Authors: E C Lasser E R Pfoh H Y Chang K S Chan J C Bailey H Kharrazi J P Weiner S M Dy
Publish Date: 2016/02/09
Volume: 27, Issue: 7, Pages: 2311-2316
Abstract
Reducing overuse of tests such as dualenergy Xray absorptiometry DXA scans in younger women is an important quality issue We evaluated trends in DXA ordering before and after Choosing Wisely recommendations were released We found no significant difference in ordering trends suggesting that other initiatives are needed to change behaviorReducing overuse of tests such as dualenergy Xray absorptiometry DXA scans in younger women is an important quality issue but trends in care are difficult to change We evaluated 1 trends in DXA ordering before and after the Choosing Wisely recommendation release and 2 patterns of key characteristics that indicate a potentially appropriate DXA scan orderWe performed a retrospective longitudinal analysis of electronic health record data at a multispecialty ambulatory care network of 34 practices across Maryland and Washington DC Since the Choosing Wisely DXA recommendation was released April 2012 the study periods were April–December 2011 preinitiative and April–December 2012 postinitiative Women between 50 and 64 years with primary care encounters and primary care providers who saw ten or more women in the study population in both pre and post periods were includedFor 42320 eligible patients the mean provider ordering rate was 26 preinitiative and 20 postinitiative there was no significant difference in trend over time Over 70 of the population had no characteristics associated with potentially appropriate DXA ordering Low body mass index current smoker status and osteopenia were the most common characteristics indicating potentially appropriate DXA orders Patients with any of these three characteristics had DXA ordering rates between 3–20 All authors contributed to the conception and/or design of this study ECL SMD JPW and JCB contributed to the acquisition of data SMD HYC and ECL contributed to the analysis of data and all authors contributed to the interpretation of data ECL SDY and ERP drafted the manuscript and all authors critically revised it for important intellectual content and approved the final version to be submitted HYC had full access to the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis
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