title: MUSIC: patterns of care in the radiographic staging of men with newly diagnosed low risk prostate cancer.
abstract: OBJECTIVE
  MUSIC is a statewide consortium of 42 urology practices that aims to improve the quality of prostate cancer care in Michigan. As an initial priority, we examined patterns of care in the radiographic staging of men with newly diagnosed prostate cancer. We determined whether collaborative-wide data review and performance feedback would decrease the imaging rate in men with low risk prostate cancer.
  
  
  METHODS
  Practices submitted standardized data, including the use and results of staging computerized tomography and bone scan, to a web based clinical registry of all men with newly diagnosed prostate cancer. We identified all patients with low risk prostate cancer and compared imaging use patterns before and after practice level performance feedback and guideline review, which were provided at collaborative-wide meetings.
  
  
  RESULTS
  In MUSIC 813 patients were newly diagnosed with low risk prostate cancer during the 19-month study period. Of 410 patients diagnosed in the prefeedback period (phase I) 15 (3.7%) and 21 (5.2%) underwent bone scan and computerized tomography, respectively. Of 403 patients diagnosed after feedback (phase II) radiographic staging was done in 5 men (1.3%) with bone scan and in 13 (3.2%) with computerized tomography (p = 0.03 and 0.17, respectively).
  
  
  CONCLUSIONS
  The overall rate of radiographic staging in men with newly diagnosed low risk prostate cancer was appropriately low. The imaging rate decreased even further after collaborative education and performance feedback. MUSIC appears to be a successful tool for quality improvement, affecting practice patterns and increasing efficiency of care.
authors.affiliation: Department of Urology, Wayne State University, Detroit, Michigan, for the Michigan Urological Surgery Improvement Collaborative.
authors.forename: Ishai
authors.initials: I
authors.lastname: Ross
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan, for the Michigan Urological Surgery Improvement Collaborative.
authors.forename: Paul
authors.initials: P
authors.lastname: Womble
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan, for the Michigan Urological Surgery Improvement Collaborative.
authors.forename: Jun
authors.initials: J
authors.lastname: Ye
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan, for the Michigan Urological Surgery Improvement Collaborative.
authors.forename: Susan
authors.initials: S
authors.lastname: Linsell
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan, for the Michigan Urological Surgery Improvement Collaborative.
authors.forename: James E
authors.initials: JE
authors.lastname: Montie
authors.affiliation: Department of Urology, University of Michigan, Ann Arbor, Michigan, for the Michigan Urological Surgery Improvement Collaborative.
authors.forename: David C
authors.initials: DC
authors.lastname: Miller
authors.affiliation: Department of Urology, Wayne State University, Detroit, Michigan, for the Michigan Urological Surgery Improvement Collaborative. Electronic address: mcher@med.wayne.edu.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Cher
mesh_terms: D003299:Cooperative Behavior; D003952:Diagnostic Imaging / Q000706:statistics & numerical data*; D005246:Feedback; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D058996:Quality Improvement; D011877:Radionuclide Imaging; D012306:Risk; D012955:Societies, Medical; D014057:Tomography, X-Ray Computed
keywords: diagnostic imaging; feedback; physician's practice patterns; prostatic neoplasms; quality improvement