Longitudinal Content Analysis of the Characteristics and Expected Impact of Low-Value Services Identified in US Choosing Wisely Recommendations

ObjectivesChoosing Wisely holds promise for increasing awareness of low-value care in physiotherapy. However, it is unclear how physiotherapists’ view Choosing Wisely recommendations. The aim of this study was to evaluate physiotherapists’ feedback on Choosing Wisely recommendations and investigate agreement with each recommendation.SettingThe Australian Physiotherapy Association emailed a survey to all 20 029 physiotherapist members in 2015 seeking feedback on a list of Choosing Wisely recommendations.ParticipantsA total of 9764 physiotherapists opened the email invitation (49%) and 543 completed the survey (response rate 5.6%). Participants were asked about the acceptability of the wording of recommendations using a closed (Yes/No) and free-text response option (section 1). Then using a similar response format, participants were asked whether they agreed with each Choosing Wisely recommendation (sections 2–6).Primary and secondary outcomesWe performed a content analysis of free-text responses (primary outcome) and used descriptive statistics to report agreement and disagreement with each recommendation (secondary outcome).ResultsThere were 872 free-text responses across the six sections. A total of 347 physiotherapists (63.9%) agreed with the ‘don’t’ style of wording. Agreement with recommendations ranged from 52.3% (electrotherapy for back pain) to 76.6% (validated decision rules for imaging). The content analysis revealed that physiotherapists felt that blanket rules were inappropriate (range across recommendations: 13.9%–30.1% of responses), clinical experience is more valuable than evidence (11.7%–28.3%) and recommendations would benefit from further refining or better defining key terms (7.3%–22.4%).ConclusionsAlthough most physiotherapists agreed with both the style of wording for Choosing Wisely recommendations and with the recommendations, their feedback highlighted a number of areas of disagreement and suggestions for improvement. These findings will support the development of future recommendations and are the first step towards increasing the impact Choosing Wisely has on physiotherapy practice.

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Do choosing wisely recommendations about low-value care target income-generating treatments provided by members? A content analysis of 1293 recommendations

BMC Health Services Research ◽

10.1186/s12913-019-4576-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Joshua R. Zadro ◽

John Farey ◽

Ian A. Harris ◽

Christopher G. Maher

Keyword(s):

Content Analysis ◽

Treatment Recommendations ◽

Choosing Wisely ◽

Similar Proportion ◽

Professional Societies ◽

Chi Squared ◽

A Priority

Abstract Background It is unknown to what extent Choosing Wisely recommendations about income-generating treatments apply to members of the society generating the recommendations. The primary aim of this study is to determine the proportion of Choosing Wisely recommendations targeting income-generating treatments, and whether recommendations from professional societies on income-generating treatments are more likely to target members or non-members. The secondary aim is to determine the prevalence of qualified statements, and whether qualified statements are more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. Methods We performed a content analysis of all Choosing Wisely recommendations, with data extracted from Choosing Wisely websites. Two researchers coded recommendations as test or treatment-based, for or against a procedure, containing qualified statements, income-generating and applying to members. Disagreements were resolved by discussion or consultation with a third researcher. A Chi-squared test evaluated whether society recommendations on income-generating treatments were more likely to target members or non-members; and whether qualified statements were more likely to appear in recommendations targeting income-generating or non-income-generating treatments that apply to members. Results We found 1293 Choosing Wisely recommendations (48.3% tests and 48.6% treatments). Ninety-eight treatment recommendations targeted income-generating treatments (17.8%), and recommendations on income-generating treatments were less likely to target members compared to non-members (15.6% vs. 40.4%, p < 0.001). Nearly half of all recommendations were qualified (41.9%), with a similar proportion of recommendations targeting income-generating and non-income-generating treatments that apply to members containing qualified statements (49.4% vs. 42.0%, p = 0.23). Conclusions Many societies provide Choosing Wisely recommendations that minimise impact on their own members. Only 20% of treatment recommendations target income-generating treatments, and of these recommendations mostly target non-members. Many recommendations are also qualified. Increasing the number of recommendations from societies that are unqualified and target member clinicians responsible for de-implementation of low-value and costly treatments should be a priority.

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Of Frames and Cultures - A Cross-Cultural Comparison of TV Newscasts

Zeitschrift für Medienpsychologie ◽

10.1026/1617-6383.18.4.160 ◽

2006 ◽

Vol 18 (4) ◽

pp. 160-173 ◽

Cited By ~ 3

Author(s):

Maria Senokozlieva ◽

Oliver Fischer ◽

Gary Bente ◽

Nicole Krämer

Keyword(s):

Content Analysis ◽

Arab World ◽

Methodological Approach ◽

Cross Cultural ◽

Cultural Comparison ◽

Explorative Study ◽

Cross Cultural Comparison ◽

Tv News ◽

The Usa ◽

The Relationship

Abstract. TV news are essentially cultural phenomena. Previous research suggests that the often-overlooked formal and implicit characteristics of newscasts may be systematically related to culture-specific characteristics. Investigating these characteristics by means of a frame-by-frame content analysis is identified as a particularly promising methodological approach. To examine the relationship between culture and selected formal characteristics of newscasts, we present an explorative study that compares material from the USA, the Arab world, and Germany. Results indicate that there are many significant differences, some of which are in line with expectations derived from cultural specifics. Specifically, we argue that the number of persons presented as well as the context in which they are presented can be interpreted as indicators of Individualism/Collectivism. The conclusions underline the validity of the chosen methodological approach, but also demonstrate the need for more comprehensive and theory-driven category schemes.

