Trial reportCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2014
Physicians, clinics, and neighborhoods: multiple levels of influence on colorectal cancer screening.
Trial report in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed.
- Neighborhood effects in a behavioral randomized controlled trial.Health & place · 2014Trial
- Variation in mental health-related sickness absence duration: The role of occupational health professionals.PloS one · 2026Article
- Geographic and Physician-Level Variation in the Use of Hypofractionated Radiation Therapy for Breast Cancer in the U.S.: A Cross-Classified Multilevel Analysis.Advances in radiation oncology · 2024Article
- Predicting adoption of colorectal cancer screening among Korean Americans using a decision tree model.Ethnicity & health · 2023Article
- The effect of physician density on colorectal cancer stage at diagnosis: causal inference methods for spatial data applied on regional-level data.International journal of health geographics · 2023Article
- Cross-classified multilevel models (CCMM) in health research: A systematic review of published empirical studies and recommendations for best practices.SSM - population health · 2020Review
- Correlates of colorectal cancer screening rates in primary care clinics serving low income, medically underserved populations.Preventive medicine · 2019Article
- GIScience and cancer: State of the art and trends for cancer surveillance and epidemiology.Cancer · 2019Review
- Identifying quality improvement targets to facilitate colorectal cancer screening completion.Preventive medicine reports · 2018Article
- Multilevel predictors of colorectal cancer testing modality among publicly and privately insured people turning 50.Preventive medicine reports · 2017Article
- Geospatial Approaches to Cancer Control and Population Sciences.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2017Article
- Determinants of variations in self-reported barriers to colonoscopy among uninsured patients in a primary care setting.Journal of community health · 2015Article
- Missed opportunities: racial and neighborhood socioeconomic disparities in emergency colorectal cancer diagnosis and surgery.BMC cancer · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundWe (i) described variability in colorectal cancer (CRC) test use across multiple levels, including physician, clinic, and neighborhood; and (ii) compared the performance of novel cross-classified models versus traditional hierarchical models.
methodsWe examined multilevel variation in CRC test use among patients not up-to-date with screening in a large, urban safety net health system (2011-2012). Outcomes included: (i) fecal occult blood test (FOBT) or (ii) colonoscopy and were ascertained using claims data during a 1-year follow-up. We compared Bayesian (i) cross-classified four-level logistic models nesting patients within separate, nonoverlapping "levels" (physicians, clinics, and census tracts) versus (ii) three hierarchical two-level models using deviance information criterion. Models were adjusted for covariates (patient sociodemographic factors, driving time to clinic, and census tract poverty rate).
resultsOf 3,195 patients, 157 (4.9%) completed FOBT and 292 (9.1%) completed colonoscopy during the study year. Patients attended 19 clinics, saw 177 physicians, and resided in 332 census tracts. Significant variability was observed across all levels in both hierarchical and cross-classified models that was unexplained by measured covariates. For colonoscopy, variance was similar across all levels. For FOBT, physicians, followed by clinics, demonstrated the largest variability. Model fit using cross-classified models was superior or similar to 2-level hierarchical models.
conclusionsSignificant and substantial variability was observed across neighborhood, physician, and clinic levels in CRC test use, suggesting the importance of factors at each of these levels on CRC testing. IMPACT: Future multilevel research and intervention should consider the simultaneous influences of multiple levels, including clinic, physician, and neighborhood.
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