Evidence map›Paper›PMID 31028607›Full record

ArticleBreast cancer research and treatment2019

Shared-patient physician networks and their impact on the uptake of genomic testing in breast cancer.

Jason Rotter, Lauren Wilson, Melissa A Greiner, Craig E Pollack, Michaela Dinan

Abstract read
In one paragraph

Article in Breast cancer research and treatment, 2019. 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
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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

5 authors.

Jason RotterDepartment of Population Health Science, Duke University School of Medicine, Durham, USA. jrotter@live.unc.edu.ORCID http://orcid.org/0000-0002-4386-332X
Lauren WilsonDepartment of Population Health Science, Duke University School of Medicine, Durham, USA.
Melissa A GreinerDepartment of Population Health Science, Duke University School of Medicine, Durham, USA.
Craig E PollackJohns Hopkins School of Medicine, Baltimore, USA.
Michaela DinanDepartment of Population Health Science, Duke University School of Medicine, Durham, USA.

Funding

National Utilization Patterns of Oncotype DX in Early Stage Breast CancerR00HS022189 · AHRQ · DUKE UNIVERSITY · PI DINAN, MICHAELA ANN · 2015 to 2017
$746k
Agency for Healthcare Research and Quality R00HS022189AHRQ HHS R00 HS022189
6 · The paper itself

Abstract

backgroundFactors influencing the adoption of genomic testing are poorly understood, which may lead to inequitable and suboptimal treatment in cancer patients. Oncotype DX (ODX) is one of the first and most widely used genomic assays to stratify risk in women with early-stage breast cancer (BC). Physician networks have emerged as a significant and modifiable driver of emerging medical technology adoption.

objectiveTo investigate the association between physician network connections and the use of ODX testing.

methodsA retrospective study of women diagnosed with BC using SEER-Medicare from 2008 to 2012 was used. Medical oncologists were "connected" if they shared two or more patients during the early-adoption period (2008-2009). Parallel physician- and patient-level analyses employed logistic mixed models to determine the impact of being "connected" to an early-adopting oncologist on ODX use in 2011-2012.

results24,463 women met study criteria; 12,874 were diagnosed with BC in the early-adoption time period. 2129 medical oncologists treated these patients from 2008 to 2009. Medical oncologists had a median number of peer connections of 4 (IQR: 2-7). Peer connection to an early-adopting provider in 2008-2009 was associated with a 1.7-fold increase in providers' adopting ODX (95% CI: 1.1-2.6) and a 1.5-fold increase in their patients receiving ODX (95% CI: 1.1-2.0) in 2010-2012.

conclusionsPeer connectedness to an early-adopting physician predicts ODX adoption in both physician-level and patient-level analyses. Provider networks may provide a potent and modifiable means to modulate the diffusion of emerging medical technologies. Efforts to increase testing, where appropriate, may benefit from peer-to-peer-based connection strategies.

Indexed as

Breast NeoplasmsCommunity NetworksFemaleGenetic TestingGenomicsHealth PersonnelHumansMaleNeoplasm StagingPhysician-Patient RelationsReagent Kits, DiagnosticRetrospective StudiesSEER ProgramReagent Kits, DiagnosticBreast cancerGenetic testingOncotype DXProvider network

Identifiers

PMID31028607
PMCPMC6556129

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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.