title: Physician attitudes toward dissemination of optical spectroscopy devices for cervical cancer control: an industrial-academic collaborative study.
abstract: BACKGROUND
  Optical spectroscopy has been studied for biologic plausibility, technical efficacy, clinical effectiveness, patient satisfaction, and cost-effectiveness.
  
  
  OBJECTIVE
  We sought to identify health care provider attitudes or practices that might act as barriers or to the dissemination of this new technology.
  
  
  METHODS
  Through an academic-industrial partnership, we conducted a series of focus groups to examine physician barriers to optical diagnosis. The study was conducted in 2 stages. First, a pilot group of 10 physicians (8 obstetrician gynecologists and 2 family practitioners) was randomly selected from 8 regions of the United States and each physician was interviewed individually. Physicians were presented with the results of a large trial (N = 980) testing the accuracy of a spectroscopy-based device in the detection of cervical neoplasia. They were also shown a prototype of the device and were given a period of time to ask questions and receive answers regarding the device. They were also asked to provide feedback on a questionnaire that was then revised and presented to 3 larger focus groups (n = 13, 15, and 17 for a total N = 45). The larger focus groups were conducted during national scientific meetings with 20 obstetrician gynecologists and 25 primary care physicians (family practitioners and internists).
  
  
  RESULTS
  When asked about the dissemination potential of the new cervical screening technology, all study groups tended to rely on established clinical guidelines from their respective professional societies with regard to the screening and diagnosis of cervical cancer. In addition, study participants consistently agreed that real-time spectroscopy would be viewed positively by their patients. Participants were positive about the new technology's potential as an adjunct to colposcopy and agreed that the improved accuracy would result in reduced health care costs (due to decreased biopsies and decreased visits). Although all participants saw the potential of real-time diagnosis, there were many perceived barriers. These barriers included changes in scheduling and work-flow, liability, documentation, ease of use, length of training, device cost, and reimbursement by third-party payers.
  
  
  CONCLUSIONS
  Barriers exist to the dissemination of optical technologies into physician practice. These will need to be addressed before cervical screening and diagnosis programs can take advantage of spectroscopy-based instruments for cancer control.
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. eshinn@mdanderson.org
authors.forename: Eileen
authors.initials: E
authors.lastname: Shinn
authors.forename: Usman
authors.initials: U
authors.lastname: Qazi
authors.forename: Shalini
authors.initials: S
authors.lastname: Gera
authors.forename: Joan
authors.initials: J
authors.lastname: Brodovsky
authors.forename: Jessica
authors.initials: J
authors.lastname: Simpson
authors.forename: Michele
authors.initials: M
authors.lastname: Follen
authors.forename: Karen
authors.initials: K
authors.lastname: Basen-Engquist
authors.forename: Calum
authors.initials: C
authors.lastname: Macaulay
mesh_terms: D052685:Alphapapillomavirus / Q000302:isolation & purification; D001291:Attitude of Health Personnel; D003127:Colposcopy; D005194:Family Practice; D005260:Female; D017144:Focus Groups; D006176:Gynecology; D006801:Humans; D007388:Internal Medicine; D017060:Patient Satisfaction; D013050:Spectrometry, Fluorescence / Q000295:instrumentation; D013057:Spectrum Analysis / Q000295:instrumentation* / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control* / Q000821:virology