Bruce L Jacobs1, Jonathan G Yabes2, Samia H Lopa3, Dwight E Heron4, Chung-Chou H Chang5, Justin E Bekelman6, Joel B Nelson3, Julie P W Bynum7, Amber E Barnato8, Jeremy M Kahn9. 1. Department of Urology, University of Pittsburgh, Pittsburgh, PA; Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA. Electronic address: jacobsbl2@upmc.edu. 2. Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA. 3. Department of Urology, University of Pittsburgh, Pittsburgh, PA. 4. Department of Radiation Oncology-Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA. 5. Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. 6. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA; Division of General Internal Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA. 7. Department of Medicine, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, MI. 8. Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH; Dartmouth Institute Geisel School of Medicine, Lebanon, NH. 9. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA.
Abstract
INTRODUCTION: Technology availability and prior experience with novel cancer treatments may partially drive their use. We sought to examine this issue in the context of stereotactic body radiation therapy (SBRT) by studying how its use for an established indication (lung cancer) impacts its use for an emerging indication (prostate cancer). METHODS: Using SEER-Medicare from 2007 to 2011, we developed prostate cancer-specific physician-hospital networks. Our primary dependent variable was SBRT use for prostate cancer and our primary independent variable was SBRT use for lung cancer, both at the network level. To assess the influence of SBRT availability and experiential use, we generated predicted probabilities of SBRT use for prostate cancer stratified by a network's use of lung cancer SBRT, adjusting for network characteristics. To assess intensity of use, we examined the correlation between the proportion of prostate cancer patients and lung cancer patients receiving SBRT within a network. RESULTS: We identified 316 networks that served 41,034 prostate cancer and 83,433 lung cancer patients. A network was significantly more likely to use SBRT for prostate cancer if that network used SBRT for lung cancer (e.g., in 2011, odds ratio [OR] 12.7; 95% confidence interval [CI] 3.9-41.8). The Pearson's correlation between the proportion of prostate cancer patients and lung cancer patients receiving SBRT in a network was 0.34, which was not statistically significant (P = 0.12). CONCLUSIONS: SBRT availability and experiential use for lung cancer influences its use for prostate cancer, but intensity of use for one does not relate to intensity of use for the other.
INTRODUCTION: Technology availability and prior experience with novel cancer treatments may partially drive their use. We sought to examine this issue in the context of stereotactic body radiation therapy (SBRT) by studying how its use for an established indication (lung cancer) impacts its use for an emerging indication (prostate cancer). METHODS: Using SEER-Medicare from 2007 to 2011, we developed prostate cancer-specific physician-hospital networks. Our primary dependent variable was SBRT use for prostate cancer and our primary independent variable was SBRT use for lung cancer, both at the network level. To assess the influence of SBRT availability and experiential use, we generated predicted probabilities of SBRT use for prostate cancer stratified by a network's use of lung cancerSBRT, adjusting for network characteristics. To assess intensity of use, we examined the correlation between the proportion of prostate cancerpatients and lung cancerpatients receiving SBRT within a network. RESULTS: We identified 316 networks that served 41,034 prostate cancer and 83,433 lung cancerpatients. A network was significantly more likely to use SBRT for prostate cancer if that network used SBRT for lung cancer (e.g., in 2011, odds ratio [OR] 12.7; 95% confidence interval [CI] 3.9-41.8). The Pearson's correlation between the proportion of prostate cancerpatients and lung cancerpatients receiving SBRT in a network was 0.34, which was not statistically significant (P = 0.12). CONCLUSIONS:SBRT availability and experiential use for lung cancer influences its use for prostate cancer, but intensity of use for one does not relate to intensity of use for the other.
Authors: Quoc-Dien Trinh; Marco Bianchi; Maxine Sun; Jesse Sammon; Jan Schmitges; Shahrokh F Shariat; Shyam Sukumar; Claudio Jeldres; Kevin Zorn; Paul Perrotte; Craig G Rogers; James O Peabody; Francesco Montorsi; Mani Menon; Pierre I Karakiewicz Journal: Urol Oncol Date: 2011-11-18 Impact factor: 3.498
Authors: Robert Timmerman; Rebecca Paulus; James Galvin; Jeffrey Michalski; William Straube; Jeffrey Bradley; Achilles Fakiris; Andrea Bezjak; Gregory Videtic; David Johnstone; Jack Fowler; Elizabeth Gore; Hak Choy Journal: JAMA Date: 2010-03-17 Impact factor: 56.272
Authors: Hubert Y Pan; Bruce G Haffty; Benjamin P Falit; Thomas A Buchholz; Lynn D Wilson; Stephen M Hahn; Benjamin D Smith Journal: Int J Radiat Oncol Biol Phys Date: 2016-03-05 Impact factor: 7.038
Authors: Christopher R King; Debra Freeman; Irving Kaplan; Donald Fuller; Giampaolo Bolzicco; Sean Collins; Robert Meier; Jason Wang; Patrick Kupelian; Michael Steinberg; Alan Katz Journal: Radiother Oncol Date: 2013-09-20 Impact factor: 6.280