@article {Gillettejabfm.2022.220185R1, author = {Chris Gillette and Sarah Garvick and Nathan Bates and Courtney M. Martin and Amresh Hanchate and Daniel S. Reuland}, title = {The Prevalence of Low-Value Prostate Cancer Screening in Primary Care Clinics: A Study Using the National Ambulatory Medical Care Survey}, elocation-id = {jabfm.2022.220185R1}, year = {2023}, doi = {10.3122/jabfm.2022.220185R1}, publisher = {The Journal of the American Board of Family Medicine}, abstract = {Introduction: There has been an increasing focus on improving value in health care and deimplementing the use of low-value services, such as prostate cancer (PC) screening for men aged \>70 years. The objectives of this study are to (1) identify the proportion of primary care visits at which low-value PC screening is ordered, and (2) identify predisposing, enabling, and health care need characteristics associated with low-value PC screening in the United States.Methods: This was a secondary analysis of the National Ambulatory Medicare Care Survey datasets from 2013 to 2016 and 2018. Andersen{\textquoteright}s Behavioral Model of Health Services Use guided independent variable selection. Weighted multivariable logit models were used to analyze data.Results: There were 6.71 low-value prostate-specific antigens (PSAs) per 100 visits and 1.65 low-value digital rectal exams (DREs) per 100 visits. For each additional service ordered by primary care providers, the odds of ordering a low-value PSA increased by 49\%, and the odds of performing a low-value DRE increased by 37\%.Conclusions: The use of low-value PSAs and DREs was sizable during the observed time period. Organizations who want to reduce low-value PSAs and DREs may want to focus interventions on providers who order a high number of tests.}, issn = {1557-2625}, URL = {https://www.jabfm.org/content/early/2023/01/02/jabfm.2022.220185R1}, eprint = {https://www.jabfm.org/content/early/2023/01/02/jabfm.2022.220185R1.full.pdf}, journal = {The Journal of the American Board of Family Medicine} }