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Amy L Mirand - One of the best experts on this subject based on the ideXlab platform.
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Approaches to Breast Cancer Screening among nurse practitioners.
Journal of the American Academy of Nurse Practitioners, 2004Co-Authors: Silvana Lawvere, Martin C Mahoney, Jessica J Englert, Andrew B Symons, Susan B. Klein, Amy L MirandAbstract:Purpose To determine nurse practitioners’ (NPs’) knowledge and reported practices regarding Breast Cancer Screening in a climate of conflicting guidelines. Data Source A descriptive, cross-sectional survey design was used to examine approaches to Cancer Screening among NPs in western New York. Conclusions Among the 175 NP respondents, agreement with the accepted answer for the individual Breast Cancer—Screening items ranged from 51% to 80%; responses did not vary by age group or gender. Overall, 54% demonstrated agreement with three or more of four Breast Cancer—Screening items. Implications for Practice These findings suggest the need to implement educational interventions as one means of decreasing variation in Breast Cancer Screening among NPs. Also, the development and endorsement of a single set of evidence-based Breast Cancer—Screening guidelines would promote adoption of a single Screening recommendation.
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Breast Cancer Screening beliefs by practice location
BMC Public Health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice. Methods A cross-sectional survey design was used to examine approaches to Breast Cancer Screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about Breast Cancer Screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location. Results Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four Breast Cancer Screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written Breast Cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas. Conclusion Development of an evidence-based consensus statement regarding Breast Cancer Screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how Breast Cancer Screening is approached across varied clinical settings.
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Breast Cancer Screening beliefs by practice location.
BMC public health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice.
Robert A. Smith - One of the best experts on this subject based on the ideXlab platform.
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Informed Decision-Making and Breast Cancer Screening
Journal of medical screening, 2015Co-Authors: Peter Sasieni, Robert A. Smith, Stephen W. DuffyAbstract:In a recent Lancet publication, Hersch et al reported findings on the influence of alternative-content decision aids on knowledge, attitudes, and intentions related to Breast Cancer Screening.1 The alternative decision aid booklets were provided to 879 women aged 48–50 in New South Wales, Australia who were approaching the target age to begin Breast Cancer Screening. Briefly, the authors randomized 440 women to an intervention group which received a Breast Screening information booklet that included quantitative information on overdiagnosis, and 439 to a control group that received the same information booklet without reference to overdiagnosis. The authors then administered a questionnaire to all randomized women, on knowledge, attitudes, and intentions relating to Breast Cancer Screening. Based on a woman’s answers, the researchers classified each woman on whether she had made an informed choice about Breast Cancer Screening (defined as adequate knowledge and intentions consistent with attitudes). The authors concluded that women in the intervention group were more likely to make an informed choice, due to their greater knowledge about overdiagnosis. In addition, fewer women in the intervention group than in the control group intended to be screened (74% v 87%; p
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Counterpoint: Overdiagnosis in Breast Cancer Screening.
Journal of the American College of Radiology : JACR, 2014Co-Authors: Robert A. SmithAbstract:INTRODUCTION In the ongoing debate over the balance of benefits and harms associated with Breast Cancer Screening, overdiagnosis has become the dommage du jour. Dr Berlin [1] is right to be concerned about overdiagnosis. There can be no argument that treatment of a nonprogressive, mammographically detected lesion is the greatest possible harm associated with Breast Cancer Screening, and to the extent that overdiagnosis exists, women need to be informed of that possibility. However, the magnitude of overdiagnosis in Breast Cancer Screening is uncertain, with a wide range of estimates (0% to >50%) deriving from a wide range of study methodologies [2]. Estimating the magnitude of overdiagnosis in Breast Cancer Screening is exceedingly complex, although we can say with confidence that the most credible estimates are considerably smaller than thoseBerlin cites. Thus, he overpromises when he asserts that his commentary on overdiagnosis is “the truth vs. whole truth, vs. nothing but the truth.”
