Evidence map›Paper›PMID 29630957›Full record

ArticleUrology2018

Impact of Accountable Care Organizations on Diagnostic Testing for Prostate Cancer.

Amy N Luckenbaugh, Brent K Hollenbeck, Samuel R Kaufman, Phyllis Yan, Lindsey A Herrel, Ted A Skolarus, Edward C Norton, Florian R Schroeck, Bruce L Jacobs, David C Miller and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Trends in the Cost of Cancer Care: Beyond Drugs.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020
    Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Amy N LuckenbaughDepartment of Urology, University of Michigan, Ann Arbor, MI.
Brent K HollenbeckDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Samuel R KaufmanDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Phyllis YanDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Lindsey A HerrelDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Ted A SkolarusDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Edward C NortonDepartment of Internal Medicine, University of Michigan, Ann Arbor, MI; Department of Economics, University of Michigan, Ann Arbor, MI; National Bureau of Economic Research, Cambridge, MA.
Florian R SchroeckThe Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH.
Bruce L JacobsDepartment of Urology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
David C MillerDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
John M HollingsworthDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Vahakn B ShahinianDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI; Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
Tudor BorzaDepartment of Urology, University of Michigan, Ann Arbor, MI; Dow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI. Electronic address: tborza@med.umich.edu.

Funding

Advanced Training in Urologic OncologyT32CA180984 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu, VAHAKN B SHAHINIAN · 2014 to 2026
$3.4M
Major surgery in patients with Alzheimer's disease and related dementias: effects of technology and policyR01AG048071 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K. · 2015 to 2019
$3.0M
Understanding optimal delivery systems for cancer careR01CA174768 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MILLER, DAVID C · 2014 to 2018
$2.0M
Assessing the Effects of Accountable Care Organizations on Surgical Spending and QualityR01HS024525 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLINGSWORTH, JOHN MALCOLM · 2016 to 2020
$1.7M
Impact of urologist practice organization and health policy on prostate cancer treatment, overtreatment and spendingR01HS025707 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K., SHAHINIAN, VAHAKN B · 2017 to 2021
$1.7M
Impact of Urologist Practice Structure on Prostate Cancer CareR01CA168691 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K., SHAHINIAN, VAHAKN B · 2013 to 2016
$1.6M
Will the Reach of ACOs Extend to Specialty Care?R01HS024728 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLINGSWORTH, JOHN MALCOLM · 2016 to 2020
$1.6M
Improving the prostate cancer survivorship care of veteransIK2HX001162 · VA · VETERANS HEALTH ADMINISTRATION · PI SKOLARUS, TED ALBERT · 2015 to 2018
–
AHRQ HHS R01 HS024525AHRQ HHS R01 HS024728AHRQ HHS R01 HS025707HSRD VA IK2 HX001162NCI NIH HHS R01 CA168691NCI NIH HHS R01 CA174768NCI NIH HHS T32 CA180984NIA NIH HHS R01 AG048071
6 · The paper itself

Abstract

objectiveTo determine if Accountable Care Organizations (ACOs) have the potential to accelerate the impact of prostate cancer screening recommendations.

methodsWe performed a retrospective cohort study using Medicare data evaluating the rates of PSA testing and prostate biopsy among men without prostate cancer between 2011 and 2014. We assessed PSA testing and biopsy rates before and after policy implementation among patients of ACO and non-ACO-aligned physicians. To control for secular trends, difference-in-differences methods were used to determine the effects of ACO implementation.

resultsWe identified 1.1 million eligible men without prostate cancer. From 2011 to 2014, the rates of PSA testing and biopsy declined by 22.3% and 7.0%, respectively. PSA testing declined similarly regardless of ACO participation-from 618 to 530 tests per 1000 beneficiaries among ACO-aligned physicians and from 607 to 516 tests per 1000 beneficiaries among non-ACO-aligned physicians (difference-in-differences P = .11). Whereas rates of prostate biopsy remained constant for patients of non-ACO-aligned physicians at 12 biopsies per 1000 beneficiaries, these rates increased from 11.6 to 12.5 biopsies per 1000 beneficiaries of patients of ACO-aligned physicians (difference-in-differences P = .03).

conclusionPSA testing and prostate biopsy rates decreased significantly between 2011 and 2014. The rate of PSA testing was not differentially affected by ACO participation. Conversely, there was an increase in the rate of prostate biopsy among patients of ACO-aligned physicians. ACOs did not accelerate deimplementation of PSA testing for eligible Medicare beneficiaries without prostate cancer.

Indexed as

Accountable Care OrganizationsEarly Detection of CancerAdenocarcinomaAgedAged, 80 and overBiopsy, NeedleCost SavingsGuideline AdherenceHumansInsurance BenefitsLife ExpectancyMaleMedicareMiddle AgedPhysicians, Primary CarePractice Guidelines as TopicProstate-Specific Antigen

Identifiers

PMID29630957
PMCPMC5975111

What OpenQuestion holds

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Registered trials

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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.