Robert M Turner1, Jonathan G Yabes2, Benjamin J Davies3, Dwight E Heron4, Bruce L Jacobs5. 1. Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA. Electronic address: turnerrm@upmc.edu. 2. Division of Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA. 3. Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA. 4. Department of Radiation Oncology, University of Pittsburgh Cancer Institute, Pittsburgh, PA. 5. Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA; Center for Research on Health Care, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Abstract
OBJECTIVE: To examine factors associated with bone scan use in patients undergoing radical cystectomy and to assess trends in use over time. MATERIALS AND METHODS: Using Surveillance, Epidemiology, and End Results-Medicare data, we identified 5573 patients who underwent radical cystectomy from 2004 to 2011. The primary outcome was completion of a bone scan within 6 months prior to surgery. Demographic, regional, and clinicopathologic predictors of bone scan use were examined using a mixed logit model with health service area as a random effect. RESULTS: Among radical cystectomy patients, 1754 (31%) completed a preoperative bone scan. Urologists ordered most of these studies (69%). The adjusted probability of a patient undergoing a bone scan decreased from 0.40 in 2004 to 0.29 in 2011 (P = .01). Compared with patients in the northeast region, those in the south, central, and west regions were less likely to have a bone scan (P <.001). Compared with those with stage ≤T1, patients with higher stage disease were more likely to have a bone scan (P <.001). Among the highest volume surgeons, there was significant variation in the proportion of patients who completed preoperative bone scans (P < .001). CONCLUSION: Despite a recent decline, bone scans are used frequently in the preoperative staging of bladder cancer. Although some clinical factors are associated with bone scan use, significant regional and provider variation suggest areas to improve standardization of practice.
OBJECTIVE: To examine factors associated with bone scan use in patients undergoing radical cystectomy and to assess trends in use over time. MATERIALS AND METHODS: Using Surveillance, Epidemiology, and End Results-Medicare data, we identified 5573 patients who underwent radical cystectomy from 2004 to 2011. The primary outcome was completion of a bone scan within 6 months prior to surgery. Demographic, regional, and clinicopathologic predictors of bone scan use were examined using a mixed logit model with health service area as a random effect. RESULTS: Among radical cystectomy patients, 1754 (31%) completed a preoperative bone scan. Urologists ordered most of these studies (69%). The adjusted probability of a patient undergoing a bone scan decreased from 0.40 in 2004 to 0.29 in 2011 (P = .01). Compared with patients in the northeast region, those in the south, central, and west regions were less likely to have a bone scan (P <.001). Compared with those with stage ≤T1, patients with higher stage disease were more likely to have a bone scan (P <.001). Among the highest volume surgeons, there was significant variation in the proportion of patients who completed preoperative bone scans (P < .001). CONCLUSION: Despite a recent decline, bone scans are used frequently in the preoperative staging of bladder cancer. Although some clinical factors are associated with bone scan use, significant regional and provider variation suggest areas to improve standardization of practice.
Authors: Faysal A Yafi; Armen G Aprikian; Joseph L Chin; Yves Fradet; Jonathan Izawa; Eric Estey; Adrian Fairey; Ricardo Rendon; Ilias Cagiannos; Louis Lacombe; Jean-Baptiste Lattouf; David Bell; Darrel Drachenberg; Wassim Kassouf Journal: BJU Int Date: 2010-12-16 Impact factor: 5.588
Authors: Shahrokh F Shariat; Pierre I Karakiewicz; Ganesh S Palapattu; Yair Lotan; Craig G Rogers; Gilad E Amiel; Amnon Vazina; Amit Gupta; Patrick J Bastian; Arthur I Sagalowsky; Mark P Schoenberg; Seth P Lerner Journal: J Urol Date: 2006-12 Impact factor: 7.450
Authors: Usha Subramanian; Morris Weinberger; George J Eckert; Gilbert J L'Italien; Pablo Lapuerta; William Tierney Journal: J Gen Intern Med Date: 2002-08 Impact factor: 5.128
Authors: Sung Han Kim; Ho Kyung Seo; Hee Chul Shin; Sung Ja Chang; Sooin Yun; Jungnam Joo; Ja Hyeon Ku; Hyung Suk Kim; Hwang Gyun Jeon; Byong Chang Jeong; In Gab Jeong; Seok Ho Kang; Bumsik Hong Journal: J Korean Med Sci Date: 2015-07-15 Impact factor: 2.153
Authors: Avinash Maganty; Robert M Turner; Jonathan G Yabes; Dwight E Heron; Jeffrey R Gingrich; Benjamin J Davies; Bruce L Jacobs Journal: Eur J Cancer Care (Engl) Date: 2020-02-05 Impact factor: 2.520