MP42-02 POTENTIAL OF ADDITIONAL MAGNETIC RESONANCE IMAGING (MRI)-TARGETED PROSTATE BIOPSY TO AVOID UNDERESTIMATION OF SYSTEMATIC 14-CORE BIOPSY

2014 
INTRODUCTION AND OBJECTIVES: The Michigan Urological Surgery Improvement Collaborative (MUSIC) is a state-wide consortium of 29 urology practices funded by Blue Cross Blue Shield with the goal of improving the quality of prostate cancer care in Michigan. As an initial priority we examined practice-level and temporal variations in the use of radiographic staging among men with newly diagnosed prostate cancer. METHODS: Practices submit standardized data, including use and results of staging computed tomography and bone scans, to a webbased clinical registry for all men with newly-diagnosed prostate cancer. We compared patterns of imaging utilization across patient risk groups before (Phase I, March-October 2012) and after (Phase II, November 2012-June 2013) practice-level performance feedback and guideline review provided at one of our tri-annual collaborative-wide meetings. RESULTS: Across all MUSIC practices in Phase I, imaging studieswereorderedwith significant variability amongpractices (p 0.001) for approximately 5%, 20%, and 70% of low, intermediate, and high risk patients, respectively. After practice-specific feedback there was a statistically significant decreased in imaging for low risk disease (Table 1). CONCLUSIONS: Although variability exists among urology practices in Michigan, patterns of care regarding the use of imaging studies seem to be quite appropriate and significantly improving for low risk disease based on collaborative education and performance feedback. Opportunities exist for further improvement in the rates of imaging and refinement of imaging criteria and risk classifications. Table 1 Rates of radiographic staging in phase I (March 2012 October 2012) compared to phase II (November 2012 June 2013)
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