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Michaela Ann Dinan

Michaela Ann Dinan

Adjunct Associate Professor in Population Health Sciences
Population Health Sciences
michaela.dinan@duke.edu
Duke Box 104023, Durham, NC 27710
60 College St, PO Box 208034, New Haven, CT 06520

Selected Publications

Off-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma.

Journal Article Clin Genitourin Cancer · March 15, 2025 INTRODUCTION: Immune checkpoint inhibitors (ICI) were approved by the Food and Drug Administration (FDA) for patients with metastatic renal cell carcinoma (mRCC) in the second- line setting in 2015 and the first-line (1L) in 2018. Little is known about 1 L ... Full text Link to item Cite

Strength of evidence underlying the CMS-FDA parallel review of comprehensive genomic profiling tests in the cancer setting.

Journal Article J Natl Cancer Inst · January 1, 2025 BACKGROUND: Although use of comprehensive genomic profiling was approved by a novel Centers for Medicare & Medicaid Services-US Food and Drug Administration parallel review process, the quality of the supporting evidence is unclear. We evaluated the rigor ... Full text Link to item Cite

Characterization of time toxicity in older patients with metastatic breast cancer.

Journal Article Breast Cancer Res Treat · October 2024 PURPOSE: Recognizing that receiving healthcare can be time intensive and burdensome, time toxicity has been conceptualized as the time spent by patients seeking healthcare. This study investigates the association between age at diagnosis and time toxicity ... Full text Link to item Cite

Changes in Facility Share of Medicaid-insured Patients With Urologic Cancers Following Implementation of the Patient Protection and Affordable Care Act.

Journal Article Urology · October 2024 OBJECTIVE: To examine Medicaid-insurance acceptance at facilities treating urologic cancers following implementation of the Affordable Care Act (ACA). METHODS: We conducted a retrospective, longitudinal study with a pre-post design. We accessed 2010-2017 d ... Full text Link to item Cite

Cost trends of metastatic renal cell carcinoma therapy: the impact of oral anticancer agents and immunotherapy.

Journal Article JNCI Cancer Spectr · September 2, 2024 BACKGROUND: Immunotherapy (IO) and oral anticancer agents (OAA) have improved outcomes for metastatic renal cell carcinoma (mRCC), but there is a need to understand real-world costs from the perspective of payers and patients. METHODS: We used retrospectiv ... Full text Link to item Cite

ACO leakage among gynecologic cancer patients: Incidence, predictors, and impact on annual Medicare expenditure.

Journal Article Gynecol Oncol · August 2024 OBJECTIVE: To examine patterns of Accountable Care Organizations (ACO) leakage, the receipt of healthcare by ACO-assigned patients from institutions outside assigned ACO network, among patients with gynecologic cancer. ACO leakage was estimated as rates of ... Full text Link to item Cite

Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma.

Journal Article JAMA Netw Open · April 1, 2024 IMPORTANCE: Area-level measures of sociodemographic disadvantage may be associated with racial and ethnic disparities with respect to receipt of treatment for metastatic renal cell carcinoma (mRCC) but have not been investigated previously, to our knowledg ... Full text Link to item Cite

Trends in new and persistent opioid use in older adults with and without cancer.

Conference J Natl Cancer Inst · February 8, 2024 BACKGROUND: The impact of ongoing efforts to decrease opioid use on patients with cancer remains undefined. Our objective was to determine trends in new and additional opioid use in patients with and without cancer. METHODS: This retrospective cohort study ... Full text Link to item Cite

Managing Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors.

Journal Article Am J Hosp Palliat Care · January 2024 OBJECTIVES: Many cancer survivors experience chronic pain after completing curative-intent treatment. Based on available data, chronic pain may be undertreated in this context; however, little is known about cancer survivors' experiences with clinical mana ... Full text Link to item Cite

Characteristics, healthcare utilization, and outcomes of patients with HER2-low breast cancer.

Journal Article Breast Cancer Res Treat · January 2024 PURPOSE: Treatment for HER2-low [defined as ImmunoHistoChemistry (IHC) 1 + or 2 + and negative/normal in Situ Hybridization (ISH)] breast cancer patients is rapidly evolving, yet we lack critical information about the HER2-low population. METHODS: We condu ... Full text Link to item Cite

Zillow MD: Do housing prices predict cancer survival?

Journal Article JNCI Cancer Spectr · October 31, 2023 Full text Link to item Cite

Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History.

Journal Article J Racial Ethn Health Disparities · October 2023 BACKGROUND: The purpose of this study was to estimate COVID-19 vaccination rate among Medicare beneficiaries with cancer history and determine whether COVID-19 vaccine uptake is higher among non-Hispanic White beneficiaries compared with racially and ethni ... Full text Link to item Cite

Relative Burden of Cancer and Noncancer Mortality Among Long-Term Survivors of Breast, Prostate, and Colorectal Cancer in the US.

