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Deborah R Kaye

Assistant Professor of Urology
Urology
20 Medicine Circle, Durham, NC 27710

Selected Publications


Medication Payments by Insurers and Patients for the Treatment of Metastatic Castrate-Resistant Prostate Cancer.

Journal Article JCO oncology practice · April 2023 PurposeThe implications of high prices for cancer drugs on health care costs and patients' financial burdens are a growing concern. Patients with metastatic castrate-resistant prostate cancer (mCRPC) are often candidates for multiple first-line sy ... Full text Cite

End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy.

Journal Article JCO oncology practice · February 2023 PurposeNew therapies including oral anticancer agents (OAAs) have improved outcomes for patients with metastatic renal cell carcinoma (mRCC). However, little is known about the quality of end-of-life (EOL) care and systemic therapy use at EOL in p ... Full text Cite

Oral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC).

Journal Article Urology · October 2022 OBJECTIVE: To examine real-world adherence to oral anticancer agents (OAAs) and its association with outcomes among Medicare beneficiaries with metastatic renal cell carcinoma (mRCC). METHODS: SEER-Medicare retrospective cohort study of patients with metas ... Full text Link to item Cite

Association between cognitive impairment and oral anticancer agent use in older patients with metastatic renal cell carcinoma.

Journal Article J Am Geriatr Soc · August 2022 BACKGROUND: Kidney cancer is the fastest-growing cancer diagnosis in the developed world. About 16% of new cases are stage IV, which has a low five-year survival rate. Many patients with metastatic renal cell carcinoma (mRCC) are older and may have mild co ... Full text Link to item Cite

Evaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma.

Journal Article J Geriatr Oncol · June 2022 BACKGROUND: Dementia and cancer are both more common in adults as they age. As new cancer treatments become more popular, it is important to consider how these treatments might affect older patients. This study evaluates metastatic renal cell carcinoma (mR ... Full text Link to item Cite

Association Between Delivery System Structure and Intensity of End-of-Life Cancer Care.

Journal Article JCO Oncol Pract · July 2020 PURPOSE: To determine whether the type of delivery system is associated with intensity of care at the end of life for Medicare beneficiaries with cancer. PATIENTS AND METHODS: We used SEER registry data linked with Medicare claims to evaluate intensity of ... Full text Link to item Cite

Understanding the Costs Associated With Surgical Care Delivery in the Medicare Population.

Journal Article Ann Surg · January 2020 BACKGROUND: Surgical care has been largely untargeted by Medicare payment reforms because episode costs associated with its delivery are not currently well understood. OBJECTIVE: To quantify the costs of inpatient and outpatient surgery in the Medicare pop ... Full text Link to item Cite

Confirmatory Magnetic Resonance Imaging with or without Biopsy Impacts Decision Making in Newly Diagnosed Favorable Risk Prostate Cancer.

Journal Article J Urol · May 2019 PURPOSE: We investigated how magnetic resonance imaging and post-magnetic resonance imaging biopsy impact decision making in men considering active surveillance. MATERIALS AND METHODS: We reviewed the records of men in the Michigan Urological Surgery Impro ... Full text Link to item Cite

Pathological upgrading at radical prostatectomy for patients with Grade Group 1 prostate cancer: implications of confirmatory testing for patients considering active surveillance.

Journal Article BJU Int · May 2019 OBJECTIVE: To examine the association between National Comprehensive Cancer Network (NCCN) risk, number of positive biopsy cores, age, and early confirmatory test results on pathological upgrading at radical prostatectomy¬†(RP), in order to better understan ... Full text Link to item Cite

Variation in Physician-Specific Episode Payments for Major Cancer Surgery and Implications for the Merit-Based Incentive Program.

Journal Article J Surg Res · April 2019 BACKGROUND: Nearly 1.5 million clinicians in the United States will be affected by Centers for Medicare and Medicaid Services' (CMS) new payment program, the Merit-based Incentive Program (MIPS), where clinicians will be penalized or rewarded based on the ... Full text Link to item Cite

The Stability of Physician-Specific Episode Costs for Urologic Cancer Surgery: Implications for Urologists Under the Merit-Based Incentive Program.

Journal Article Urology · January 2019 OBJECTIVE: To evaluate the stability of physician-specific episode payments for prostatectomy, nephrectomy, and cystectomy in the context of value-based purchasing programs, such as the merit-based incentive payment system. METHODS: We utilized Surveillanc ... Full text Link to item Cite

Association Between Early Confirmatory Testing and the Adoption of Active Surveillance for Men With Favorable-risk Prostate Cancer.

