Practice-Based Research—“Blue Highways” on the NIH Roadmap

Westfall, John M.; Mold, James W.; Fagnan, Lyle J.

doi:10.1001/jama.297.4.403

Cited by 1,048 publications

(867 citation statements)

References 16 publications

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“…48 This potential policy lever has several limitations, including its reliance on imperfect methods for identifying ''excellent'' providers, 48 its indifference to patient preferences for where they receive care, 52 its potential to yield delays in care as a result of saturation of designated providers, 53 its failure to address the obstacles encountered by surgeons endeavoring to adopt beneficial innovations, 40,51 and its assumption that variations in convalescence and morbidity (as opposed to mortality) sufficiently motivate a policy-based intervention. Ultimately, the development of specific interventions to increase the use of partial nephrectomy and laparoscopy will be informed by future studies that further characterize surgeon-level (eg, attitudes, practice structure and setting) and hospital-level (eg, technology, ancillary staff) determinants of adoption as well as patient preferences.…”

Section: Discussionmentioning

confidence: 99%

Diffusion of surgical innovation among patients with kidney cancer

Miller

Saigal

Banerjee

et al. 2008

Cancer

107

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BACKGROUNDDespite their potential benefits to patients with kidney cancer, the adoption of partial nephrectomy and laparoscopy has been gradual and asymmetric. To clarify whether this trend reflects differences in kidney cancer patients or differences in surgeon practice styles, the authors compared the magnitude of surgeon‐attributable variance in the use of partial nephrectomy and laparoscopic radical nephrectomy with that attributable to patient and tumor characteristics.METHODSBy using linked Surveillance, Epidemiology, and End Results‐Medicare data, the authors identified a cohort of 5483 Medicare beneficiaries who underwent surgery for kidney cancer between 1997 and 2002. Two primary outcomes were defined: 1) the use of partial nephrectomy and (2) the use of laparoscopy among patients undergoing radical nephrectomy. By using multilevel models, surgeon‐ and patient‐level contributions to observed variations in the use of partial nephrectomy and laparoscopic radical nephrectomy were estimated.RESULTSOf the 5483 cases identified, 611 (11.1%) underwent partial nephrectomy (43 performed laparoscopically), and 4872 (88.9%) underwent radical nephrectomy (515 performed laparoscopically). After adjusting for patient demographics, comorbidity, tumor size, and surgeon volume, the surgeon‐attributable variance was 18.1% for partial nephrectomy and 37.4% for laparoscopy. For both outcomes, the percentage of total variance attributable to surgeon factors was consistently higher than that attributable to patient characteristics.CONCLUSIONSFor many patients with kidney cancer, the surgery provided depends more on their surgeon's practice style than on the characteristics of the patient and his or her disease. Consequently, dismantling barriers to surgeon adoption of partial nephrectomy and laparoscopy is an important step toward improving the quality of care for patients with early‐stage kidney cancer. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Diffusion of surgical innovation among patients with kidney cancer

Miller

Saigal

Banerjee

et al. 2008

Cancer

107

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“…are required in order to resolve this issue. E.g., some universities around the world have established programs for training researchers, who would be familiar with specific peculiarities of both fundamental and clinical research and be able to put a link between them; a special program of the National Institutes of Health (NIH) sponsoring training of such specialists has been in effect in the United States of America since 1964 [16]. NIH provide grants (Clinical and Translational Science Awards) for organization of clinical and translational studies [12].…”

Section: Resultsmentioning

confidence: 99%

“…This stage may involve evaluation of medical technologies and pharmacoeconomic analysis. On the other hand, Westfall et al consider correction of clinical practice as the endpoint of translation; they see translation as a continuum, which may be continuously interrupted by validation of the data obtained at the previous stages [16]. Translational research impact on different outcomes.…”

Section: Resultsmentioning

confidence: 99%

Modern Approaches to the Organization of Translational Research

Колбин¹,

Гапешин²,

Малышев³

2014

Pediatr. farmakol.

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“…The new information environment will be perceived as unappealing, unfriendly, or even hostile if it fails to take into account basic human characteristics such as cognitive capacity, cultural backgrounds, attitudinal dispositions, linguistic capabilities, motivations, or affective states. Conversely, a health information environment that systematically supports positive health behaviors can save lives by optimizing the reach, effectiveness, and efficiency of current best practice [11,38,39].…”

Section: Integral Members Of the Design Teammentioning

confidence: 99%

Guest editors’ introduction to the special section on information technology and evidence implementation

Abernethy

Hesse

2011

Behav. Med. Pract. Policy Res.

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Healthcare is experiencing a transformation-perhaps as significant as the publication of the first randomized controlled trial-in the ways in which basic discovery is translated into effective practice. The change is being precipitated by efforts to undergird the healthcare industry with the same transformational capacities from information technology as is afforded to other sectors in the economy. Although the transformation has been slow in materializing, change is expected to accelerate under the stimulating influence of the Health Information Technology for Economic and Clinical Health Act of 2009 and the Patient Protection and Affordable Care Act of 2010. As the changes ripple throughout the healthcare sector, two aspects of medical care in the twenty-first century are expected to rise in importance: data and behavior. Each of the articles within this inaugural issue of Translational Behavioral Medicine has been selected to illustrate treatment of these two assets in one way or another. The editors hope this first issue will serve as a vanguard illustration for how behavioral scientists can be included as integral members of the design team in creating a new platform for evidence implementation in the USA and abroad.

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Practice-Based Research—“Blue Highways” on the NIH Roadmap

Cited by 1,048 publications

References 16 publications

Diffusion of surgical innovation among patients with kidney cancer

Diffusion of surgical innovation among patients with kidney cancer

Modern Approaches to the Organization of Translational Research

Guest editors’ introduction to the special section on information technology and evidence implementation

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