Evidence map›Paper›PMID 26957641›Full record

ArticleJournal of oncology practice2016

Are Small Reimbursement Changes Enough to Change Cancer Care? Reimbursement Variation in Prostate Cancer Treatment.

Shellie D Ellis, Ronald C Chen, Stacie B Dusetzina, Stephanie B Wheeler, George L Jackson, Matthew E Nielsen, William R Carpenter, Morris Weinberger

Open access · bronzeAbstract read
In one paragraph

Article in Journal of oncology practice, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
6.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Shellie D EllisUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC sellis4@kumc.edu.
Ronald C ChenUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
Stacie B DusetzinaUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
Stephanie B WheelerUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
George L JacksonUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
Matthew E NielsenUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
William R CarpenterUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
Morris WeinbergerUniversity of Kansas School of Medicine, Kansas City, KS; University of North Carolina at Chapel Hill, Chapel Hill; Durham Veterans Affairs Medical Center; and Duke University Medical Center, Durham, NC.
Duke Medical Center · USDuke University Hospital · USUniversity of Kansas · USUniversity of North Carolina at Chapel Hill · US

Funding

North Carolina Translational & Clinical Sciences Institute (NC TraCS)UL1TR001111 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BUSE, JOHN BERNARD, CAREY, TIMOTHY S · 2013 to 2017
$43.9M
Cancer Training GrantR25CA116339 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BASCH, ETHAN M., REEVE, BRYCE B · 2008 to 2017
$4.0M
NCATS NIH HHS UL1 TR001111NCATS NIH HHS UL1TR001111NCI NIH HHS N01 PC035136NCI NIH HHS N01 PC035139NCI NIH HHS N02 PC015105NCI NIH HHS R25 CA116339NCI NIH HHS R25CA116339
6 · The paper itself

Abstract

purposeThe Centers for Medicare and Medicaid Services recently initiated small reimbursement adjustments to improve the value of care delivered under fee-for-service. To estimate the degree to which reimbursement influences physician decision making, we examined utilization of gonadotropin-releasing hormone (GnRH) agonists among urologists as Part B drug reimbursement varied in a fee-for-service environment.

methodsWe analyzed treatment patterns of urologists treating 15,128 men included in SEER-linked Medicare claims who were diagnosed with localized prostate cancer between January 1, 2000, and December 31, 2003. We calculated a reimbursement generosity index to measure differences in GnRH agonist reimbursement among regional Medicare carriers and over time. We used multilevel analysis to control for patient and provider characteristics.

resultsAmong urologists treating early-stage and lower grade prostate cancer, variation in reimbursement was not associated with overuse of GnRH agonists from 2000 to 2003, a period of guideline stability (odds ratio, 1.00; 95% CI, 0.99 to 1.00).

conclusionSmall differences in androgen-deprivation therapy reimbursement generosity were not associated with differential use. Fee-for-service reimbursement changes currently being implemented to improve quality in fee-for-service Medicare may not affect patterns of cancer care.

Indexed as

Antineoplastic Agents, HormonalFee-for-Service PlansGonadotropin-Releasing HormoneHumansMaleMedicaidMedicarePatient CarePractice Patterns, Physicians'Prostatic NeoplasmsReimbursement MechanismsRetrospective StudiesSEER ProgramUnited StatesAntineoplastic Agents, HormonalGonadotropin-Releasing Hormone

Identifiers

PMID26957641
PMCPMC4960458
OpenAlexW2296710345

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.