Evidence map›Paper›PMID 28679805›Full record

ArticleHealth affairs (Project Hope)2017

Medicare Beneficiaries With Advanced Lung Cancer Experience Diverse Patterns Of Care From Diagnosis To Death.

Megan S Schuler, Nina R Joyce, Haiden A Huskamp, Elizabeth B Lamont, Laura A Hatfield

Abstract read
In one paragraph

Article in Health affairs (Project Hope), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 15% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Variation in Outpatient Postpartum Care Use in the United States: A Latent Class Analysis.Women's health issues : official publication of the Jacobs Institute of Women's Health
    Article
  7. The Effect of Hospice on End-of-Life Costs for Terminal Medicare Patients With HIV.Inquiry : a journal of medical care organization, provision and financing
    Article
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

5 authors at 5 institutions in 3 countries.

Megan S SchulerMegan S. Schuler is a health policy researcher at the RAND Corporation, in Boston, Massachusetts.
Nina R JoyceNina R. Joyce is a National Institute of Mental Health Postdoctoral Fellow in the Department of Health Care Policy, Harvard Medical School, in Boston.
Haiden A HuskampHaiden A. Huskamp is a professor in the Department of Health Care Policy, Harvard Medical School.
Elizabeth B LamontElizabeth B. Lamont is a Biomedical Informatics Research Training (BIRT) Fellow in the Division of General Medicine, Brigham and Women's Hospital, in Boston, and an associate professor of medicine at the Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School.
Laura A HatfieldLaura A. Hatfield (hatfield@hcp.med.harvard.edu) is an associate professor in the Department of Health Care Policy, Harvard Medical School.
Brigham and Women's Hospital · USHarvard University · USNational Institute of Health · AMRAND Corporation · USThe Centre for Health (New Zealand) · NZ

Funding

Health Policy Training Program: Promoting Outcomes, Quality, Equity and Diffusion of AdvancesT32MH019733 · NIMH · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI Benjamin Le Cook, Haiden A Huskamp · 1993 to 2026
$7.0M
Develop Patient Centered Outcomes Scholars for Comparative Effectiveness ResearchK12HS022998 · AHRQ · BROWN UNIVERSITY · PI TRIKALINOS, THOMAS · 2014 to 2018
$3.4M
Comparative Effectiveness of Treatment Regimens in Lung CancerR21AG047175 · NIA · HARVARD MEDICAL SCHOOL · PI HUSKAMP, HAIDEN A. · 2014 to 2015
$458k
AHRQ HHS K12 HS022998NIA NIH HHS R21 AG047175NIMH NIH HHS T32 MH019733
6 · The paper itself

Abstract

Characterizations of average end-of-life care for people with cancer can obscure important differences in patients' experiences. Using Medicare claims data for 14,257 patients diagnosed with extensive-stage small-cell lung cancer in the period 1995-2009, we used latent class analysis to identify classes of people with different care patterns. We characterized care trajectories from diagnosis to death using time spent in five care settings-home, hospital inpatient unit (acute), hospital intensive care unit (ICU), postacute skilled nursing facility, and hospice-and transitions across these settings. We identified four classes of patients: 66 percent spent the time primarily at home, 11 percent were primarily in hospice, 17 percent were largely in an acute setting, and 6 percent were largely in an ICU. Patients in these classes differed significantly in terms of baseline clinical characteristics, survival length, time spent in hospice, site of death, and spending. The findings show substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.

Indexed as

Lung NeoplasmsMedicareAgedContinuity of Patient CareFemaleHumansInsurance Claim ReviewMaleSEER ProgramTerminal CareUnited StatesElderlyHealth SpendingMedicareMedicine/Clinical IssuesVariations

Identifiers

PMID28679805
PMCPMC5641368
OpenAlexW2726832161

What OpenQuestion holds

Textmetadata
LicenceTDM
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.