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Open AccessArticle

Low-Value Clinical Practices: Knowledge and Beliefs of Spanish Surgeons and Anesthetists

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CIBER Epidemiología y Salud Pública (CIBERESP), Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
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Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
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Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Ramón y Cajal, Departamento de Medicina y Especialidades Médicas, Facultad de Medicina, Universidad de Alcalá, IRYCIS, 28034 Madrid, Spain
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Miguel Hernández University of Elche, 03202 Elche, Spain
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Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46020 Valencia, Spain
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Alicante-Sant Joan Health District, Ministry of Health, 03550 Alicante, Spain
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REDISSEC, Health Services Network Oriented to Chronic Diseases, Spain
*
Author to whom correspondence should be addressed.
Members are listed at the Acknowledgments.
Int. J. Environ. Res. Public Health 2020, 17(10), 3556; https://doi.org/10.3390/ijerph17103556
Received: 16 April 2020 / Revised: 13 May 2020 / Accepted: 15 May 2020 / Published: 19 May 2020
(This article belongs to the Special Issue Medical and Health Professions Education: Are We Stepping Forward?)
OBJECTIVES: To know the frequency and causes of low value surgical practices, according to the opinion of surgeons and anesthetists, and to determine their degree of knowledge about the Spanish “Choosing wisely” initiative. METHODS: Cross-sectional observational study, based on a self-administered online questionnaire through an opportunistic sample of 370 surgeons and anesthetists from three Spanish regions, contacted through Scientific Societies. The survey took part between July and December 2017. RESULTS: A patient profile requesting unnecessary practices was identified (female, 51−65 years old and unaffiliated disease). The frequency of requests was weekly or daily for 50.0% of the professionals, of whom 15.1% acknowledged succumbing to these pressures. To dissuade the patient, clinical reasons (47%) were considered the most effective. To increase control and safety in the case was the main reason to indicate them. The greatest responsibility for overuse was attributed to physicians, defensive medicine and mass media. Assessing professionals’ knowledge on unnecessary practices, an average of 5 correct answers out of 7 was obtained. Some 64.1% of the respondents were unaware of the Spanish “Choosing wisely” initiative. CONCLUSIONS: Low value surgical practices are perceived as a frequent problem, which requires an approach entailing intervention with patients and the media as well as professionals. Increase awareness on unnecessary surgical practices, and how to avoid them remain essential. View Full-Text
Keywords: medical overuse; unnecessary procedures; surgery; anesthesia medical overuse; unnecessary procedures; surgery; anesthesia
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Aranaz Andrés, J.M.; Valencia-Martín, J.L.; Vicente-Guijarro, J.; Díaz-Agero Pérez, C.; López-Fresneña, N.; Carrillo, I.; Mira Solves, J.J.; SOBRINA Working Group. Low-Value Clinical Practices: Knowledge and Beliefs of Spanish Surgeons and Anesthetists. Int. J. Environ. Res. Public Health 2020, 17, 3556.

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