Breast Cancer Screening and Diagnosis Clinical Practice Guidelines

2006 ◽  
Vol 4 (5) ◽  
pp. 480 ◽  
Author(s):  
_ _
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
The United States ◽  
Mammographic Screening ◽  
Effective Manner ◽  
Recent Version

The lifetime risk of a woman developing breast cancer has increased over the past 5 years in the United States: of every 7 women, 1 is at risk based on a life expectancy of 85 years. An estimated 214,640 new cases (212,920 women and 1,720 men) of breast cancer and 41,430 deaths (40,970 women and 460 men) from this disease will occur in the United States in 2006. However, mortality from breast cancer has decreased slightly, attributed partly to mammographic screening. Early detection and accurate diagnosis made in a cost-effective manner are critical to a continued reduction in mortality. These practice guidelines are designed to facilitate clinical decision making. For the most recent version of the guidelines, please visit NCCN.org

Breast Cancer Screening and Diagnosis Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (2) ◽  
pp. 242 ◽  
Keyword(s):  
Breast Cancer ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
Accurate Diagnosis ◽  
Effective Manner ◽  
Recent Version ◽  
Screening And Diagnosis ◽  
Made In

The key to a continued reduction in mortality from breast cancer is early detection and accurate diagnosis made in a cost-effective manner. These practice guidelines are designed to facilitate clinical decision making on the important issues in screening for breast cancer. For the most recent version of the guidelines, please visit NCCN.org

Breast Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (2) ◽  
pp. 148 ◽  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Invasive Breast Cancer ◽  
The United States ◽  
Cancer Society ◽  
Nccn Guidelines ◽  
Recent Version

The American Cancer Society estimates that approximately 205,000 new cases of breast cancer were diagnosed in the United States in the year 2002, and approximately 40,000 patients will die of this disease. The NCCN guidelines discuss the complex and varied therapeutic options for patients with noninvasive or invasive breast cancer. For the most recent version of the guidelines, please visit NCCN.org

Why Carbon Pricing Is Appealing

2018 ◽  
pp. 1-12
Author(s):  
Barry G. Rabe
Keyword(s):  
United States ◽  
Fossil Fuels ◽  
Cost Effective ◽  
Carbon Price ◽  
The United States ◽  
Carbon Taxes ◽  
Excise Taxes ◽  
Effective Manner ◽  
Reduce Emissions ◽  
Direct Tax

The use of taxes to elevate the price of popular commodities in order to reduce consumption and risks related to use did not originate with carbon taxes. Excise taxes on tobacco have been used aggressively by governments in the United States and beyond in recent decades to achieve significant reductions in smoking. Fossil fuel use has long been deemed by diverse economists as a viable target for a sequel, leading to innumerable reports and scholarly arguments making the case for a carbon price. This can take the form of either a direct tax on the carbon content of fossil fuels or a cap-and-trade system that allows for purchase of rights to release emissions at a price. Both are thought to offer effective paths to reduce emissions in a cost-effective manner.

Gastric Cancer Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (1) ◽  
pp. 28 ◽  
Keyword(s):  
United States ◽  
Gastric Cancer ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
The United States ◽  
Major Health Problem ◽  
Major Health ◽  
Recent Version ◽  
Upper Gastrointestinal

Carcinomas originating in the upper gastrointestinal tract constitute a major health problem around the world. In fact, experts estimate that approximately 34,700 new cases of upper gastrointestinal carcinomas and 25,000 deaths will have occurred in the United States in 2002. This article summarizes the NCCN clinical practice guidelines for managing gastric cancer, which portray uniformity in the systemic approach to cancer in the United States. The article also discusses anticipated future advances in the treatment of gastric carcinoma. For the most recent version of the guidelines, please visit NCCN.org

scholarly journals Influence of Prior Authorization Requirements on Provider Clinical Decision Making

2021 ◽  
Author(s):  
Stephen Salzbrenner ◽  
Maxwell Lydiatt ◽  
Brandon Heldin ◽  
Lawrence M. Scheier ◽  
Harrison Greene ◽  
...  
Keyword(s):  
United States ◽  
Decision Making ◽  
Health Plan ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The United States ◽  
Trial Registration ◽  
Prior Authorization ◽  
Step Therapy ◽  
Effective Use

