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'Choosing Wisely' culture among Brazilian cardiologists.

Publication ,  Journal Article
Correia, LCL; Barcellos, GB; Calixto, V; Volschan, A; Barreto-Filho, JAS; Lopes, RD; Rassi, A; Levinson, W; de Paola, AAV
Published in: Int J Qual Health Care
July 1, 2018

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.

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Published In

Int J Qual Health Care

DOI

EISSN

1464-3677

Publication Date

July 1, 2018

Volume

30

Issue

6

Start / End Page

437 / 442

Location

England

Related Subject Headings

  • Unnecessary Procedures
  • Surveys and Questionnaires
  • Societies, Medical
  • Middle Aged
  • Male
  • Humans
  • Health Services Misuse
  • Health Policy & Services
  • Female
  • Diagnostic Techniques, Cardiovascular
 

Citation

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Correia, L. C. L., Barcellos, G. B., Calixto, V., Volschan, A., Barreto-Filho, J. A. S., Lopes, R. D., … de Paola, A. A. V. (2018). 'Choosing Wisely' culture among Brazilian cardiologists. Int J Qual Health Care, 30(6), 437–442. https://doi.org/10.1093/intqhc/mzy028
Correia, Luis C. L., Guilherme B. Barcellos, Vitor Calixto, André Volschan, José A. S. Barreto-Filho, Renato D. Lopes, Anis Rassi, Wendy Levinson, and Angelo A. V. de Paola. “'Choosing Wisely' culture among Brazilian cardiologists.Int J Qual Health Care 30, no. 6 (July 1, 2018): 437–42. https://doi.org/10.1093/intqhc/mzy028.
Correia LCL, Barcellos GB, Calixto V, Volschan A, Barreto-Filho JAS, Lopes RD, et al. 'Choosing Wisely' culture among Brazilian cardiologists. Int J Qual Health Care. 2018 Jul 1;30(6):437–42.
Correia, Luis C. L., et al. “'Choosing Wisely' culture among Brazilian cardiologists.Int J Qual Health Care, vol. 30, no. 6, July 2018, pp. 437–42. Pubmed, doi:10.1093/intqhc/mzy028.
Correia LCL, Barcellos GB, Calixto V, Volschan A, Barreto-Filho JAS, Lopes RD, Rassi A, Levinson W, de Paola AAV. 'Choosing Wisely' culture among Brazilian cardiologists. Int J Qual Health Care. 2018 Jul 1;30(6):437–442.
Journal cover image

Published In

Int J Qual Health Care

DOI

EISSN

1464-3677

Publication Date

July 1, 2018

Volume

30

Issue

6

Start / End Page

437 / 442

Location

England

Related Subject Headings

  • Unnecessary Procedures
  • Surveys and Questionnaires
  • Societies, Medical
  • Middle Aged
  • Male
  • Humans
  • Health Services Misuse
  • Health Policy & Services
  • Female
  • Diagnostic Techniques, Cardiovascular