Understanding the multilevel determinants of clinicians’ imaging decision-making: setting the stage for de-implementation of low-value imaging

Soohyun Hwang, Sarah A. Birken, Matthew E. Nielsen, Jennifer Elston-Lafata, Stephanie B. Wheeler & Lisa P. Spees
Abstract Background De-implementation requires understanding and targeting multilevel determinants of low-value care. The objective of this study was to identify multilevel determinants of imaging for prostate cancer (PCa) and asymptomatic microhematuria (AMH), two common urologic conditions that have contributed substantially to the annual spending on unnecessary imaging in the US. Methods We used a convergent mixed-methods approach involving survey and interview data. Using a survey, we asked 33 clinicians (55% response-rate) to indicate their imaging...
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