The relationship between provider beliefs and practice regarding post-treatment surveillance head-and-neck exams for upper aerodigestive tract carcinoma in American head and neck society members
There are many varying guidelines for post-treatment surveillance of upper aerodigestive tract (UADT) squamous cell carcinoma (SCCa), though none provide sufficient or clear guidance on the execution of ideal post-treatment care. It is important to better understand the relationship between clinical beliefs and clinical practice in the setting of unclear or insufficient evidence. We sought to determine whether there was a relationship between published rationales and beliefs regarding post-treatment surveillance and self-reported practice style from a set of head-and-neck cancer specialists. We also sought to determine if there was a relationship between the same rationales and beliefs regarding post-treatment surveillance and accordance of self-reported frequency of head-and-neck exam frequency following treatment and National Comprehensive Cancer Network (NCCN) guideline adherence among AHNS members. A cross-sectional web-based self-report survey was sent via e-mail to 977 AHNS members, with 58 responses (5.9% response rate) and 39 usable responses (67%). Respondents represented a diverse and well-informed population based on demographic information and comparing surveillance practices to literature. Main analyses were limited by low response rate, especially with regard to interpreting negative results. However, there was significant heterogeneity among practice patterns, as well as rationales and beliefs regarding practice. There was a significant association between valuing the importance of monitoring other smoking-related complications and late (>5 years) head-and-neck exam self-reported frequency. There was also a significant association between believing that routine surveillance should be lifelong and NCCN guideline adherence. Despite limited response, this study highlights the heterogeneity of rationales and beliefs for post-treatment surveillance, while showing whether (and how) those beliefs and rationales relate to practice variations. Hopefully this study prompts further efforts to identify and encourage optimal post-treatment care.
Pattisapu, Prasanth, "The relationship between provider beliefs and practice regarding post-treatment surveillance head-and-neck exams for upper aerodigestive tract carcinoma in American head and neck society members" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1566354.