BACKGROUND: Research has shown that older women with breast cancer are less likely than younger women to receive treatment in accordance with accepted guidelines. Cancer-related research networks (eg, Comprehensive Cancer Centers) have been funded by the National Cancer Institute to increase the dissemination of new treatment strategies, but little is known about their relationship to cancer treatment patterns. OBJECTIVES: We used a 3-level hierarchical regression model to examine the relationship of treating facilities' memberships in cancer research networks to compliance with guidelines for primary treatment of early stage breast cancer, controlling for patient and facility factors. RESEARCH DESIGN: We analyzed data from a database linking SEER registry data and Medicare claims in patients aged 65 years of age or older with early-stage breast cancer to data on the treating facility, including variables that indicate membership(s) in cancer research networks. SUBJECTS: A total of 16,600 women with stage I or stage II breast cancer, diagnosed between 1990 and 1994, and who received treatment in one of 423 facilities were studied. MEASURES: The key independent variable in this analysis was membership in NCI-funded cancer research networks. The outcome measure is a 3-category variable defined as (1) mastectomy (MAST), (2) breast-conserving surgery plus radiation therapy (BCS+RT), or (3) BCS alone. RESULTS: Patients treated at facilities that were members of 2 or more cancer research networks were more likely to receive guideline-concordant treatment (ie, MAST or BCS+RT) than similar patients treated at non-member facilities. CONCLUSIONS: Organizational factors may influence compliance with treatment guidelines and be useful in improving the quality of care.
BACKGROUND: Research has shown that older women with breast cancer are less likely than younger women to receive treatment in accordance with accepted guidelines. Cancer-related research networks (eg, Comprehensive Cancer Centers) have been funded by the National Cancer Institute to increase the dissemination of new treatment strategies, but little is known about their relationship to cancer treatment patterns. OBJECTIVES: We used a 3-level hierarchical regression model to examine the relationship of treating facilities' memberships in cancer research networks to compliance with guidelines for primary treatment of early stage breast cancer, controlling for patient and facility factors. RESEARCH DESIGN: We analyzed data from a database linking SEER registry data and Medicare claims in patients aged 65 years of age or older with early-stage breast cancer to data on the treating facility, including variables that indicate membership(s) in cancer research networks. SUBJECTS: A total of 16,600 women with stage I or stage II breast cancer, diagnosed between 1990 and 1994, and who received treatment in one of 423 facilities were studied. MEASURES: The key independent variable in this analysis was membership in NCI-funded cancer research networks. The outcome measure is a 3-category variable defined as (1) mastectomy (MAST), (2) breast-conserving surgery plus radiation therapy (BCS+RT), or (3) BCS alone. RESULTS:Patients treated at facilities that were members of 2 or more cancer research networks were more likely to receive guideline-concordant treatment (ie, MAST or BCS+RT) than similar patients treated at non-member facilities. CONCLUSIONS: Organizational factors may influence compliance with treatment guidelines and be useful in improving the quality of care.
Authors: William R Carpenter; Alice K Fortune-Greeley; Leah L Zullig; Shoou-Yih Lee; Bryan J Weiner Journal: Contemp Clin Trials Date: 2011-10-02 Impact factor: 2.226
Authors: William R Carpenter; Katherine Reeder-Hayes; John Bainbridge; Anne-Marie Meyer; Keith D Amos; Bryan J Weiner; Paul A Godley Journal: Med Care Date: 2011-02 Impact factor: 2.983
Authors: William R Carpenter; Anne-Marie Meyer; Yang Wu; Bahjat Qaqish; Hanna K Sanoff; Richard M Goldberg; Bryan J Weiner Journal: Med Care Date: 2012-08 Impact factor: 2.983
Authors: Katherine E Reeder-Hayes; John Bainbridge; Anne Marie Meyer; Keith D Amos; Bryan J Weiner; Paul A Godley; William R Carpenter Journal: Breast Cancer Res Treat Date: 2011-02-22 Impact factor: 4.872
Authors: Tracy Onega; Eric J Duell; Xun Shi; Eugene Demidenko; Daniel Gottlieb; David C Goodman Journal: Med Care Res Rev Date: 2009-05-19 Impact factor: 3.929
Authors: Steven B Clauser; Maureen R Johnson; Donna M O'Brien; Joy M Beveridge; Mary L Fennell; Arnold D Kaluzny Journal: Implement Sci Date: 2009-09-26 Impact factor: 7.327