Table 5.
—Associations Between Specialty, Graduation Year, and Guideline-Consistent Care of Physicians Ordering or Performing the First Invasive Diagnostic Test
| Specialtya | No. Patients | Guideline-Consistent Care, % | OR (95% CI) | P Value |
| Internal medicine | ||||
| Prior to 1980 | 1,424 | 6.95 | Reference | … |
| 1980-1989 | 1,137 | 7.74 | 1.12 (0.83-1.51) | .4469 |
| 1990+ | 498 | 6.83 | 0.98 (0.66-1.47) | .9247 |
| Unknown | 220 | 28.64 | 5.37 (3.76-7.67) | < .0001 |
| Surgery | ||||
| Prior to 1980 | 499 | 34.87 | Reference | … |
| 1980-1989 | 316 | 41.77 | 1.34 (1.00-1.79) | .0477 |
| 1990+ | 132 | 35.61 | 1.03 (0.69-1.54) | .8747 |
| Unknown | 157 | 62.42 | 3.10 (2.14-4.50) | < .0001 |
| Oncology | ||||
| Prior to 1980 | 149 | 1.34 | Reference | … |
| 1980-1989 | 102 | 4.9 | 3.79 (0.72-19.92) | .1157 |
| 1990+ | 42 | 2.38 | 1.79 (0.16-20.26) | .6372 |
| Unknown | 0 | 0 | … | … |
| Pulmonary | ||||
| Prior to 1980 | 3,816 | 8.54 | Reference | … |
| 1980-1989 | 3,102 | 13.09 | 1.61 (1.38-1.88) | < .0001 |
| 1990+ | 1,227 | 19.48 | 2.59 (2.16-3.10) | < .0001 |
| Unknown | 591 | 12.86 | 1.58 (1.21-2.06) | .0008 |
| Other | ||||
| Prior to 1980 | 58 | 0 | Reference | … |
| 1980-1989 | 80 | 2.5 | … | .9326 |
| 1990+ | 50 | 0 | … | 1.00 |
| Unknown | 8 | 0 | … | 1.00 |
| Thoracic surgery | ||||
| Prior to 1980 | 1,190 | 70.84 | Reference | … |
| 1980-1989 | 705 | 71.77 | 1.05 (0.85-1.29) | .6648 |
| 1990+ | 159 | 79.87 | 1.63 (1.09-2.45) | .0183 |
| Unknown | 355 | 74.65 | 1.21 (0.93-1.59) | .1625 |
| Unknown | ||||
| Prior to 1980 | 188 | 17.02 | Reference | … |
| 1980-1989 | 74 | 33.78 | 2.49 (1.35-4.60) | .0036 |
| 1990+ | 18 | 22.22 | 1.39 (0.43-4.51) | .5803 |
| Unknown | 1,476 | 2.3 | 0.12 (0.07-0.19) | < .0001 |
a
For procedures, this was the physician performing the procedure. For CT scan-guided biopsy, this was the referring physician. Internal medicine includes family practice and all subspecialties of internal medicine other than oncology and pulmonary medicine physicians. Surgery includes all other subspecialties of surgery other than thoracic or cardiothoracic surgery. Thoracic surgery and cardiothoracic surgery are included under thoracic surgery.