A randomized trial of medical quality assurance. Improving physicians' use of pelvimetry
M. R. Chassin and S. M. McCue
The capacity of educational programs to improve physician performance
remains doubtful despite many evaluative efforts. This is especially true
for programs sponsored by the federal government. We tested the efficacy of
an educational program conducted by Professional Standards Review
Organizations in reducing the inappropriate use of x-ray pelvimetry. This
procedure may cause harm to the fetus, and there is little evidence that it
is efficacious. We randomly assigned 120 hospitals in six Professional
Standards Review Organizations to study and control groups. Physicians with
delivery privileges at each study hospital participated in an educational
program that discussed acceptable indications for x-ray pelvimetry.
Pelvimetry use was similar in study and control hospitals before the
program. However, after the program, pelvimetry was performed by physicians
at study hospitals less than one third as often as by physicians at control
hospitals. We conclude that educational programs can improve physician
performance substantially and that such programs can be effectively
conducted by federally sponsored physician organizations.
