Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
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Original Article

Volume 8, Number 9, September 2016, pages 633-640

Improving Clinical Practice Using a Novel Engagement Approach: Measurement, Benchmarking and Feedback, A Longitudinal Study


Figure 1.
Figure 1. Example feedback form.
Figure 2.
Figure 2. Round 1 overall CPV score for all provider sites.


Table 1. List of CPV Cases
Set ASet B
Atypical ductal hyperplasiaAtypical ductal hyperplasia
Invasive ductal CA, stage IInvasive ductal CA, stage I
Invasive lobular CA, stage II CHFInvasive lobular CA, stage II CHF
Invasive ductal CA, stage IIInvasive ductal CA, stage IIB in pregnancy
Invasive ductal CA, stage IIIInvasive ductal CA, stage III
Recurrent stage IIIB with bone metastasisRecurrent stage IIIB with solitary CNS metastasis
Recurrent stage II invasive ductal CAIsolated axillary recurrence, invasive ductal CA
Stage IIIB with recurrent disease to brain, liverLocal recurrence of stage IIIB invasive ductal CA
Multifocal breast cancer, stage IIBilateral breast CA, stage IIIA (left), stage I (right)
Diffuse large B cell NHL, stage IIIAE. No breast CADuctal carcinoma in situ
Hyperparathyroidism from adenoma. No progression of breast CAInflammatory breast CA stage IIIB
Dense breastsPrimary stage IV breast CA with bone metastasis


Table 2. Provider Characteristics, Overall and by Site
OverallSite 1Site 2Site 3Site 4
Average age (years)46.447.545.045.647.6
Provider type
  Medical oncologist3471278
  Radiation oncologist1136-2
  Other (other MD, PharmD)1010---
  APP (PA, APRN)13526-
Breast cancer patients (%)46.447.029.183.416.0
Time spent teaching (%)
Average years of experience11.610.811.412.013.7
Average case load per week (all)20.621.413.233.610.8


Table 3. Average Overall and Domain CPV Scores and Standard Deviation (SD) at Baseline and Subsequent Rounds
234Round 4 vs. baseline
Number of CPVs149151149130
Overall score56.6 (12.6)60.0 (14.4)69.2 (13.2)70.5 (16.8)< 0.01
Domain score
  History69.5 (13.1)70.9 (15.7)80.5 (16.8)85.4 (15.0)< 0.01
  Physical83.1 (20.6)81.5 (21.8)89.4 (18.9)84.8 (19.9)< 0.01
  Workup40.0 (20.8)48.9 (22.3)57.7 (24.1)63.4 (20.6)< 0.01
  Diagnosis-treatment45.6 (20.8)51.4 (20.7)61.9 (19.5)57.6 (18.6)< 0.01


Table 4. Comparison of Baseline to Latest Round of CPV Scores by Areas of Care
Area of careSite 1Site 2Site 3Site 4
BaselineRound 4BaselineRound 4BaselineRound 4BaselineRound 4
Axillary management62%81%39%32%50%67%31%80%
Radiation therapy58%65%57%73%50%100%83%50%
Hormonal therapy60%81%71%72%60%75%79%67%