Journal Article JAMA Netw Open · July 3, 2023 IMPORTANCE: Improvements in cancer outcomes have led to a need to better understand long-term oncologic and nononcologic outcomes and quantify cancer-specific vs noncancer-specific mortality risks among long-term survivors. OBJECTIVE: To assess absolute an ... Full text Link to item Cite

Factors Associated With Receipt of Molecular Testing and its Impact on Time to Initial Systemic Therapy in Metastatic Non-Small Cell Lung Cancer.

Journal Article Clin Lung Cancer · June 2023 BACKGROUND: Despite recommendations for molecular testing irrespective of patient characteristics, differences exist in receipt of molecular testing for oncogenic drivers amongst metastatic non-small cell lung cancer (mNSCLC) patients. Exploration into the ... Full text Link to item Cite

Disparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma.

Journal Article JNCI Cancer Spectr · May 2, 2023 Disparities in metastatic renal cell carcinoma (mRCC) outcomes persist in the era of oral anticancer agents (OAAs) and immunotherapies (IOs). We examined variation in the utilization of mRCC systemic therapies among US Medicare beneficiaries from 2015 to 2 ... Full text Link to item Cite

Clinician Perspectives on Managing Chronic Pain After Curative-Intent Cancer Treatment.

Journal Article JCO Oncol Pract · April 2023 PURPOSE: Among cancer survivors who have completed curative-intent treatment, the high prevalence and adverse consequences of chronic pain are well documented. Yet, research on clinicians' experiences with and perspectives on managing chronic pain among ca ... Full text Link to item Cite

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

Journal Article JCO Oncol Pract · February 2023 PURPOSE: New 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 patients ... Full text Link to item Cite

Genetic testing in privately insured women with surgically treated breast cancer.

Journal Article Breast Cancer Res Treat · February 2023 PURPOSE: Rates of BRCA1 and BRCA2 prevalence among women with breast cancer vary by age, hormone receptor status, and family history. Recommendations for genetic testing have varied between overlapping guidelines, payor coverage policies, and have evolved ... Full text Link to item Cite

Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis.

Journal Article Support Care Cancer · December 2022 PURPOSE: Cancer is a major reason for concurrent prescription of opioids with other sedating medications-particularly benzodiazepines and gabapentinoids-yet population-based assessments of the extent and predictors of concurrent prescribing among clinicall ... Full text Link to item Cite

Patient- And Provider-Level Predictors of Survival Among Patients With Metastatic Renal Cell Carcinoma Initiating Oral Anticancer Agents.

Journal Article Clin Genitourin Cancer · October 2022 PURPOSE: In an era of rapid expansion of FDA approvals for oral anticancer agents (OAAs), it is important to understand the factors associated with survival among real-world populations, which include groups not well-represented in pivotal clinical trials ... Full text Link to item 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

Patient, provider, and hospital factors associated with oral anti-neoplastic agent initiation and adherence in older patients with metastatic renal cell carcinoma.

Journal Article J Geriatr Oncol · June 2022 INTRODUCTION: Oral anti-neoplastic agents (OAAs) for metastatic renal cell carcinoma (mRCC) are associated with increased cancer-specific survival. However, racial disparities in survival persist and older adults have the lowest rates of cancer-specific su ... Full text Link to item Cite

Mediators of Racial Disparity in the Use of Prostate Magnetic Resonance Imaging Among Patients With Prostate Cancer.

Journal Article JAMA Oncol · May 1, 2022 IMPORTANCE: Racial disparity in the use of prostate magnetic resonance imaging (MRI) presents obstacles to closing gaps in prostate cancer diagnosis, treatment, and outcome. OBJECTIVE: To identify clinical, sociodemographic, and structural processes underl ... Full text Link to item Cite

Opioid Prescribing and Use Among Cancer Survivors: A Mapping Review of Observational and Intervention Studies.

Journal Article J Pain Symptom Manage · April 2022 CONTEXT: Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear. OBJECTIVES: To provide an evidence synthesis. METHODS: We se ... Full text Link to item Cite

Patterns and Predictors of Oral Anticancer Agent Use in Diverse Patients With Metastatic Renal Cell Carcinoma.

Journal Article JCO Oncol Pract · December 2021 PURPOSE: Availability of targeted oral anticancer agents (OAAs) has transformed care for patients with metastatic renal cell carcinoma (mRCC). Our objective was to identify patterns and predictors of OAA use within 12 months after mRCC was detected to unde ... Full text Link to item Cite

Low-touch, team-based care for co-morbidity management in cancer patients: the ONE TEAM randomized controlled trial.

Journal Article BMC Fam Pract · November 18, 2021 BACKGROUND: As treatments for cancer have improved, more people are surviving cancer. However, compared to people without a history of cancer, cancer survivors are more likely to die of cardiovascular disease (CVD). Increased risk for CVD-related mortality ... Full text Link to item Cite

Predictors of Chronic Opioid Use: A Population-Level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims.

Journal Article J Natl Cancer Inst · November 2, 2021 BACKGROUND: No population-based studies have examined chronic opioid use among cancer survivors who are diverse with respect to diagnosis, age group, and insurance status. METHODS: We conducted a retrospective cohort study using North Carolina cancer regis ... Full text Link to item Cite

Provider- and patient-level predictors of oral anticancer agent initiation and adherence in patients with metastatic renal cell carcinoma.