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Searching Online for Methods of Suicide

Crisis ◽

10.1027/0227-5910/a000701 ◽

2020 ◽

pp. 1-8

Author(s):

Christian Ulrich Eriksen ◽

Flemming Konradsen ◽

Thilde Vildekilde

Keyword(s):

Content Analysis ◽

English Language ◽

Significant Proportion ◽

Background Information ◽

Access To Information ◽

Online Content ◽

Negative Effects ◽

Search Terms ◽

Methods Of Suicide

Abstract. Background: Information on methods of suicide is available online, and access to information on methods of suicide appears to contribute to a small but significant proportion of suicides. There is limited documentation of how methods of suicide are being profiled, as well as what content exists in other languages than English. Aim: We aimed to analyze and compare how methods of suicide are profiled on Danish and English-language websites. Method: We applied a categorization and content analysis of websites describing methods of suicide. Sites were retrieved by applying widely used Danish and English-language search terms. Results: A total of 136 English-language websites and 106 Danish-language websites were included for analysis. Websites were more often categorized as prevention or support sites, academic or policy sites, and against suicide sites than dedicated suicide sites (i.e., pro-suicide sites), or information sites. However, information on methods of suicide was available, and 20.1% and 8.9% of the English and Danish-language sites, respectively, suggested that a particular method of suicide was quick, easy, painless, or certain to result in death. Limitations: Only one author coded and analyzed all websites. A further operationalization of the content analysis checklist is warranted to increase reliability. Conclusion: The websites primarily had a prevention or anti-suicide focus, but information on methods of suicide was available, requiring an increased focus on how to diminish the negative effects of harmful online content.

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Types of Stressors on Nonprofessional Against-Suicide and Pro-Suicide Message Boards

Crisis ◽

10.1027/0227-5910/a000562 ◽

2019 ◽

Vol 40 (4) ◽

pp. 257-264 ◽

Cited By ~ 1

Author(s):

Thomas Niederkrotenthaler ◽

Benedikt Till

Keyword(s):

Content Analysis ◽

Interpersonal Problems ◽

Suicide Method ◽

Presenting Problems ◽

Message Boards ◽

Safe Method ◽

Different Types ◽

Psychiatric Problems

Abstract. Background: Little is known about presenting problems of primary posters (i.e., posters opening the thread) and their responders in nonprofessional against-suicide and pro-suicide message boards. Aims: We aimed to compare problems described in suicide message boards between different types of users (primary posters and respondents) and between against-suicide, neutral, and pro-suicide message boards. Method: In all, 1,182 archival threads with 20,499 individual postings from seven nonprofessional suicide message boards supporting an against-suicide, neutral, or pro-suicide attitude were randomly selected. Problems mentioned by primary posters and their respondents were coded with content analysis. Differences between pro-suicide, neutral, and against suicide boards, as well as correlations between primary posters and respondents, were calculated. Results: Interpersonal problems were most frequently mentioned by primary posters in against-suicide threads (40.9%) and less frequently in pro-suicide threads (11.8%; p < .001). In pro-suicide boards, the most frequent stressors were suicide method-related (e.g., how to identify a safe method: 26.2% vs. 2.5% in against-suicide boards, p < .001). Primary posters resembled respondents in terms of presenting problems in pro-suicide boards, but not in against-suicide boards. Limitations: Only self-reported problems were assessed. Conclusion: The results confirm a stronger focus on death than on life among users in pro-suicide message boards, and posters with similar problems meet in pro-suicide boards. The posters appear to clearly emphasize social strains over psychiatric problems compared with some professional settings.

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How to be ConTENT With Rorschach CONtent

Rorschachiana Journal of the International Society for the Rorschach ◽

10.1027/1192-5604/a000082 ◽

2016 ◽

Vol 37 (2) ◽

pp. 147-165

Author(s):

Charles A. Peterson

Keyword(s):

Content Analysis ◽

Pros And Cons ◽

Abstract Content

Abstract. Content analysis is a late and contentious addition to the Rorschach canon. The determinants have ruled. Hermann Rorschach was at best, ambivalent about content analysis, focusing on the perceptual aspects of the process. Rorschachers have been not been conTENT about CONtent. The literature on the pros and cons and the how-to of content analysis is reviewed chronologically, concluding with eight issues and objections that have left Rorschach practitioners malcontent with content. Hoping to help practitioners improve the analysis of Rorschach content, ten suggestions, often with examples, are offered, these “hints” affecting both conceptualization and practice. A case fragment is appended to the review to host the above suggestions and to illustrate the (likely) less frequent “active evocation” of content to further the analysis.

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