A Statewide Intervention Improves Appropriate Imaging in Localized Prostate Cancer

No AccessJournal of UrologyAdult Urology1 May 2017A Statewide Intervention Improves Appropriate Imaging in Localized Prostate Cancer Patrick Hurley, Apoorv Dhir, Yuqing Gao, Brian Drabik, Kenneth Lim, Jon Curry, Paul R. Womble, Susan M. Linsell, Andrew Brachulis, Donald W. Sexton, Khurshid R. Ghani, Brian T. Denton, David C. Miller, James E. Montie, and Michigan Urological Surgery Improvement Collaborative Patrick HurleyPatrick Hurley , Apoorv DhirApoorv Dhir , Yuqing GaoYuqing Gao , Brian DrabikBrian Drabik , Kenneth LimKenneth Lim , Jon CurryJon Curry , Paul R. WomblePaul R. Womble , Susan M. LinsellSusan M. Linsell , Andrew BrachulisAndrew Brachulis , Donald W. SextonDonald W. Sexton , Khurshid R. GhaniKhurshid R. Ghani , Brian T. DentonBrian T. Denton , David C. MillerDavid C. Miller , James E. MontieJames E. Montie , and Michigan Urological Surgery Improvement Collaborative View All Author Informationhttps://doi.org/10.1016/j.juro.2016.11.098AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We implemented a statewide intervention to improve imaging utilization for the staging of patients with newly diagnosed prostate cancer. Materials and Methods: MUSIC (Michigan Urological Surgery Improvement Collaborative) is a quality improvement collaborative comprising 42 diverse practices representing approximately 85% of the urologists in Michigan. MUSIC has developed imaging appropriateness criteria (prostate specific antigen greater than 20 ng/ml, Gleason score 7 or higher and clinical stage T3 or higher) which minimize unnecessary imaging with bone scan and computerized tomography. After baseline rates of radiographic staging were established in 2012 and 2013, we used multidimensional interventions to deploy these criteria in 2014. Imaging utilization was then remeasured in 2015 to evaluate for changes in practice patterns. Results: A total of 10,554 newly diagnosed patients with prostate cancer were entered into the MUSIC registry from January 1, 2012 through December 31, 2013 and January 1, 2015 through December 31, 2015. Of these patients 7,442 (79%) and 7,312 (78%) met our criteria to avoid bone scan and computerized tomography imaging, respectively. The use of bone scan imaging when not indicated decreased from 11.0% at baseline to 6.5% after interventions (p <0.0001). The use of computerized tomography when not indicated decreased from 14.7% at baseline to 7.7% after interventions (p <0.0001). Variability among practices decreased substantially after the interventions as well. The use of recommended imaging remained stable during these periods. 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Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLoloi J, Eccles J, Owens G, Lehman E, Kaag M, Raman J and Merrill S (2021) Diagnostic Imaging in Low-Risk Prostate Cancer: More Harm Than Good?Urology Practice, VOL. 9, NO. 2, (134-139), Online publication date: 1-Mar-2022.Noyes S, Kim T, Johnson A, Linsell S, Qi J, Moldovan T, Patel A, Ghani K, Montie J, Rogers C and Lane B (2020) Quality of Care for Renal Masses: The Michigan Urological Surgery Improvement Collaborative—Kidney Mass: Identifying & Defining Necessary Evaluation & Therapy (MUSIC-KIDNEY)Urology Practice, VOL. 7, NO. 6, (507-514), Online publication date: 1-Nov-2020.Xu L, Mao X, Grey A, Scandura G, Guo T, Burke E, Marzec J, Abdu S, Stankiewicz E, Davies C, Rajan P, Tipples K, Hines J, Chan P, Campbell D, Wilkinson K, Kudahetti S, Shamash J, Oliver T, Berney D, Shaw G and Lu Y (2019) Noninvasive Detection of Clinically Significant Prostate Cancer Using Circulating Tumor CellsJournal of Urology, VOL. 203, NO. 1, (73-82), Online publication date: 1-Jan-2020.Nielsen M, Averch T, Chi T, Fredricks N, Shiu-Kai Fung G, Montie J, Purysko A, Remer E, Smith-Bindman R, Sternberg K, Venkatesh A, Wolf J, Ziemba J and Moore C (2019) American Urological Association, American College of Emergency Physicians and American College of Radiology Quality Improvement Summit 2017: Challenges and Opportunities for Stewardship of Urological ImagingUrology Practice, VOL. 6, NO. 5, (300-308), Online publication date: 1-Sep-2019.Smith J (2017) This Month in Adult UrologyJournal of Urology, VOL. 197, NO. 5, (1181-1182), Online publication date: 1-May-2017. Volume 197Issue 5May 2017Page: 1222-1228 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsbone neoplasmsneoplasm metastasisdiagnostic imagingquality improvementMetricsAuthor Information Patrick Hurley More articles by this author Apoorv Dhir More articles by this author Yuqing Gao More articles by this author Brian Drabik More articles by this author Kenneth Lim More articles by this author Jon Curry More articles by this author Paul R. Womble More articles by this author Susan M. Linsell More articles by this author Andrew Brachulis More articles by this author Donald W. Sexton More articles by this author Khurshid R. Ghani Financial interest and/or other relationship with BCBSM. More articles by this author Brian T. Denton More articles by this author David C. Miller More articles by this author James E. Montie More articles by this author Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...