Journal Article Cancer Med · October 2021 BACKGROUND: Improving oral anticancer agent (OAA) initiation and adherence is the important quality-of-care issues, particularly since one fourth of anticancer agents being developed will be administered orally. Our objective was to identify provider- and ... Full text Link to item Cite

Adoption of New Risk Stratification Technologies Within US Hospital Referral Regions and Association With Prostate Cancer Management.

Journal Article JAMA Netw Open · October 1, 2021 IMPORTANCE: The clinical decisions that arise from prostate magnetic resonance imaging (MRI) and genomic testing in patients with prostate cancer are not well understood. OBJECTIVE: To evaluate the association between regional uptake of prostate MRI and ge ... Full text Link to item Cite

Analysis of Sociodemographic, Clinical, and Genomic Factors Associated With Breast Cancer Mortality in the Linked Surveillance, Epidemiology, and End Results and Medicare Database.

Journal Article JAMA Netw Open · October 1, 2021 IMPORTANCE: Understanding interactions among health service, sociodemographic, clinical, and genomic factors in breast cancer disparities research has been limited by a disconnect between health services and basic biological approaches. OBJECTIVE: To descr ... Full text Link to item Cite

Treatment at Integrated Centers Might Bridge the Academic-Community Survival Gap in Patients With Metastatic Non-Small Cell Carcinoma of the Lung.

Journal Article Clin Lung Cancer · July 2021 BACKGROUND: Non-small cell lung cancer (NSCLC) is responsible for the most cancer-related deaths in the United States. A better understanding of treatment-related disparities and ways to address them are important to improving survival for patients with me ... Full text Link to item Cite

Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015.

Journal Article J Geriatr Oncol · April 2021 BACKGROUND: Inflation-adjusted cancer costs in the United States have increased 40% in the last decade, leading to increasing financial burden on both payers and patients. Patients under 65 show substantial increases in utilization of expensive targeted th ... Full text Link to item Cite

Reporting of Study Participant Demographic Characteristics and Demographic Representation in Premarketing and Postmarketing Studies of Novel Cancer Therapeutics.

Journal Article JAMA Netw Open · April 1, 2021 IMPORTANCE: Adequate representation of demographic subgroups in premarketing and postmarketing clinical studies is necessary for understanding the safety and efficacy associated with novel cancer therapeutics. OBJECTIVE: To characterize and compare the rep ... Full text Link to item Cite

Real-world systemic therapy utilization in Medicare patients with locally advanced or metastatic urothelial carcinoma diagnosed between 2008 and 2012.

Journal Article J Geriatr Oncol · March 2021 PURPOSE: Treatment of advanced urothelial carcinoma (UC) remains a challenging clinical entity occurring predominantly in older patients with limited treatment options. However, real-world treatment patterns, differential cancer center access, and associat ... Full text Link to item Cite

Real-World Utilization of Oral Anticancer Agents and Related Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States.

Journal Article Kidney Cancer · 2021 BACKGROUND: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may un ... Full text Link to item Cite

Association of 21-Gene Assay (OncotypeDX) Testing and Receipt of Chemotherapy in the Medicare Breast Cancer Patient Population Following Initial Adoption.

Journal Article Clin Breast Cancer · December 2020 BACKGROUND: Our objective was to investigate why early studies regarding adoption of the 21-gene recurrence score (RS) assay did not show an initial reduction in the number of patients with breast cancer receiving real-world chemotherapy. MATERIALS AND MET ... Full text Link to item Cite

Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer.

Journal Article J Oncol Pract · December 2019 PURPOSE: Efforts to curb the rising costs of cancer care while improving quality include alternative payment models (APMs), which offer incentives to reduce avoidable spending and provide high-quality and cost-efficient care. The impact of proposed APMs ha ... Full text Link to item Cite

Proposal for Value-Based, Tiered Reimbursement for Tumor Biomarker Tests to Promote Innovation and Evidence Generation.

Journal Article JCO Precis Oncol · December 2019 Cancer precision medicine depends on high-quality tumor biomarker tests (TBTs) for treatment selection. TBT reimbursement within the United States in the current regulatory environment is not tied to premarket evidence of clinical utility, resulting in a v ... Full text Link to item Cite

Low-Risk Thyroid Cancer in Elderly: Total Thyroidectomy/RAI Predominates but Lacks Survival Advantage.

Journal Article J Surg Res · November 2019 BACKGROUND: Papillary thyroid cancer (PTC) is the fastest increasing cancer in the United States; incidence increases with age. It generally has a favorable prognosis but may behave more aggressively in older patients. This study aims to describe national ... Full text Link to item Cite

Extent of surgery for low-risk thyroid cancer in the elderly: Equipoise in survival but not in short-term outcomes.

