title: Conflicting and changing breast cancer screening recommendations: survey study of a national sample of ob-gyns after the release of the 2009 USPSTF guidelines.
abstract: OBJECTIVE
  To assess obstetrician-gynecologists' (ob-gyns') use of multiple conflicting guidelines assess after the release of the 2009 U.S. Preventive Services Task Force (USPSTF) breast cancer screening recommendations.
  
  
  METHODS
  A nationally representative sample of American College of Obstetricians and Gynecologists (ACOG) Fellows were invited to complete a survey.
  
  
  RESULTS
  A total of 235 of 399 ob-gyns responded (59% response rate). Twenty percent and 89% indicated that USPSTF and ACOG guidelines influence their practice, respectively, 84% are influenced by more than one guideline. The plurality of respondents was able to correctly identify ACOG and USPSTF guidelines on 10 of 12 questions. One-third agreed with both ACOG's and USPSTF's recommendations regarding mammography screening for women 40-49 years old. A total of 42% of the sample made at least one change in their practice after the release of the 2009 USPSTF breast cancer screening guidelines.
  
  
  CONCLUSIONS
  Some ob-gyns made changes to their practices after the release of the USPSTF guidelines. When multiple guidelines exist, as in the case with breast cancer screening, physicians utilize multiple, and at times conflicting, guidelines. More research will be needed to better understand the impact (negative or positive) of multiple guidelines on the quality of healthcare.
authors.affiliation: banderson@acog.org
authors.forename: Britta L
authors.initials: BL
authors.lastname: Anderson
authors.forename: Mark
authors.initials: M
authors.lastname: Pearlman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Griffin
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
mesh_terms: D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards / Q000639:trends; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data / Q000639:trends; D006176:Gynecology / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008327:Mammography / Q000592:standards* / Q000639:trends; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards* / Q000706:statistics & numerical data / Q000639:trends; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D012955:Societies, Medical / Q000592:standards / Q000639:trends; D014481:United States
keywords: breast cancer; evidence-based practice/guidelines; health promotion and screening; research quantitative