Care Appropriateness

Amid calls for improving value in medicine, there has been increasing attention to the appropriateness of delivered care. Issues of care appropriateness include efforts to ensure optimal delivery of proven effective care and avoiding inappropriate care or overuse, defined as care for which potential harms exceed potential benefits. Specific areas of interest include conflicts of interest, guideline integrity, drivers of overuse, and quantifying harms of overuse.

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Guideline Integrity

Merkow RP, Korenstein D, Yeahia R, Bach PB, Baxi SS. Quality of Cancer Surveillance Clinical Practice Guidelines: Specificity and Consistency of Recommendations. JAMA Intern Med. 2017; 177(5):701-9. doi: 10.1001/jamainternmed.2017.0079. 

Conflicts of Interest

Linker A, Yang A, Roper N, Evans W, Korenstein D. Impact of industry collaboration on randomized controlled trials in oncology. European J Cancer. 2017; 72: 71-7. doi: 10.1016/j.ejca.2016.11.005. 

Ahn R*, Woodbridge A*, Abraham A*, Saba S*, Korenstein D, Madden E, Keyhani S. Financial ties among principal investigators and randomized controlled trial outcomes: a cross sectional study. BMJ. 2017; 356:i6770. doi: 10.1136/bmj.i6770.*co-first authors

Overuse

Lipitz-Snyderman A and Korenstein D. Reducing overuse- is patient safety the answer? JAMA. 2017; 317(8):810-11. doi: 10.1001/jama.2017.0896. 

Baxi SS, Kale M, Keyhani S, Roman BR, Yang A, DeRosa AP, Korenstein D. Overuse of Health Care Services in the Management of Cancer: A Systematic Review. Med Care. 2017 May 11. doi: 10.1097/MLR.0000000000000734. doi: 10.1097/MLR.0000000000000734. 

Brownlee S, Chalkidou K, Doust J, Elshaug AG, Glasziou, Heath I, Nagpal S, Saini V, Chalmers K, Korenstein D. Evidence for Overuse of Medical Services Around the World. Lancet. 2017 Jan 6. doi 10.1016/S0140-6736(16)32585-5. doi: 10.1016/S0140-6736(16)32585-5. 

Roman BR, Yang A, Masciale J, Korenstein D. Attitudes regarding overuse of inpatient laboratory testing vary according to provider type. JAMA Intern Med 2017 Aug 1; 177(8): 1205-7. doi: 10.1001/jamainternmed.2017.1634. 

Lipitz-Snyderman, Bach PB. Overuse of health care services: when less is more…more or less. JAMA Intern Med 2013 July 22; 173(14): 1277-8. doi: 10.1001/jamainternmed.2013.6181. 

Morgan DJ, Dhruva SS, Coon ER, Wright SM, Korenstein D. 2017 Update on Medical Overuse: A Systematic Review. JAMA Intern Med 2017 Oct 2. doi 10.1001/jamainternmed.2017.4361. [Epub ahead of print]