Journal Article Surgery · November 2019 BACKGROUND: Total thyroidectomy is more common than lobectomy for low-risk papillary thyroid cancer, despite equipoise in survival. Because postoperative morbidity increases with age, we aimed to investigate how the extent of thyroidectomy affects short-te ... Full text Link to item Cite

Shared-patient physician networks and their impact on the uptake of genomic testing in breast cancer.

Journal Article Breast Cancer Res Treat · July 2019 BACKGROUND: Factors influencing the adoption of genomic testing are poorly understood, which may lead to inequitable and suboptimal treatment in cancer patients. Oncotype DX (ODX) is one of the first and most widely used genomic assays to stratify risk in ... Full text Link to item Cite

Chemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011.

Journal Article J Natl Compr Canc Netw · March 1, 2019 BACKGROUND: This study examined whether associations between 21-gene recurrence score (RS) genomic testing and lower costs among patients with early-stage, estrogen receptor-positive breast cancer are observable in real-world data from the Medicare populat ... Full text Link to item Cite

Abstract P4-09-08: Shared-patient physician networks and their impact on the uptake of genomic testing in early-stage breast cancer

Conference Cancer Research · February 15, 2019 AbstractBackground: Oncotype DX (ODX) or 21-gene recurrence score genomic testing is used to stratify risk and determine appropriate treatment in women with early-stage breast cancer (BC). Diffusion of ODX b ... Full text Cite

INITIAL ADOPTION OF RECOMBINANT HUMAN THYROID-STIMULATING HORMONE FOLLOWING THYROIDECTOMY IN THE MEDICARE THYROID CANCER PATIENT POPULATION.

Journal Article Endocr Pract · January 2019 OBJECTIVE: Recombinant human thyroid-stimulating hormone (rhTSH) has been approved for diagnostic (1998) and therapeutic (2008) indications in conjunction with radioactive iodine (RAI) administration post-thyroidectomy. Potential benefits of rhTSH, includi ... Full text Link to item Cite

Survival Comparison in Patients with Stage IV Lung Cancer in Academic versus Community Centers in the United States.

Journal Article J Thorac Oncol · December 2018 INTRODUCTION: Although metastatic NSCLC is widely treated in both academic centers (ACs) and community-based centers (CCs), it is unclear whether outcomes are similar across both settings. A growing variety of chemotherapies and targeted agents for an incr ... Full text Link to item Cite

Nationwide utilization and costs of targeted anti-cancer drugs for elderly patients with solid tumors in the United States, 2004-2015.

Conference Journal of Clinical Oncology · October 20, 2018 23 Background: Studies of patients age < 65 suggest large increases in utilization and costs of targeted anti-cancer drugs (TADs). However, use and costs of TADs in patients age 65+ have not been examined in a national sample. ... Full text Cite

Advanced imaging and hospice use in end-of-life cancer care.

Journal Article Support Care Cancer · October 2018 INTRODUCTION: Advanced imaging can inform prognosis and may be a mechanism to de-escalate unnecessary end-of-life care in patients with cancer. Associations between greater use of advanced imaging and less-aggressive end-of-life care in real-world practice ... Full text Link to item Cite

Association between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008-2011.

Journal Article Breast Cancer Res Treat · July 2018 PURPOSE: We sought to determine whether physician-level characteristics were associated with 21-gene recurrence score (RS) genomic testing to evaluate recurrence risk and benefit of adjuvant chemotherapy in patients with estrogen receptor-positive, node-ne ... Full text Link to item Cite

Androgen deprivation therapy (ADT) and cardiovascular mortality (CVD) in men with early-stage prostate cancer (PC) receiving curative radiation therapy (RT).

Conference Journal of Clinical Oncology · March 1, 2018 127 Background: Combined with RT, ADT is a highly effective and utilized treatment for men with localized PC, but some studies suggest that use of ADT leads to increased CVD. We explored the association between ADT and CVD in men ... Full text Cite

Real-world systemic therapy utilization in Medicare patients with locally advanced or metastatic urothelial carcinoma.

Conference Journal of Clinical Oncology · February 20, 2018 415 Background: Several immunotherapies recently have been approved for the treatment of locally advanced or metastatic bladder cancer that is prevalent in older adults. Utilization patterns in Medicare patients have not been exa ... Full text Cite

Trends in hospital-physician integration in medical oncology.

Journal Article Am J Manag Care · October 2017 OBJECTIVES: Hospitals have rapidly acquired medical oncology practices in recent years. Experts disagree as to whether these trends are related to oncology-specific market factors or reflect a general trend of hospital-physician integration. The objective ... Link to item Cite

Use of Whole Brain Radiation Therapy and Immune Checkpoint Inhibition in the Management of Brain Metastases

Conference International Journal of Radiation Oncology*Biology*Physics · October 2017 Full text Cite

Algorithms for prediction of the Oncotype DX recurrence score using clinicopathologic data: a review and comparison using an independent dataset.

Journal Article Breast Cancer Res Treat · February 2017 PURPOSE: Given the potential savings in cost and resource utilization, several algorithms have been proposed to predict Oncotype DX recurrence score (ODX RS) using commonly acquired histopathologic variables. Although it is promising, additional independen ... Full text Link to item Cite

How Many Lymph Nodes Are Enough? Assessing the Adequacy of Lymph Node Yield for Papillary Thyroid Cancer.