Abstract Background: Prior authorization (PA) of medications is widely used by payers in the United States as a way to promote safe and effective use of medications and to control costs. However, PA-related tasks such as completing forms, submitting forms, researching medical history and submitting required documentation can all contribute to burden on healthcare providers. This study examines how such tasks and affect provider burden and treatment decisions. Methods: We developed and administered a nationwide, cross-sectional online survey of medical providers in the United States in 2020 based on a convenience sample of 100,000 providers (physicians, nurse practitioners, and physician assistants). Path analysis was used to test the associations between provider practice characteristics, step therapy and other health plan requirements, perceived burdens of PA, and communication issues with insurers on prescribing behaviors, which included prescribing a different medication, avoiding prescribing of newer medications, and modifying a diagnosis. Weighted analyses were also conducted to account for sample bias due to non-response. Results: A total of 1173 providers (1.2% response rate) provided 1147 usable surveys. The sample was 49.6% female, and a majority were MD/DO providers (85%). Step therapy requirements had the largest influence on prescribing a different medication than planned (b = .22, 95% CI = .160-.285) and avoiding prescribing a newer medication despite meeting evidence-based guidelines (b = .24, 95% CI = .181-.309). A unit-weighted index of perceived PA burden risk was associated with prescribing a different medication (b = .09, 95% CI = .012-.128) and modifying a diagnosis to obtain PA approval (b = .14, 95% CI = .065-.195). Communication issues were associated with prescribing a different medication (b = .11, 95% CI = .029-.186), while health plan requirements (e.g., clinical documentation) was significantly associated with all three prescribing outcomes. Weighted analyses showed that the study conclusions were unlikely to have been biased by nonresponse. Conclusions: Providers report altering prescribing and modifying diagnoses to avoid PA requirements and related burdens. Processes that reduce the administrative burden of PA through improved communication and transparency as well as standardized documentation may help ensure that PA more seamlessly achieves its goals of safe and effective use of medications. Trial Registration: NA Keywords: clinical decision making, health plan, prior authorization, provider burden, specialty types, workaroundsTrial Registration: NA

scholarly journals The United States Medical Licensing Examination Step 1 Is Changing—US Medical Curricula Should Too

10.2196/20182 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e20182
Author(s):  
Benjamin Liu
Keyword(s):  
United States ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The United States ◽  
Medical Decision ◽  
Medical Licensing ◽  
Traditional Lectures ◽  
Usmle Step 1 ◽  
Licensing Examination ◽  
Usmle Step

In recent years, US medical students have been increasingly absent from medical school classrooms. They do so to maximize their competitiveness for a good residency program, by achieving high scores on the United States Medical Licensing Examination (USMLE) Step 1. As a US medical student, I know that most of these class-skipping students are utilizing external learning resources, which are perceived to be more efficient than traditional lectures. Now that the USMLE Step 1 is adopting a pass/fail grading system, it may be tempting to expect students to return to traditional basic science lectures. Unfortunately, my experiences tell me this will not happen. Instead, US medical schools must adapt their curricula. These new curricula should focus on clinical decision making, team-based learning, and new medical decision technologies, while leveraging the validated ability of these external resources to teach the basic sciences. In doing so, faculty will not only increase student engagement but also modernize the curricula to meet new standards on effective medical learning.

Quality improvement strategies and tools: A comparative analysis between Italy and the United States

2018 ◽  
Vol 31 (4) ◽  
pp. 205-217 ◽  
Author(s):  
Stefano Villa ◽  
Joseph D Restuccia ◽  
Eugenio Anessi-Pessina ◽  
Marco Giovanni Rizzo ◽  
Alan B Cohen
Keyword(s):  
United States ◽  
Quality Improvement ◽  
Clinical Decision Making ◽  
Clinical Pathways ◽  
Clinical Decision ◽  
The United States ◽  
Quality Performance ◽  
Report Quality ◽  
Improvement Strategies ◽  
The Difference