Journal Article Urology · August 2018 OBJECTIVE: To examine the relationship between the use and results of early confirmatory testing and persistence on active surveillance (AS). METHODS: We identified all men in the Michigan Urological Surgery Improvement Collaborative registry diagnosed wit ... Full text Link to item Cite

Costs of Cancer Care Across the Disease Continuum.

Journal Article Oncologist · July 2018 PURPOSE: The aim of this study was to estimate Medicare payments for cancer care during the initial, continuing, and end-of-life phases of care for 10 malignancies and to examine variation in expenditures according to patient characteristics and cancer sev ... Full text Link to item Cite

Association of Delivery System Integration and Outcomes for Major Cancer Surgery.

Journal Article Ann Surg Oncol · April 2018 BACKGROUND: Integrated delivery systems (IDSs) are postulated to reduce spending and improve outcomes through successful coordination of care across multiple providers. Nonetheless, the actual impact of IDSs on outcomes for complex multidisciplinary care s ... Full text Link to item Cite

System-Level Health-Care Integration and the Costs of Cancer Care Across the Disease Continuum.

Journal Article J Oncol Pract · March 2018 PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medica ... Full text Link to item Cite

Use of Routine Home Health Care and Deviations From an Uncomplicated Recovery Pathway After Radical Prostatectomy.

Journal Article Urology · February 2018 OBJECTIVE: To evaluate the statistical association between routine home health use after prostatectomy, short-term surgical outcomes, and payments. METHODS: We identified all men who underwent a robotic radical prostatectomy from April 1, 2014, to October ... Full text Link to item Cite

Episode-based Payment Variation for Urologic Cancer Surgery.

Journal Article Urology · January 2018 OBJECTIVE: To investigate payment variation for 3 common urologic cancer surgeries and evaluate the potential for applying bundled payment programs to these procedures. METHODS: Using 2008-2011 Surveillance, Epidemiology, and End Results-Medicare linked da ... Full text Link to item Cite

Clinical utility of gene expression classifiers in men with newly diagnosed prostate cancer

Journal Article JCO Precision Oncology · January 1, 2018 Purpose Tissue-based gene expression classifiers (GECs) may assist with management decisions in patients with newly diagnosed prostate cancer. We sought to assess the current use of GEC tests and determine how the test results are associated with primary d ... Full text Cite

Association Between Patient Satisfaction and Short-Term Outcomes After Major Cancer Surgery.

Journal Article Ann Surg Oncol · November 2017 OBJECTIVE: The aim of this study was to investigate whether patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, is associated with short-term outcomes after major cancer surgery. MATERI ... Full text Link to item Cite

Understanding the relationship between the Centers for Medicare and Medicaid Services' Hospital Compare star rating, surgical case volume, and short-term outcomes after major cancer surgery.

Journal Article Cancer · November 1, 2017 BACKGROUND: Both the Centers for Medicare and Medicaid Services' (CMS) Hospital Compare star rating and surgical case volume have been publicized as metrics that can help patients to identify high-quality hospitals for complex care such as cancer surgery. ... Full text Link to item Cite

Medication Payments by Insurers and Patients for the Treatment of Metastatic Castrate-Resistant Prostate Cancer.

Journal Article JCO oncology practice · April 2023 PurposeThe implications of high prices for cancer drugs on health care costs and patients' financial burdens are a growing concern. Patients with metastatic castrate-resistant prostate cancer (mCRPC) are often candidates for multiple first-line sy ... Full text Cite

End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy.

Journal Article JCO oncology practice · February 2023 PurposeNew therapies including oral anticancer agents (OAAs) have improved outcomes for patients with metastatic renal cell carcinoma (mRCC). However, little is known about the quality of end-of-life (EOL) care and systemic therapy use at EOL in p ... Full text Cite

Oral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC).

Journal Article Urology · October 2022 OBJECTIVE: To examine real-world adherence to oral anticancer agents (OAAs) and its association with outcomes among Medicare beneficiaries with metastatic renal cell carcinoma (mRCC). METHODS: SEER-Medicare retrospective cohort study of patients with metas ... Full text Link to item Cite

Association between cognitive impairment and oral anticancer agent use in older patients with metastatic renal cell carcinoma.

Journal Article J Am Geriatr Soc · August 2022 BACKGROUND: Kidney cancer is the fastest-growing cancer diagnosis in the developed world. About 16% of new cases are stage IV, which has a low five-year survival rate. Many patients with metastatic renal cell carcinoma (mRCC) are older and may have mild co ... Full text Link to item Cite

Evaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma.