Journal Article J Clin Oncol · October 1, 2016 PURPOSE: Patients who undergo surgery for papillary thyroid cancer with only a limited lymph node examination are thought to be at risk for potentially harboring occult disease. However, this risk has not been objectively quantified and may have implicatio ... Full text Link to item Cite

Knowledge of pathologically versus clinically negative lymph nodes is associated with reduced use of radioactive iodine post-thyroidectomy for low-risk papillary thyroid cancer.

Journal Article Endocrine · June 2016 Cervical lymph node metastases are common in papillary thyroid cancer (PTC). Clinically negative lymph nodes confer uncertainty about true lymph node status, potentially prompting empiric postoperative radioactive iodine (RAI) administration even in low-ri ... Full text Link to item Cite

Patient-Centered Communication for Discussing Oncotype DX Testing.

Journal Article Cancer Invest · May 27, 2016 Oncotype DX testing (ODX), a tumor gene expression test, may improve breast cancer care, however, communicating results remains challenging. We identified patient-centered communication strategies/gaps for discussing ODX results. We applied a patient-cente ... Full text Link to item Cite

Otolaryngology utilization of speech-language pathology services for voice disorders.

Journal Article Laryngoscope · April 2016 OBJECTIVES/HYPOTHESIS: To examine the utilization of speech-language pathology (SLP) services by otolaryngology for outpatients with laryngeal/voice disorders. STUDY DESIGN: Retrospective analysis of a large, national, administrative US claims database. ME ... Full text Link to item Cite

Chemotherapy costs associated with receipt of the adoption of oncotype DX in early-stage breast cancer within the SEER-Medicare population.

Conference Journal of Clinical Oncology · March 1, 2016 32 Background: The Oncotype DX (ODX) multigene assay has been previously suggested to result in an overall reduction in the use of adjuvant chemotherapy and associated costs for women with early stage, estrogen receptor (ER)-posi ... Full text Cite

Resource Use in the Last Year of Life Among Patients Who Died With Versus of Prostate Cancer.

Journal Article Clin Genitourin Cancer · February 2016 UNLABELLED: We conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Among 34,727 patients, those who died of their prostate cancer had more hospice and outpatient use, less inpatient a ... Full text Link to item Cite

Racial Variation in the Uptake of Oncotype DX Testing for Early-Stage Breast Cancer.

Journal Article J Clin Oncol · January 10, 2016 PURPOSE: Oncotype DX (ODX) is a tumor gene-profiling test that aids in adjuvant chemotherapy decision-making. ODX has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in cancer care quality may ... Full text Link to item Cite

ONCOLOGISTS' BARRIERS AND FACILITATORS FOR ONCOTYPE DX USE: QUALITATIVE STUDY.

Journal Article Int J Technol Assess Health Care · January 2016 BACKGROUND: Oncotype DX (ODX), a tumor gene profiling test, has been incorporated into clinical guidelines to aid in adjuvant chemotherapy decision making for early-stage, hormone receptor positive breast cancer patients. Despite United States (U.S.) guide ... Full text Link to item Cite

Longitudinal Trends in Costs of Palliative Radiation for Metastatic Prostate Cancer.

Conference J Palliat Med · November 2015 BACKGROUND: In recent years, palliative treatment of prostate cancer metastases has been characterized by the use of more complex radiation treatment, despite a lack of evidence demonstrating a clinical benefit of these technologies in the palliative setti ... Full text Link to item Cite

Association Between Use of the 21-Gene Recurrence Score Assay and Receipt of Chemotherapy Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005-2009.

Journal Article JAMA Oncol · November 2015 IMPORTANCE: Guidelines recommend consideration of chemotherapy for most patients with early-stage, estrogen receptor-positive, invasive breast cancer in the absence of additional prognostic information. The 21-gene recurrence score (RS) assay has been show ... Full text Link to item Cite

Minimally Invasive Versus Open Pancreaticoduodenectomy for Cancer: Practice Patterns and Short-term Outcomes Among 7061 Patients.

Journal Article Ann Surg · August 2015 OBJECTIVES: To describe national practice patterns regarding utilization of minimally invasive pancreaticoduodenectomy (MIPD) and compare short-term outcomes with those following open pancreaticoduodenectomy for cancer. BACKGROUND: There is increasing inte ... Full text Link to item Cite

Racial variation in adjuvant chemotherapy initiation among breast cancer patients receiving oncotype DX testing.

Journal Article Breast Cancer Res Treat · August 2015 It is unknown whether racial differences exist in adjuvant chemotherapy initiation among women with similar oncotype DX (ODX) risk scores. We examined whether adjuvant chemotherapy initiation varied by race. Data come from the Phase III, Carolina Breast Ca ... Full text Link to item Cite

Presence and Number of Lymph Node Metastases Are Associated With Compromised Survival for Patients Younger Than Age 45 Years With Papillary Thyroid Cancer.

