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A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study.

Publication ,  Journal Article
Eskander, A; Sahovaler, A; Shin, J; Deutsch, K; Crowson, M; Goyal, N; Witsell, DL; Schulz, K; Gross, ND; Weber, R; Khariwala, SS; Cohen, S ...
Published in: Bmc Oral Health
May 17, 2021

BACKGROUND: To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. METHODS: Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 with follow-up from 2013 to 2014. Diagnostic and procedure codes were utilized to identify oral cavity patients with a defined treatment modality. Compliance with guideline-recommended processes of care, which included pre-treatment imaging, thyroid-function testing (TFTs), multidisciplinary consultation and gastrostomy-tube insertion rates, were assessed. RESULTS: A total of 2752 patients were identified. Surgery alone was the most common treatment (60.8%), followed by surgery with adjuvant chemoradiotherapy (20.4%) and surgery with adjuvant radiotherapy (18.8%). Head/neck and chest imaging were obtained in 60% and 62.5% of patients respectively. Significant geographical differences in head and neck imaging were observed between North-central (64%), South (58.4%) and West (56.1%) regions (p = 0.026). Differences in chest imaging were also present between North-east (65%) and West (56.8%; p = 0.007). TFTs were obtained in 54.4% of the patients after radiation treatment, and 18.6% of patients had multidisciplinary consultation during the 6 months before and 3 months after initiation of treatment. During the year after treatment initiation, 21.2% of patients underwent G-tube placement, with significantly higher rates in patients receiving triple modality treatment (58%) when compared to surgery plus radiation (27%) and surgery alone (15%; p < 0.01). CONCLUSION: Adherence to evidence-based practices was low based on the database coding. These data suggest a potential to improve adherence and increase the routine use of practices delineated in national clinical practice guidelines. CLINICAL RELEVANCE: This study reflects a suboptimal adherence to guidelines based on the database employed. This study should be considered by healthcare providers and efforts should be maximized to follow the processes of care which have proven to impact on patient's outcomes.

Duke Scholars

Published In

Bmc Oral Health

DOI

EISSN

1472-6831

Publication Date

May 17, 2021

Volume

21

Issue

1

Start / End Page

270

Location

England

Related Subject Headings

  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Mouth Neoplasms
  • Humans
  • Guideline Adherence
  • Dentistry
  • Databases, Factual
  • 1105 Dentistry
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Eskander, A., Sahovaler, A., Shin, J., Deutsch, K., Crowson, M., Goyal, N., … Mehta, V. (2021). A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study. Bmc Oral Health, 21(1), 270. https://doi.org/10.1186/s12903-021-01616-x
Eskander, Antoine, Axel Sahovaler, Jennifer Shin, Konrado Deutsch, Matthew Crowson, Neerav Goyal, David L. Witsell, et al. “A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study.Bmc Oral Health 21, no. 1 (May 17, 2021): 270. https://doi.org/10.1186/s12903-021-01616-x.
Eskander A, Sahovaler A, Shin J, Deutsch K, Crowson M, Goyal N, et al. A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study. Bmc Oral Health. 2021 May 17;21(1):270.
Eskander, Antoine, et al. “A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study.Bmc Oral Health, vol. 21, no. 1, May 2021, p. 270. Pubmed, doi:10.1186/s12903-021-01616-x.
Eskander A, Sahovaler A, Shin J, Deutsch K, Crowson M, Goyal N, Witsell DL, Schulz K, Gross ND, Weber R, Khariwala SS, Cohen S, CyrLee DW, Mehta V. A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study. Bmc Oral Health. 2021 May 17;21(1):270.
Journal cover image

Published In

Bmc Oral Health

DOI

EISSN

1472-6831

Publication Date

May 17, 2021

Volume

21

Issue

1

Start / End Page

270

Location

England

Related Subject Headings

  • Retrospective Studies
  • Radiotherapy, Adjuvant
  • Mouth Neoplasms
  • Humans
  • Guideline Adherence
  • Dentistry
  • Databases, Factual
  • 1105 Dentistry