoli
    • 1
  • Stephen B. Soumerai
    • 2
  • Jerry H. Gurwitz
    • 3
  • Catherine Borbas
    • 4
  • Charles L. Shapiro
    • 5
  • Jane C. Weeks
    • 6
  • Nora Morris
    • 4
  1. 1.Department of Health Care PolicyHarvard Medical SchoolBostonUSA
  2. 2.Department of Ambulatory Care and PreventionHarvard Medical School and Harvard Pilgrim Health CareBostonUSA
  3. 3.The Meyers Primary Care Institute, Fallon Healthcare Systemthe University of Massachusetts Medical SchoolWorcesterUSA
  4. 4.The Healthcare Education and Research Foundation, Inc.St.PaulUSA
  5. 5.The Arthur James Cancer HospitalColumbusUSA
  6. 6.The Dana-Farber Cancer InstituteBostonUSA