Journal Article J Clin Oncol · July 20, 2015 PURPOSE: Cervical lymph node metastases are recognized as a prognostic indicator only in patients age 45 years or older with papillary thyroid cancer (PTC); patients younger than age 45 years are perceived to have low-risk disease. The current American Joi ... Full text Link to item Cite

Initial Trends in the Use of the 21-Gene Recurrence Score Assay for Patients With Breast Cancer in the Medicare Population, 2005-2009.

Journal Article JAMA Oncol · May 2015 IMPORTANCE: In 2006, the Centers for Medicare & Medicaid Services approved coverage for the use of the 21-gene recurrence score (RS) assay in women with early-stage, estrogen receptor-positive, node-negative breast cancers to help guide recommendations for ... Full text Link to item Cite

Costs, effectiveness, and workload impact of management strategies for women with an adnexal mass

Journal Article Obstetrical and Gynecological Survey · April 22, 2015 Full text Cite

Adjuvant radioactive iodine therapy is associated with improved survival for patients with intermediate-risk papillary thyroid cancer.

Journal Article J Clin Endocrinol Metab · April 2015 CONTEXT: Papillary thyroid cancer (PTC) is the most common endocrine malignancy. The long-term prognosis is generally excellent. Due to a paucity of data, debate exists regarding the benefit of adjuvant radioactive iodine therapy (RAI) for intermediate-ris ... Full text Link to item Cite

Relative Incidence of Uterine Sarcoma and Surgical Treatments for Fibroids

Conference ANNALS OF SURGICAL ONCOLOGY · February 1, 2015 Link to item Cite

Impact of extent of surgery on survival for papillary thyroid cancer patients younger than 45 years.

Journal Article J Clin Endocrinol Metab · January 2015 CONTEXT: Papillary thyroid cancer (PTC) patients <45 years old are considered to have an excellent prognosis; however, current guidelines recommend total thyroidectomy for PTC tumors >1.0 cm, regardless of age. OBJECTIVE: Our objective was to examine the i ... Full text Link to item Cite

Costs, effectiveness, and workload impact of management strategies for women with an adnexal mass.

Journal Article J Natl Cancer Inst · January 2015 BACKGROUND: We compared the estimated clinical outcomes, costs, and physician workload resulting from available strategies for deciding which women with an adnexal mass should be referred to a gynecologic oncologist. METHODS: We used a microsimulation mode ... Full text Link to item Cite

Management of chemotherapy-induced neutropenia: measuring quality, cost, and value.

Journal Article J Natl Compr Canc Netw · January 2015 Treatment-associated neutropenia continues to represent the most common dose-limiting toxicity of cancer chemotherapy. It often leads to fever and infection, prompting hospitalization and occasionally resulting in serious morbidity, and even mortality, des ... Full text Link to item Cite

Impact of extent of surgery on survival for papillary thyroid cancer patients younger than 45 years

Journal Article Journal of Clinical Endocrinology and Metabolism · 2015 © 2015 by the Endocrine Society.Context: Papillary thyroid cancer (PTC) patients <45 years old are considered to have an excellent prognosis; however, current guidelines recommend total thyroidectomy for PTC tumors 1.0 cm, regardless of age. Objective: ... Full text Cite

Robotic thyroidectomy for cancer in the US: patterns of use and short-term outcomes.

Journal Article Ann Surg Oncol · November 2014 BACKGROUND: We describe nationally representative patterns of utilization and short-term outcomes from robotic versus open thyroidectomy for thyroid cancer. METHODS: Descriptive statistics and multivariable analysis were used to analyze patterns of use of ... Full text Link to item Cite

Impact of extent of surgery on survival in patients with small nonfunctional pancreatic neuroendocrine tumors in the United States.

Journal Article Ann Surg Oncol · October 2014 BACKGROUND: Nonfunctional pancreatic neuroendocrine tumors (PNETs) ≤2 cm have uncertain malignant potential, and optimal treatment remains unclear. Objectives of this study were to better understand their malignant potential, determine whether extent of su ... Full text Link to item Cite

Treatment patterns and outcomes for patients with adrenocortical carcinoma associated with hospital case volume in the United States.

Journal Article Ann Surg Oncol · October 2014 BACKGROUND: Adrenocortical carcinoma (ACC) is a rare, aggressive disease with no apparent change in treatment or survival in the United States over the past two decades. Our objective was to determine whether treatment patterns or clinical outcomes vary by ... Full text Link to item Cite

Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61,775 patients.

Journal Article Ann Surg · October 2014 OBJECTIVE: To examine the association between the extent of surgery and overall survival in a large contemporary cohort of patients with papillary thyroid cancer (PTC). BACKGROUND: Guidelines recommend total thyroidectomy for PTC tumors >1 cm, based on old ... Full text Link to item Cite

Redistribution of health care costs after the adoption of positron emission tomography among medicare beneficiaries with non-small-cell lung cancer, 1998-2005.

