PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Information patients use to pick physicians not always good predictor of quality, study finds

2010-09-13
(Press-News.org) When looking for a new physician, patients are often encouraged to select those who are board certified or who have not made payments on malpractice claims. Yet these characteristics are not always a good predictor of which physicians will provide the highest quality medical care, according to a new study from the RAND Corporation, a nonprofit research organization, and the University of Pittsburgh School of Medicine.

"We found that the types of information widely available to patients for choosing a physician do not predict whether that physician will deliver evidence-based care," said Rachel Reid, the study's lead author and a medical student at the University of Pittsburgh School of Medicine. "These findings underscore the need for better physician performance data to help consumers choose their doctor."

Studying a large group of physicians over a two-year period, researchers found that three characteristics were associated with better quality medical care: being female, being board certified and graduating from a domestic medical school.

But each of these characteristics increased quality only a small amount and none offers consumers much guidance when it comes to choosing a high-quality medical provider, according to findings appearing in the Sept. 13 edition of the Archives of Internal Medicine.

Because detailed information about physician performance is seldom available to the general public, patients are encouraged to select physicians based on characteristics such as board certification, educational history and whether they have made payments on malpractice claims.

To test this advice, researchers examined the care provided by about 10,000 Massachusetts physicians to more than 1.3 million adults during 2004 and 2005. Using information from insurance claims, researchers evaluated the quality of care the physicians provided for 22 common medical problems such as diabetes and heart disease, by examining the fraction of the time physicians delivered guideline-based care to their patients.

Researchers found that the physicians studied provided on average about 63 percent of the recommended care. Average performance varied by condition, ranging from 31 percent for cataract care to 68 percent for care of congestive heart failure.

The difference in quality between the physicians with the best combination of characteristics (female, board-certified and domestically trained) and the average physician with the worst combination (male, noncertified and internationally trained) was only 6 percentage points, according to the study. But even among physicians with the best combination of characteristics, quality was uneven, ranging from 49 to 75 percent of recommended care.

"Few characteristics were consistently associated with high quality care and those we did find were so small in magnitude that they are not significant in a practical sense," said study co-author Ateev Mehrotra, an assistant professor at the University of Pittsburgh School of Medicine and a researcher at RAND. "There is little evidence to suggest that a patient would consistently receive higher quality care by switching to a physician with the combination of characteristics identified by our work to be associated with high-quality care."

Board certification was the characteristic associated with the largest increase in performance (3.3 percentage points) and also was associated with higher performance scores with both acute and preventive care. The finding provides preliminary evidence that there may be some quality benefit to be derived from maintenance of certification programs or the inclusion of board-certification activities as a requirement for maintaining a physician's medical license.

Researchers say it is striking that the study found no consistent association between the number of malpractice payments or disciplinary actions against physicians and the quality of care they provide. Researchers also did not find any association between physicians' years of experience and quality.

Researchers say that public reporting of individual physician quality information may provide consumers with more valuable guidance when they need to choose a new physician.

INFORMATION: Support for the study was provided by the Commonwealth Foundation and U.S. Department of Labor. Other authors of the study are Dr. Mark W. Friedberg, John. L Adams and Elizabeth A. McGlynn of RAND.

RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and health services delivery, among other topics.

The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. To sign up for RAND e-mail alerts: http://www.rand.org/publications/email.html


ELSE PRESS RELEASES FROM THIS DATE:

Wildflower 'armors' itself against disease

2010-09-13
An unusual wildflower that accumulates metals in its leaves has been found to use them as a kind of 'armor' against bacterial infection. Scientists from Oxford University have shown that when Alpine pennycress (Thlaspi caerulescens) plants accumulate metals in their leaves, they become resistant to attack by the bacterium Pseudomonas syringae pv. maculicola. They report their findings September 9 in the open-access journal PLoS Pathogens. Thlaspi, a small plant in the mustard family that grows on metal-rich soils scattered around Britain and Europe, such as the sites ...

New artificial skin could make prosthetic limbs and robots more sensitive

New artificial skin could make prosthetic limbs and robots more sensitive
2010-09-13
VIDEO: Artificial skin for people and robots could be a reality using the ultra-sensitive sensors developed by Zhenan Bao, associate professor of chemical engineering at Stanford University, and her team. The... Click here for more information. The light, tickling tread of a pesky fly landing on your face may strike most of us as one of the most aggravating of life's small annoyances. But for scientists working to develop pressure sensors for artificial skin for use on ...

Would a molecular horse trot, pace or glide across a surface?

Would a molecular horse trot, pace or glide across a surface?
2010-09-13
RIVERSIDE, Calif. – Molecular machines can be found everywhere in nature, for example, transporting proteins through cells and aiding metabolism. To develop artificial molecular machines, scientists need to understand the rules that govern mechanics at the molecular or nanometer scale (a nanometer is a billionth of a meter). To address this challenge, a research team at the University of California, Riverside studied a class of molecular machines that 'walk' across a flat metal surface. They considered both bipedal machines that walk on two 'legs' and quadrupedal ones ...

New pathway identified in Parkinson's through brain imaging

2010-09-13
(NEW YORK, NY, September 13, 2010) – A new study led by researchers at Columbia University Medical Center has identified a novel molecular pathway underlying Parkinson's disease and points to existing drugs which may be able to slow progression of the disease. The pathway involved proteins – known as polyamines – that were found to be responsible for the increase in build-up of other toxic proteins in neurons, which causes the neurons to malfunction and, eventually, die. Though high levels of polyamines have been found previously in patients with Parkinson's, the new ...