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Breast Cancer Screening: the evolving evidence
Oncology (Williston Park N.Y.), 2012Co-Authors: Robert A. Smith, Stephen W. Duffy, László TabárAbstract:Breast Cancer is a leading cause of Cancer and death from Cancer among women in the developed and developing world. Detecting and treating Breast Cancer earlier in its natural history improve prognosis and result in a reduction in Breast Cancer mortality. There have been eight population-based randomized controlled trials (RCTs) of mammography Screening, which individually and collectively provide strong support for the efficacy of Breast Cancer Screening. The evaluation of modern service Screening also has shown that modern Breast Cancer Screening is contributing to reductions in Breast Cancer mortality at a rate as good as or better than that observed in the RCTs. In the last decade, different interpretations of the evidence from the RCTs and observational studies have resulted in different Screening guidelines and contentious academic debates over the balance of benefits and potential harms from Breast Cancer Screening. In this paper, the historic and recent evidence supporting the value of Breast Cancer Screening will be described, along with the underpinnings of the current debate over the relative and absolute benefit of regular mammography Screening.
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The ongoing evaluation of Breast Cancer Screening.
Cancer, 2004Co-Authors: Robert A. SmithAbstract:Two articles in this issue of Cancer are representative of an evolving trend in research on Breast Cancer Screening, and each raises unique issues regarding how we should view the role of Screening in the control of Breast Cancer and the importance of continuing to address questions concerning early Breast Cancer detection. The first trial of Breast Cancer Screening, the Health Insurance Plan of Greater New York (HIP) study, was launched in 1963. Seven additional trials in Europe and Canada followed and have since concluded, the most recent being the National Breast Screening Studies I and II (NBSS), which were initiated in Canada in 1980. One additional trial currently is underway, the Age Trial, which was established by the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) in 1991 to address the efficacy of initiating Breast Cancer Screening in women ages 40–41 years. An interim analysis is expected in the near future. During the 40 years since trials of Breast Cancer Screening were initiated, strong scientific evidence supporting the value of the early detection of Breast Cancer has accumulated and served as the basis for health policies supporting regular Screening. However, during this same period, there have been ongoing debates, with occasional public flare-ups, over various aspects of Breast Cancer Screening, most notably questions regarding Screening efficacy for women in their 40s, concerns about harms associated with false-positive results, and concerns regarding the detection rate of ductal Cancer in situ and the overtreatment of potentially nonprogressive lesions. Some researchers have even questioned the value of Breast Cancer Screening for any woman, despite the abundance of solid evidence and the conclusions of expert groups that Screening effectively advances the time of Breast Cancer diagnosis and reduces mortality. Although the trials have made important contributions, individually and taken together the data have been limited in varying degrees with regard to answering enduring and new questions concerning the efficacy and effectiveness of mammography. Each randomized clinical trial followed a somewhat different protocol, and the outcome in each was influenced by a number of factors that have important implications for the interpretation of study results, including study methodology, the Screening interval and number of views, participation rates in the study group (compliance), Screening rates in the control group (contamination), and the number of Screening rounds before an invitation to Screening was extended to the control group. There also were other factors that likely influenced trial results, in1327
Lisa M Santora - One of the best experts on this subject based on the ideXlab platform.
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Breast Cancer Screening beliefs by practice location
BMC Public Health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice. Methods A cross-sectional survey design was used to examine approaches to Breast Cancer Screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about Breast Cancer Screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location. Results Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four Breast Cancer Screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written Breast Cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas. Conclusion Development of an evidence-based consensus statement regarding Breast Cancer Screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how Breast Cancer Screening is approached across varied clinical settings.
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Breast Cancer Screening beliefs by practice location.
BMC public health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice.
Martin C Mahoney - One of the best experts on this subject based on the ideXlab platform.
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Approaches to Breast Cancer Screening among nurse practitioners.
