Evidence map›Paper›PMID 34337452›Full record

ArticleEuropean urology open science2020

Impact of Diagnosing Urologists and Hospitals on the Use of Radical Cystectomy.

Vishnukamal Golla, Yong Shan, Hemalkumar B Mehta, Zachary Klaassen, Douglas S Tyler, Jacques Baillargeon, Ashish M Kamat, Stephen J Freedland, John L Gore, Karim Chamie and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology open science, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 46% 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

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. 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

12 authors at 6 institutions in 1 country.

Vishnukamal GollaDepartment of Urology, University of California, Los Angeles, CA, USA.
Yong ShanDepartment of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX, USA.
Hemalkumar B MehtaDepartment of Surgery, Section of Urology, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
Zachary KlaassenDepartment of Surgery, Section of Urology, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
Douglas S TylerDepartment of Surgery, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
Jacques BaillargeonDepartment of Preventive Medicine and Community Health, Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX, USA.
Ashish M KamatDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Stephen J FreedlandDepartment of Urology, Cedars Sinai Medical Center, Los Angeles, CA, USA.
John L GoreDepartment of Urology, The University of Washington, Seattle, WA, USA.
Karim ChamieDepartment of Urology, University of California, Los Angeles, CA, USA.
Yong-Fang KuoDepartment of Preventive Medicine and Community Health, Sealy Center of Aging, The University of Texas Medical Branch, Galveston, TX, USA.
Stephen B WilliamsDepartment of Surgery, Division of Urology, The University of Texas Medical Branch, Galveston, TX, USA.
The University of Texas Medical Branch at Galveston · USAugusta University · USUniversity of California, Los Angeles · USCedars-Sinai Medical Center · USThe University of Texas MD Anderson Cancer Center · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOne out of five patients with muscle-invasive bladder cancer undergo radical cystectomy-a guideline-recommended treatment. Previous studies have primarily evaluated patient characteristics associated with the use of radical cystectomy, ignoring potential nesting of data.

objectiveTo determine the impact of patient, diagnosing urologist, and hospital characteristics on the variation in the use of radical cystectomy. DESIGN SETTING AND

participantsThis is a retrospective cohort study using the Surveillance, Epidemiology, and End Results Registry (SEER)-Medicare linked database. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: A total of 7097 muscle-invasive bladder cancer patients and 4601 diagnosing urologists affiliated to 822 hospitals from January 1, 2002 to December 31, 2012 were analyzed. Multilevel logistic regression analyses were used to determine variation and factors associated with the use of radical cystectomy. RESULTS AND LIMITATIONS: Of the 7097 patients, only 27% underwent radical cystectomy. The intraclass correlation coefficient for variation in the use of radical cystectomy attributed to the hospital level was 4.3%. Higher radical cystectomy volume by diagnosing urologists (more than five vs zero to one surgery: odds ratio [OR], 1.27; 95% confidence interval [CI], 1.00-1.62) and hospitals (more than five vs zero to four surgeries: OR,1.48; 95% CI, 1.14-1.93) was associated with increased use of radical cystectomy. Patients diagnosed by female rather than male urologists were more likely to undergo radical cystectomy (OR, 1.32; 95% CI, 1.07-1.62).

conclusionsWe found that 4.3% variation in the use of radical cystectomy was attributed to the hospital level, leaving 95.7% variation in use unexplained. We identified significantly increased use among higher-volume and female diagnosing urologists. These findings support further investigation into measures beyond hospital volume, which largely impact the utilization of radical cystectomy. PATIENT SUMMARY: In this large population-based study, we found that 4.3% of variation in the use of radical cystectomy was attributed to the hospital level, leaving 95.7% variation in use unexplained. Higher radical cystectomy volume of diagnosing urologists and female urologists were independently associated with increased use of radical cystectomy. These findings support further investigation into measures beyond hospital volume, which largely impact the utilization of radical cystectomy.

Indexed as

Bladder cancerRadical cystectomyUtilizationVariation

Identifiers

PMID34337452
PMCPMC8317809
OpenAlexW3037874777

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.