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Perceived value drives use of routine asymptomatic surveillance PET/CT by physicians who treat head and neck cancer
Author(s) -
Roman Benjamin R.,
Lohia Shivangi,
Mitra Nandita,
Wang Marilene B.,
Pou Anna M.,
Holsinger F. Christopher,
Myssiorek David,
Goldenberg David,
Asch David A.,
Shea Judy A.
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26071
Subject(s) - asymptomatic , medicine , guideline , head and neck cancer , positron emission tomography , psychological intervention , cancer , radiology , family medicine , pathology , psychiatry
Background Why physicians use surveillance imaging for asymptomatic cancer survivors despite recommendations against this is not known. Methods Physicians surveilling head and neck cancer survivors were surveyed to determine relationships among attitudes, beliefs, guideline familiarity, and self‐reported surveillance positron‐emission‐tomography/computed‐tomography use. Results Among 459 responses, 79% reported using PET/CT on some asymptomatic patients; 39% reported using PET/CT on more than half of patients. Among attitudes/beliefs, perceived value of surveillance imaging (O.R. 3.57, C.I. 2.42‐5.27, P = <.0001) was the strongest predictor of high imaging, including beliefs about outcome (improved survival) and psychological benefits (reassurance, better communication). Twenty‐four percent of physicians were unfamiliar with guideline recommendations against routine surveillance imaging. Among physicians with high perceived‐value scores, those less familiar with guidelines imaged more (O.R. 3.55, C.I. 1.08‐11.67, P = .037). Conclusions Interventions to decrease routine surveillance PET/CT use for asymptomatic patients must overcome physicians' misperceptions of its value. Education about guidelines may modify the effect of perceived value.