Wives as the new breadwinners

2010-09-13
Durham, NH—September 13, 2010— During the recent recession in the United States, many industries suffered significant layoffs, leaving individuals and families to revise their spending and rethink income opportunities. Many wives are increasingly becoming primary breadwinners or entering the labor market. A new article in Family Relations tests "the added worker" theory, which suggests wives who are not working may seek work as a substitute for husband's labor if he becomes unemployed, and finds that during a time of economic downturn wives are more likely to enter the ...

Making cookies that are good for your heart

Making cookies that are good for your heart
2010-09-13
VIDEO: Years of research has proven that saturated and trans fats clog arteries, make it tough for the heart to pump and are not valuable components of any diet. Unfortunately, they... Click here for more information. COLUMBIA, Mo. ¬— Years of research has proven that saturated and trans fats clog arteries, make it tough for the heart to pump and are not valuable components of any diet. Unfortunately, they are contained in many foods. Now, a University of Missouri research ...

Obama administration responds to call to action from Concordia researchers

2010-09-13
Montreal / September 13, 2010 – September 21, 2010 marks the one year anniversary of the release of a landmark document produced by researchers at Concordia University. Mobilizing The Will to Intervene (W2I) offers governments practical steps to prevent future genocides and mass atrocities. Produced by researchers with the Montreal Institute for Genocide and Human Rights Studies (MIGS) based at Concordia, the document was presented to the governments of Canada and The United States of America. It has already yielded concrete results. Under President Barack Obama's leadership, ...

Latent HIV infection focus of NIDA's 2010 Avant-Garde Award

2010-09-13
The National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, announced today that Dr. Eric M. Verdin of the J. David Gladstone Institutes in San Francisco, Calif., has been selected as the 2010 recipient of the NIDA Avant-Garde Award for HIV/AIDS Research for his proposal to study the mechanisms of latent HIV infection. NIDA's annual Avant-Garde award competition, now in its third year, is intended to stimulate high-impact research that may lead to groundbreaking opportunities for the prevention and treatment of HIV/AIDS in drug abusers. Awardees ...

New study reconciles conflicting data on mental aging

2010-09-13
WASHINGTON — A new look at tests of mental aging reveals a good news-bad news situation. The bad news is all mental abilities appear to decline with age, to varying degrees. The good news is the drops are not as steep as some research showed, according to a study published by the American Psychological Association. "There is now convincing evidence that even vocabulary knowledge and what's called crystallized intelligence decline at older ages," said study author Timothy Salthouse, PhD. Longitudinal test scores look good in part because repeat test-takers grow familiar ...

Scientists glimpse dance of skeletons inside neurons

2010-09-13
Scientists at Emory University School of Medicine have uncovered how a structural component inside neurons performs two coordinated dance moves when the connections between neurons are strengthened. The results are published online in the journal Nature Neuroscience, and will appear in a future print issue. In experiments with neurons in culture, the researchers can distinguish two separate steps during long-term potentiation, an enhancement of communication between neurons thought to lie behind learning and memory. Both steps involve the remodeling of the internal ...

LAST 30 PRESS RELEASES:

Reality check: making indoor smartphone-based augmented reality work

Overthinking what you said? It’s your ‘lizard brain’ talking to newer, advanced parts of your brain

Black men — including transit workers — are targets for aggression on public transportation, study shows

Troubling spike in severe pregnancy-related complications for all ages in Illinois

Alcohol use identified by UTHealth Houston researchers as most common predictor of escalated cannabis vaping among youths in Texas

Need a landing pad for helicopter parenting? Frame tasks as learning

New MUSC Hollings Cancer Center research shows how Golgi stress affects T-cells' tumor-fighting ability

#16to365: New resources for year-round activism to end gender-based violence and strengthen bodily autonomy for all

Earliest fish-trapping facility in Central America discovered in Maya lowlands

São Paulo to host School on Disordered Systems

New insights into sleep uncover key mechanisms related to cognitive function

USC announces strategic collaboration with Autobahn Labs to accelerate drug discovery

Detroit health professionals urge the community to act and address the dangers of antimicrobial resistance

3D-printing advance mitigates three defects simultaneously for failure-free metal parts 

Ancient hot water on Mars points to habitable past: Curtin study

In Patagonia, more snow could protect glaciers from melt — but only if we curb greenhouse gas emissions soon

Simplicity is key to understanding and achieving goals

Caste differentiation in ants

Nutrition that aligns with guidelines during pregnancy may be associated with better infant growth outcomes, NIH study finds

New technology points to unexpected uses for snoRNA

Racial and ethnic variation in survival in early-onset colorectal cancer

Disparities by race and urbanicity in online health care facility reviews

Exploring factors affecting workers' acquisition of exercise habits using machine learning approaches

Nano-patterned copper oxide sensor for ultra-low hydrogen detection

Maintaining bridge safer; Digital sensing-based monitoring system

A novel approach for the composition design of high-entropy fluorite oxides with low thermal conductivity

A groundbreaking new approach to treating chronic abdominal pain

ECOG-ACRIN appoints seven researchers to scientific committee leadership positions

New model of neuronal circuit provides insight on eye movement

Cooking up a breakthrough: Penn engineers refine lipid nanoparticles for better mRNA therapies

[Press-News.org] Information patients use to pick physicians not always good predictor of quality, study finds