Journal Article J Geriatr Oncol · June 2022 BACKGROUND: Dementia and cancer are both more common in adults as they age. As new cancer treatments become more popular, it is important to consider how these treatments might affect older patients. This study evaluates metastatic renal cell carcinoma (mR ... Full text Link to item Cite

Association Between Delivery System Structure and Intensity of End-of-Life Cancer Care.

Journal Article JCO Oncol Pract · July 2020 PURPOSE: To determine whether the type of delivery system is associated with intensity of care at the end of life for Medicare beneficiaries with cancer. PATIENTS AND METHODS: We used SEER registry data linked with Medicare claims to evaluate intensity of ... Full text Link to item Cite

Understanding the Costs Associated With Surgical Care Delivery in the Medicare Population.

Journal Article Ann Surg · January 2020 BACKGROUND: Surgical care has been largely untargeted by Medicare payment reforms because episode costs associated with its delivery are not currently well understood. OBJECTIVE: To quantify the costs of inpatient and outpatient surgery in the Medicare pop ... Full text Link to item Cite

Confirmatory Magnetic Resonance Imaging with or without Biopsy Impacts Decision Making in Newly Diagnosed Favorable Risk Prostate Cancer.

Journal Article J Urol · May 2019 PURPOSE: We investigated how magnetic resonance imaging and post-magnetic resonance imaging biopsy impact decision making in men considering active surveillance. MATERIALS AND METHODS: We reviewed the records of men in the Michigan Urological Surgery Impro ... Full text Link to item Cite

Pathological upgrading at radical prostatectomy for patients with Grade Group 1 prostate cancer: implications of confirmatory testing for patients considering active surveillance.

Journal Article BJU Int · May 2019 OBJECTIVE: To examine the association between National Comprehensive Cancer Network (NCCN) risk, number of positive biopsy cores, age, and early confirmatory test results on pathological upgrading at radical prostatectomy¬†(RP), in order to better understan ... Full text Link to item Cite

Variation in Physician-Specific Episode Payments for Major Cancer Surgery and Implications for the Merit-Based Incentive Program.

Journal Article J Surg Res · April 2019 BACKGROUND: Nearly 1.5 million clinicians in the United States will be affected by Centers for Medicare and Medicaid Services' (CMS) new payment program, the Merit-based Incentive Program (MIPS), where clinicians will be penalized or rewarded based on the ... Full text Link to item Cite

The Stability of Physician-Specific Episode Costs for Urologic Cancer Surgery: Implications for Urologists Under the Merit-Based Incentive Program.

Journal Article Urology · January 2019 OBJECTIVE: To evaluate the stability of physician-specific episode payments for prostatectomy, nephrectomy, and cystectomy in the context of value-based purchasing programs, such as the merit-based incentive payment system. METHODS: We utilized Surveillanc ... Full text Link to item Cite

Association Between Early Confirmatory Testing and the Adoption of Active Surveillance for Men With Favorable-risk Prostate Cancer.

Journal Article Urology · August 2018 OBJECTIVE: To examine the relationship between the use and results of early confirmatory testing and persistence on active surveillance (AS). METHODS: We identified all men in the Michigan Urological Surgery Improvement Collaborative registry diagnosed wit ... Full text Link to item Cite

Costs of Cancer Care Across the Disease Continuum.

Journal Article Oncologist · July 2018 PURPOSE: The aim of this study was to estimate Medicare payments for cancer care during the initial, continuing, and end-of-life phases of care for 10 malignancies and to examine variation in expenditures according to patient characteristics and cancer sev ... Full text Link to item Cite

Association of Delivery System Integration and Outcomes for Major Cancer Surgery.

Journal Article Ann Surg Oncol · April 2018 BACKGROUND: Integrated delivery systems (IDSs) are postulated to reduce spending and improve outcomes through successful coordination of care across multiple providers. Nonetheless, the actual impact of IDSs on outcomes for complex multidisciplinary care s ... Full text Link to item Cite

System-Level Health-Care Integration and the Costs of Cancer Care Across the Disease Continuum.

Journal Article J Oncol Pract · March 2018 PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medica ... Full text Link to item Cite

Use of Routine Home Health Care and Deviations From an Uncomplicated Recovery Pathway After Radical Prostatectomy.

Journal Article Urology · February 2018 OBJECTIVE: To evaluate the statistical association between routine home health use after prostatectomy, short-term surgical outcomes, and payments. METHODS: We identified all men who underwent a robotic radical prostatectomy from April 1, 2014, to October ... Full text Link to item Cite

Episode-based Payment Variation for Urologic Cancer Surgery.

