Perspectives on the value of American Society of Clinical Oncology clinical guidelines as reported by oncologists and health maintenance organizations

被引:39
作者
Bennett, CL
Somerfield, MR
Pfister, DG
Tomori, C
Yakren, S
Bach, PB
机构
[1] VA Midw Ctr Hlth Serv & Policy Res, Dept Vet Affairs, Chicago Healthcare Syst, Lakeside Div, Chicago, IL USA
[2] Northwestern Univ, Dept Med, Div Hematol Oncol, Chicago, IL 60611 USA
[3] Northwestern Univ, Robert H Lurie Canc Ctr, Chicago, IL 60611 USA
[4] Amer Soc Clin Oncol, Hlth Serv Res Comm, Alexandria, VA USA
[5] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, Hlth Outcomes Res Grp, Div Solid Tumor Oncol, New York, NY 10021 USA
[6] Mem Sloan Kettering Canc Ctr, Dept Med, New York, NY 10021 USA
关键词
D O I
10.1200/JCO.2003.07.165
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose : Although the American Society of Clinical Onoclogy's (ASCO) Health Services Research (HSR) committee activities have primarily focused an clinical guideline development, little is known about the value placed on these guidelines by the desired end users. ASCO members and Health Maintenance Organizations (HMOs) were surveyed on the value and implementation of ASCO guidelines. In this article, we summarize our findings. Methods: ASCO members (n = 1500) were queried about whether they had read ASCO's first four clinical guidelines and technology assessment, whether they agreed with the recommendations; whether they used guidelines in clinical practice; and how guidelines had affected reimbursement. HMOs (n = 131) were queried on how they identify, implement, and value the first four ASCO clinical guidelines. Results: The membership survey indicated that ASCO guidelines were read more often by physicians in private healthcare settings compared with physicians in academic practices (P < .02). Disagreement rates were low for all guidelines (range, 1% to 79%). One quarter of respondents reported that the guidelines were difficult to find and difficult to apply to the practice setting, and approximately one tenth of respondents indicated that the guidelines were difficult to evaluate, interpret, or read. The HMO survey indicated that one third of HMOs reported use of ASCO guidelines, with higher rates of usage by larger HMOs and by those with higher National Committee on Quality Assurance (NCQA) ratings. Respondent HMOs valued guidelines for various purposes and used multiple methods of guideline identification and implementation. Conclusion: ASCO guidelines are generally highly sups ported by physicians and HMOs. Additional studies are needed to identify implementation barriers and to see whether guidelines have resulted in improvements in healthcare. (C) 2003 by American Society of Clinical Oncology.
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页码:937 / 941
页数:5
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