Radiologists have been improving their protocols for medical imaging appropriateness, reworking the manner in which they order exams for patients. The Choosing Wisely campaign, established by the American Board of Internal Medicine, has been integral to the process and continues to prove its worth.
According to AuntMinnie.com, Choosing Wisely has led to an increase in the use of short-course radiation therapy protocols for breast cancer. The improvement stems from recommendations offered by the American Society for Radiation Oncology, which felt that shorter regimens would be more effective in breast cancer treatments. Researchers from the organization found that the use of hypofractionated whole-breast irradiation methods increased from 10 percent to 21 percent in the quarter following ASTRO's recommendation in September 2013.
These results indicate that a campaign like Choosing Wisely could be an effective method for influencing physician behavior and improving care.
ASTRO originally offered five suggestions for Choosing Wisely, including one to limit the use of whole breast radiotherapy in women over the age of 50 with early stage cancer by having doctors consider shorter treatment schedules as an alternative. FierceMedicalImaging explained that following its annual meeting in San Francisco, California, ASTRO released a second list of radiation oncology-specific recommendations for the Choosing Wisely campaign, including:
- Don't suggest radiation treatments following hysterectomies for endometrial cancer patients.
- Avoid non-curative radiation therapy without first defining goals of treatment with patients.
- Forgo recommending annual follow-up mammograms for women who have had radiotherapy following breast-conserving therapy.
- Don't offer radiation to patients who have resected non-small cell lung cancer.
- Don't add adjuvant whole brain radiation to stereotactic radiosurgery for limited brain metastases.
The full list of recommendations with accompanying descriptions is reviewable on ASTRO's website.
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Ronny Bachrach
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