Journal Article J Thorac Oncol · April 2014 INTRODUCTION: Treatment patterns and cost implications of increased positron emission tomography imaging use since Medicare approval in 1998 are not well understood. We examined rates of surgery, radiotherapy, and chemotherapy and inpatient and total healt ... Full text Link to item Cite

Diagnosis change in voice-disordered patients evaluated by primary care and/or otolaryngology: a longitudinal study.

Journal Article Otolaryngol Head Neck Surg · January 2014 OBJECTIVE: Accurate diagnosis of a voice disorder is an essential first step toward its appropriate treatment. We examined differences in laryngeal diagnosis over time in outpatients evaluated by primary care physicians (PCPs) and/or otolaryngologists. STU ... Full text Link to item Cite

Oral contraceptives and risk of ovarian cancer and breast cancer among high-risk women: a systematic review and meta-analysis.

Journal Article J Clin Oncol · November 20, 2013 PURPOSE: To estimate the risks of ovarian cancer and breast cancer associated with oral contraceptive (OC) use among women at elevated risk owing to mutations in BRCA1/2 or a strong family history. METHODS: We searched PubMed, Embase, the Cochrane Database ... Full text Link to item Cite

Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review.

Journal Article Cancer Epidemiol Biomarkers Prev · November 2013 Oral contraceptives may influence the risk of certain cancers. As part of the AHRQ Evidence Report, Oral Contraceptive Use for the Primary Prevention of Ovarian Cancer, we conducted a systematic review to estimate associations between oral contraceptive us ... Full text Link to item Cite

Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis.

Journal Article Obstet Gynecol · August 2013 OBJECTIVE: To estimate the risk of venous thromboembolism, stroke, or myocardial infarction (MI) associated with the use of oral contraceptive pills (OCPs) and to describe how these risks vary by dose or formulation. DATA SOURCES: We searched PubMed, Embas ... Full text Link to item Cite

Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis.

Journal Article Obstet Gynecol · July 2013 OBJECTIVE: To estimate the overall reduction in ovarian cancer risk associated with the use of oral contraceptive pills (OCPs) and whether reduction in risk is affected by specifics of OCP use, such as formulation or duration of use. DATA SOURCES: We searc ... Full text Link to item Cite

Oral contraceptive use for the primary prevention of ovarian cancer.

Journal Article Evid Rep Technol Assess (Full Rep) · June 2013 OBJECTIVE: To estimate the overall balance of harms and benefits from the potential use of oral contraceptives (OCs) for the primary prevention of ovarian cancer DATA SOURCES: We searched PubMed®, Embase®, the Cochrane Database of Systematic Reviews, and C ... Link to item Cite

Variations in use of PET among Medicare beneficiaries with non-small cell lung cancer, 1998-2007.

Journal Article Radiology · June 2013 PURPOSE: To explore demographic and regional factors associated with the use of positron emission tomography (PET) in patients with non-small cell lung cancer (NSCLC) and to determine whether their associations with PET use has changed over time. MATERIALS ... Full text Link to item Cite

Cost-effectiveness of the 21-gene recurrence score assay in the context of multifactorial decision making to guide chemotherapy for early-stage breast cancer.

Journal Article Genet Med · March 2013 PURPOSE: New evidence is available regarding the utility of the 21-gene recurrence score assay in guiding chemotherapy use for node-negative, estrogen receptor-positive breast cancer. We applied this evidence in a decision-analytic model to re-evaluate the ... Full text Link to item Cite

Reply to M.S. Hofman et al.

Journal Article J Clin Oncol · February 20, 2013 Full text Link to item Cite

Risk of acute thromboembolic events with oral contraceptive use: a systematic review and meta-analysis.

Journal Article Obstetrics and gynecology · January 1, 2013 To estimate the risk of venous thromboembolism, stroke, or myocardial infarction (MI) associated with the use of oral contraceptive pills (OCPs) and to describe how these risks vary by dose or formulation. We searched PubMed, Embase, the Cochrane Database ... Cite

Stage migration, selection bias, and survival associated with the adoption of positron emission tomography among medicare beneficiaries with non-small-cell lung cancer, 1998-2003.

Journal Article J Clin Oncol · August 1, 2012 PURPOSE: Previous studies have linked the use of positron emission tomography (PET) with improved outcomes among patients with non-small-cell lung cancer (NSCLC). However, this association may be confounded by PET-induced stage migration and selection bias ... Full text Link to item Cite

Changes in initial treatment for prostate cancer among Medicare beneficiaries, 1999-2007.

Journal Article Int J Radiat Oncol Biol Phys · April 1, 2012 PURPOSE: In the absence of evidence from large clinical trials, optimal therapy for localized prostate cancer remains unclear; however, treatment patterns continue to change. We examined changes in the management of patients with prostate cancer in the Med ... Full text Link to item Cite

Resource use, costs, and utility estimates for patients with cystic fibrosis with mild impairment in lung function: analysis of data collected alongside a 48-week multicenter clinical trial.

