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Thomas Flaig, MD


Risk-Aligned Bladder Cancer Surveillance: Data-Driven Approach to Implementation Mapping

By: Jenna Carter, PhD
Posted: Friday, November 18, 2022

A recent article published in Implementation Science highlighted findings from a study investigating a data-driven approach to implementation mapping for improving risk-aligned surveillance of bladder cancer. Florian R. Schroeck, MD, of the Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire, and colleagues investigated these implementation strategies and found 63 unique objectives. They were also able to map 23 strategies associated with the objectives. Additional testing led to a final selection of nine strategies that reportedly had a high impact.

“Given the broad range of cancer recurrence risks, providers should align the frequency with which patients undergo surveillance cystoscopy procedures…. We previously found there is both underuse of surveillance among high-risk and overuse of surveillance among low-risk patients...,” stated Dr. Schroeck and colleagues.

Previously collected qualitative data were used to develop objectives to assess the changes needed to achieve more risk-aligned surveillance. All 73 expert recommendations for implementing change (ERIC) strategies were assessed, and those that were not applicable to the clinical setting were excluded from this study. The remaining 28 strategies were mapped to the objectives using data-visualization techniques, and specific strategies were selected based on their level of impact. High-impact strategies were selected based on three factors: (1) broad scope, defined as a strategy addressing more than the median number of objectives; (2) low or moderate time commitment from clinical teams; and (3) evidence of effectiveness from the literature.

Overall findings revealed 63 unique objectives. These objectives were mapped to the 28 selected ERIC strategies, and they were assessed for impact. Ten of the strategies required low time commitments, and eight required moderate time commitments from clinical teams. Based on these findings, nine strategies were selected based on high impact, each with a clearly documented rationale for selection. Study authors concluded that this data-driven approach may be a more practical option than relying on expert opinion.  

Disclosure: The study authors reported no conflicts of interest.

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