Journal of the American Academy of Nurse Practitioners, 2004Co-Authors: Silvana Lawvere, Martin C Mahoney, Jessica J Englert, Andrew B Symons, Susan B. Klein, Amy L MirandAbstract:Purpose To determine nurse practitioners’ (NPs’) knowledge and reported practices regarding Breast Cancer Screening in a climate of conflicting guidelines. Data Source A descriptive, cross-sectional survey design was used to examine approaches to Cancer Screening among NPs in western New York. Conclusions Among the 175 NP respondents, agreement with the accepted answer for the individual Breast Cancer—Screening items ranged from 51% to 80%; responses did not vary by age group or gender. Overall, 54% demonstrated agreement with three or more of four Breast Cancer—Screening items. Implications for Practice These findings suggest the need to implement educational interventions as one means of decreasing variation in Breast Cancer Screening among NPs. Also, the development and endorsement of a single set of evidence-based Breast Cancer—Screening guidelines would promote adoption of a single Screening recommendation.
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Breast Cancer Screening beliefs by practice location
BMC Public Health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice. Methods A cross-sectional survey design was used to examine approaches to Breast Cancer Screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about Breast Cancer Screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location. Results Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four Breast Cancer Screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written Breast Cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas. Conclusion Development of an evidence-based consensus statement regarding Breast Cancer Screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how Breast Cancer Screening is approached across varied clinical settings.
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Breast Cancer Screening beliefs by practice location.
BMC public health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice.
Jessica J Englert - One of the best experts on this subject based on the ideXlab platform.
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Approaches to Breast Cancer Screening among nurse practitioners.
Journal of the American Academy of Nurse Practitioners, 2004Co-Authors: Silvana Lawvere, Martin C Mahoney, Jessica J Englert, Andrew B Symons, Susan B. Klein, Amy L MirandAbstract:Purpose To determine nurse practitioners’ (NPs’) knowledge and reported practices regarding Breast Cancer Screening in a climate of conflicting guidelines. Data Source A descriptive, cross-sectional survey design was used to examine approaches to Cancer Screening among NPs in western New York. Conclusions Among the 175 NP respondents, agreement with the accepted answer for the individual Breast Cancer—Screening items ranged from 51% to 80%; responses did not vary by age group or gender. Overall, 54% demonstrated agreement with three or more of four Breast Cancer—Screening items. Implications for Practice These findings suggest the need to implement educational interventions as one means of decreasing variation in Breast Cancer Screening among NPs. Also, the development and endorsement of a single set of evidence-based Breast Cancer—Screening guidelines would promote adoption of a single Screening recommendation.
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Breast Cancer Screening beliefs by practice location
BMC Public Health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice. Methods A cross-sectional survey design was used to examine approaches to Breast Cancer Screening among physicians, nurse practitioners, and physician assistants involved in primary care practice. A summary index of beliefs about Breast Cancer Screening was created by summing the total number of responses in agreement with each of four survey items; values for this summary variable ranged between zero and four. Respondents were classified into urban, rural and suburban categories based upon practise location. Results Among the 428 respondents, agreement with "correct" responses ranged from 50% to 71% for the individual survey items; overall, half agreed with three or more of the four Breast Cancer Screening items. While no significant differences were noted by practice location, variation in responses were evident. Reported use of written Breast Cancer guidelines was less in both suburban (OR = 0.51) and urban areas (OR = 0.56) when compared to clinicians in rural areas. Conclusion Development of an evidence-based consensus statement regarding Breast Cancer Screening would support a single set of unambiguous guidelines for implementation in all primary care settings, thus decreasing variations in how Breast Cancer Screening is approached across varied clinical settings.
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Breast Cancer Screening beliefs by practice location.
BMC public health, 2003Co-Authors: Lisa M Santora, Martin C Mahoney, Silvana Lawvere, Jessica J Englert, Andrew B Symons, Amy L MirandAbstract:Background This study examines variations in Breast Cancer Screening among primary care clinicians by geographic location of clinical practice.