Journal Article Value Health · 2012 OBJECTIVES: Transport of ions to generate epithelial rehydration (TIGER)-1 was a randomized trial conducted to evaluate the safety and efficacy of denufosol versus placebo in patients with cystic fibrosis with mild impairment in lung function. The trial me ... Full text Link to item Cite

Personalized medicine is more than genomic medicine: confusion over terminology impedes progress towards personalized healthcare.

Journal Article Per Med · January 2012 Over the last decade, scientific discovery and technological advances have created great anticipation for capabilities to tailor individual medical decisions and provide personalized healthcare. Despite some advances, adoption has been sporadic and there r ... Full text Link to item Cite

Financial implications of changes in the initial treatment of prostate cancer among Medicare beneficiaries.

Journal Article J Clin Oncol · May 20, 2011 6115 Background: The traditional treament approaches for localized prostate cancer have included androgen suppression, watchful waiting, open radical prostatectomy, external beam radiation therapy and interstitial brachytherapy. In the last decade a number ... Link to item Cite

Use of patient-reported outcomes in randomized, double-blind, placebo-controlled clinical trials.

Journal Article Med Care · April 2011 BACKGROUND: To optimize the use of patient-reported outcomes (PROs) in clinical research, it is first necessary to review the current use of these outcomes in clinical trials to determine under what circumstances they are most useful, and to reveal current ... Full text Link to item Cite

Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

Journal Article Acad Med · November 2010 The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which ... Full text Link to item Cite

Changes in the use and costs of diagnostic imaging among Medicare beneficiaries with cancer, 1999-2006.

Journal Article JAMA · April 28, 2010 CONTEXT: Emerging technologies, changing diagnostic and treatment patterns, and changes in Medicare reimbursement are contributing to increasing use of imaging in cancer. Imaging is the fastest growing expense for Medicare but has not been examined among b ... Full text Link to item Cite

SplicerAV: a tool for mining microarray expression data for changes in RNA processing.

Journal Article BMC Bioinformatics · February 25, 2010 BACKGROUND: Over the past two decades more than fifty thousand unique clinical and biological samples have been assayed using the Affymetrix HG-U133 and HG-U95 GeneChip microarray platforms. This substantial repository has been used extensively to characte ... Full text Open Access Link to item Cite

Improving health by taking it personally.

Journal Article JAMA · January 27, 2010 Full text Link to item Cite

Costs and length of stay for patients with and without sickle cell disease after hysterectomy, appendectomy, or knee replacement.

Journal Article Am J Hematol · January 2010 Patients with sickle cell disease (SCD) who undergo surgical procedures experience greater risk for preoperative and postoperative complications than patients without SCD; however, the impact of SCD on inpatient resource use and costs had not been reported ... Full text Link to item Cite

Outcomes of inpatients with and without sickle cell disease after high-volume surgical procedures.

Journal Article Am J Hematol · November 2009 In this study, we examined differences in inpatient costs, length of stay, and in-hospital mortality between hospitalizations for patients with and without sickle cell disease (SCD) undergoing high-volume surgical procedures. We used Clinical Classificatio ... Full text Link to item Cite

Effects of disclosing financial interests on attitudes toward clinical research.

Journal Article J Gen Intern Med · June 2008 BACKGROUND: The effects of disclosing financial interests to potential research participants are not well understood. OBJECTIVE: To examine the effects of financial interest disclosures on potential research participants' attitudes toward clinical research ... Full text Link to item Cite

Perspectives of clinical research coordinators on disclosing financial conflicts of interest to potential research participants.

Journal Article Clin Trials · 2007 BACKGROUND: Disclosing financial interests to potential research participants during the informed consent process is one strategy for managing conflicts of interest. Given that clinical research coordinators are typically charged with administering the inf ... Full text Link to item Cite

Views of potential research participants on financial conflicts of interest: barriers and opportunities for effective disclosure.

Journal Article J Gen Intern Med · September 2006 BACKGROUND: There is little guidance regarding how to disclose researchers' financial interests to potential research participants. OBJECTIVE: To determine what potential research participants want to know about financial interests, their capacity to under ... Full text Link to item Cite

Policies of academic medical centers for disclosing financial conflicts of interest to potential research participants.

Journal Article Acad Med · February 2006 PURPOSE: To document the current state of institutional review board (IRB) and conflict of interest committee policies regarding disclosures of financial conflicts of interest to potential research participants, and to use this information to identify and ... Full text Link to item Cite

Disclosing conflicts of interest in clinical research: views of institutional review boards, conflict of interest committees, and investigators.

Journal Article J Law Med Ethics · 2006 Strategies for disclosing investigators' financial interests to potential research participants have been adopted by many research institutions. However, little is known about how decisions are made regarding disclosures of financial interests to potential ... Full text Link to item Cite

Comparison of conflict of interest policies and reported practices in academic medical centers in the United States.

Journal Article Account Res · 2006 The authors reviewed the conflict of interest policies of 9 academic medical centers in the United States and interviewed members of the Institutional Review Boards (IRBs) and Conflict of Interest Committees (COICs) at those institutions. They found that m ... Full text Link to item Cite