Italian and American hospitals, in two different periods, have been urged by external circumstances to extensively redesign their quality improvement strategies. This paper, through the use of a survey administered to chief quality officers in both countries, aims to identify commonalities and differences between the two systems and to understand which approaches are effective in improving quality of care. In both countries chief quality officers report quality improvement has become a strategic priority, clinical governance approaches, and tools—such as disease-specific quality improvement projects and clinical pathways—are commonly used, and there is widespread awareness that clinical decision making must be supported by protocols and guidelines. Furthermore, the study clearly outlines the critical importance of adopting a system-wide approach to quality improvement. To this extent Italy seems lagging behind compared to US in fact: (i) responsibilities for different dimensions of quality are spread across different organizational units; (ii) quality improvement strategies do not typically involve administrative staff; and (iii) quality performance measures are not disseminated widely within the organization but are reported primarily to top management. On the other hand, in Italy chief quality officers perceive that the typical hospital organizational structure, which is based on clinical directories, allows better coordination between clinical specialties than in the United States. In both countries, the results of the study show that it is not the single methodology/model that makes the difference but how the different quality improvement strategies and tools interact to each other and how they are coherently embedded with the overall organizational strategy.

Anal Canal Cancer Clinical Practice Guidelines in Oncology

2005 ◽  
Vol 3 (4) ◽  
pp. 510 ◽  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Anal Canal ◽  
Practice Guidelines ◽  
Digestive System ◽  
The United States ◽  
Anal Canal Cancer ◽  
Nccn Guidelines ◽  
Recent Version

An estimated 3,990 new cases of anal cancer will occur in 2005, accounting for approximately 1.6% of digestive system cancers in the United States. Prognosis directly depends on the size of the primary tumor and the likelihood of lymphatic spread, with tumors 2 cm or smaller cured in 80% of cases. The NCCN guidelines recommend a thorough evaluation for any patient with a suspicious lesion in the anal canal and include additional recommendations for diagnosis, treatment, and follow up for anal canal cancer. For the most recent version of the guidelines, please visit NCCN.org

Breast Cancer Clinical Practice Guidelines in Oncology

2005 ◽  
Vol 3 (3) ◽  
pp. 238 ◽  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Lung Cancer ◽  
Breast Cancer Mortality ◽  
The United States ◽  
Cancer Death ◽  
Cancer Society ◽  
The Past ◽  
Recent Version ◽  
Common Malignancy

The American Cancer Society estimates that approximately 217,440 new cases of breast cancer will have been diagnosed in the United States in the year 2004 and approximately 40,580 patients will die of this disease. Breast cancer is the most common malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. The incidence of breast cancer has increased steadily in the United States over the past few decades, but breast cancer mortality appears to be declining. This suggests a benefit from early detection and more effective treatment. For the most recent version of the guidelines, please visit NCCN.org

scholarly journals The United States Medical Licensing Examination Step 1 Is Changing—US Medical Curricula Should Too (Preprint)

2020 ◽  
Author(s):  
Benjamin Liu
Keyword(s):  
United States ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The United States ◽  
Medical Decision ◽  
Medical Licensing ◽  
Traditional Lectures ◽  
Usmle Step 1 ◽  
Licensing Examination ◽  
Usmle Step

UNSTRUCTURED In recent years, US medical students have been increasingly absent from medical school classrooms. They do so to maximize their competitiveness for a good residency program, by achieving high scores on the United States Medical Licensing Examination (USMLE) Step 1. As a US medical student, I know that most of these class-skipping students are utilizing external learning resources, which are perceived to be more efficient than traditional lectures. Now that the USMLE Step 1 is adopting a pass/fail grading system, it may be tempting to expect students to return to traditional basic science lectures. Unfortunately, my experiences tell me this will not happen. Instead, US medical schools must adapt their curricula. These new curricula should focus on clinical decision making, team-based learning, and new medical decision technologies, while leveraging the validated ability of these external resources to teach the basic sciences. In doing so, faculty will not only increase student engagement but also modernize the curricula to meet new standards on effective medical learning.

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