Journal Article Urology · January 2018 OBJECTIVE: To investigate payment variation for 3 common urologic cancer surgeries and evaluate the potential for applying bundled payment programs to these procedures. METHODS: Using 2008-2011 Surveillance, Epidemiology, and End Results-Medicare linked da ... Full text Link to item Cite

Clinical utility of gene expression classifiers in men with newly diagnosed prostate cancer

Journal Article JCO Precision Oncology · January 1, 2018 Purpose Tissue-based gene expression classifiers (GECs) may assist with management decisions in patients with newly diagnosed prostate cancer. We sought to assess the current use of GEC tests and determine how the test results are associated with primary d ... Full text Cite

Association Between Patient Satisfaction and Short-Term Outcomes After Major Cancer Surgery.

Journal Article Ann Surg Oncol · November 2017 OBJECTIVE: The aim of this study was to investigate whether patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, is associated with short-term outcomes after major cancer surgery. MATERI ... Full text Link to item Cite

Understanding the relationship between the Centers for Medicare and Medicaid Services' Hospital Compare star rating, surgical case volume, and short-term outcomes after major cancer surgery.

Journal Article Cancer · November 1, 2017 BACKGROUND: Both the Centers for Medicare and Medicaid Services' (CMS) Hospital Compare star rating and surgical case volume have been publicized as metrics that can help patients to identify high-quality hospitals for complex care such as cancer surgery. ... Full text Link to item Cite

Alternative payment models and urology.

Journal Article Curr Opin Urol · July 2017 PURPOSE OF REVIEW: The Medicare Access and CHIP Reauthorization Act (MACRA) is a historic bill that was recently passed that establishes how quality measurement and practice patterns will affect physician reimbursement. Alternative payment models (APMs) ar ... Full text Link to item Cite

Frailty as a marker of adverse outcomes in patients with bladder cancer undergoing radical cystectomy.

Journal Article Urol Oncol · June 2016 OBJECTIVE: To investigate the modified frailty index (mFI) as a preoperative predictor of postoperative complications following radical cystectomy (RC) in patients with bladder cancer. MATERIALS AND METHODS: Patients undergoing RC were identified from the ... Full text Link to item Cite

Do African American patients treated with radical cystectomy for bladder cancer have worse overall survival? Accounting for pathologic staging and patient demographics beyond race makes a difference

Journal Article Bladder Cancer · January 1, 2016 Background: It is estimated that 74,000 men and women in the United States will be diagnosed with bladder cancer and 16,000 will die from the disease in 2015. The incidence of bladder cancer in Caucasian males is double that of African American males, but ... Full text Cite

Robotic surgery in urological oncology: patient care or market share?

Journal Article Nat Rev Urol · January 2015 Surgical robotic use has grown exponentially in spite of limited or uncertain benefits and large costs. In certain situations, adoption of robotic technology provides value to patients and society. In other cases, however, the robot provides little or no i ... Full text Link to item Cite

Robotic ultrasound and needle guidance for prostate cancer management: review of the contemporary literature.

Journal Article Curr Opin Urol · January 2014 PURPOSE OF REVIEW: To present the recent advances in needle guidance and robotic ultrasound technology which are used for prostate cancer (PCa) diagnosis and management. RECENT FINDINGS: Prostate biopsy technology has remained relatively unchanged. Improve ... Full text Link to item Cite

Urinary outcomes are significantly affected by nerve sparing quality during radical prostatectomy.

Journal Article Urology · December 2013 OBJECTIVE: To assess the effect of nerve sparing (NS) quality on self-reported patient urinary outcomes after radical prostatectomy. METHODS: A total of 102 preoperatively potent men underwent laparoscopic or robotic radical prostatectomy; NS was prospecti ... Full text Link to item Cite

The use of regenerative medicine in the management of invasive bladder cancer

Journal Article Advances in Urology · September 19, 2012 Muscle invasive and recurrent nonmuscle invasive bladder cancers have been traditionally treated with a radical cystectomy and urinary diversion. The urinary diversion is generally accomplished through the creation of an incontinent ileal conduit, continen ... Full text Cite

Partial adrenalectomy: underused first line therapy for small adrenal tumors.

Journal Article J Urol · July 2010 PURPOSE: Many patients with small adrenal masses undergo total adrenalectomy. We evaluated partial adrenalectomy outcomes by performing a comprehensive literature review. MATERIALS AND METHODS: We performed a PubMed search of the English language literatur ... Full text Link to item Cite