Evidence map›Paper›PMID 29691776›Full record

ArticleJournal of neuro-oncology2018

Management of glioblastoma at safety-net hospitals.

Michael G Brandel, Robert C Rennert, Christian Lopez Ramos, David R Santiago-Dieppa, Jeffrey A Steinberg, Reith R Sarkar, Arvin R Wali, J Scott Pannell, James D Murphy, Alexander A Khalessi

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

8 citing papers in PubMed.

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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

10 authors.

Michael G BrandelDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.ORCID http://orcid.org/0000-0001-7422-390X
Robert C RennertDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.
Christian Lopez RamosDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.
David R Santiago-DieppaDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.
Jeffrey A SteinbergDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.
Reith R SarkarDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, San Diego, CA, USA.
Arvin R WaliDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.
J Scott PannellDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA.
James D MurphyDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, San Diego, CA, USA.
Alexander A KhalessiDepartment of Neurosurgery, University of California, San Diego, 9300 Campus Point Drive, La Jolla, Mail Code 7893, San Diego, CA, 92037, USA. akhalessi@ucsd.edu.

Funding

National Institutes of Health TL1TR001443
6 · The paper itself

Abstract

backgroundSafety-net hospitals (SNHs) provide disproportionate care for underserved patients. Prior studies have identified poor outcomes, increased costs, and reduced access to certain complex, elective surgeries at SNHs. However, it is unknown whether similar patterns exist for the management of glioblastoma (GBM). We sought to determine if patients treated at HBHs receive equitable care for GBM, and if safety-net burden status impacts post-treatment survival.

methodsThe National Cancer Database was queried for GBM patients diagnosed between 2010 and 2015. Safety-net burden was defined as the proportion of Medicaid and uninsured patients treated at each hospital, and stratified as low (LBH), medium (MBH), and high-burden (HBH) hospitals. The impact of safety-net burden on the receipt of any treatment, trimodality therapy, gross total resection (GTR), radiation, or chemotherapy was investigated. Secondary outcomes included post-treatment 30-day mortality, 90-day mortality, and overall survival. Univariate and multivariate analyses were utilized.

resultsOverall, 40,082 GBM patients at 1202 hospitals (352 LBHs, 553 MBHs, and 297 HBHs) were identified. Patients treated at HBHs were significantly less likely to receive trimodality therapy (OR = 0.75, p < 0.001), GTR (OR = 0.84, p < 0.001), radiation (OR = 0.73, p < 0.001), and chemotherapy (OR = 0.78, p < 0.001) than those treated at LBHs. Patients treated at HBHs had significantly increased 30-day (OR = 1.25, p = 0.031) and 90-day mortality (OR = 1.24, p = 0.001), and reduced overall survival (HR = 1.05, p = 0.039).

conclusionsGBM patients treated at SNHs are less likely to receive standard-of-care therapies and have increased short- and long-term mortality. Additional research is needed to evaluate barriers to providing equitable care for GBM patients at SNHs.

Indexed as

HospitalsSafety-net ProvidersBrain NeoplasmsFemaleGlioblastomaHealthcare DisparitiesHumansMaleMedicaidMedically UninsuredMiddle AgedQuality of Health CareSurvival AnalysisTreatment OutcomeUnited StatesChemoradiationGlioblastomaGross total resectionSafety-net hospitalsTrimodality therapy

Identifiers

PMID29691776

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.