Evidence map›Paper›PMID 34419007›Full record

ArticleBMC nephrology2021

Uptake of evidence by physicians: De-adoption of erythropoiesis-stimulating agents after the TREAT trial.

Khoa Vu, Jiani Zhou, Alexander Everhart, Nihar Desai, Jeph Herrin, Anupam B Jena, Joseph S Ross, Nilay D Shah, Pinar Karaca-Mandic

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

Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 80% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

9 authors at 4 institutions in 1 country.

Khoa VuDepartment of Applied Economics, University of Minnesota, 1994 Buford Avenue, St. Paul, MN, 55108, USA.
Jiani ZhouUniversity of Minnesota School of Public Health, 420 Delaware St. SE, Minneapolis, MN, 55455, USA.
Alexander EverhartUniversity of Minnesota School of Public Health, 420 Delaware St. SE, Minneapolis, MN, 55455, USA.
Nihar DesaiCardiovascular Medicine, Yale School of Medicine, 15 York Street, PO Box 208017, New Haven, CT, 06520-8017, USA.
Jeph HerrinYale School of Medicine, PO Box 2254, Charlottesville, Virginia, 22902, USA.
Anupam B JenaHarvard Medical School and National Bureau of Economic Research, 180 Longwood Avenue, Boston, MA, 02115, USA.
Joseph S RossYale School of Medicine, General Internal Medicine, P.O. Box 208093, New Haven, CT, 06520-8093, USA.
Nilay D ShahMayo Clinic, Rochester, MN, 55905, USA.
Pinar Karaca-MandicNational Bureau of Economic Research and OptumLabs Visiting Fellow, University of Minnesota Carlson School of Management, 321 19th Avenue South, Minneapolis, MN, 55455, USA. pkmandic@umn.edu.ORCID 0000-0002-6682-1982
University of Minnesota · USYale University · USMayo Clinic in Arizona · USNational Bureau of Economic Research · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Understanding and Improving Healthcare Decision-Making and Outcomes for People Living with Alzheimer's Disease and Related DementiasP01AG005842 · NIA · NATIONAL BUREAU OF ECONOMIC RESEARCH · PI JOSEPH J DOYLE · 1986 to 2026
$56.5M
Medical reversals: De-implementing ineffective and unsafe treatmentsR01HS025164 · AHRQ · UNIVERSITY OF MINNESOTA · PI KARACA-MANDIC, PINAR · 2017 to 2020
$1.4M
Diffusion of Clinical Evidence into Practice: Physician Networks, Delivery Organizations, and MarketsR56HL130496 · NHLBI · UNIVERSITY OF MINNESOTA · PI KARACA-MANDIC, PINAR · 2016 to 2016
$634k
AHRQ HHS R01 HS025164NCATS NIH HHS UL1 TR001863NHLBI NIH HHS R56 HL130496NIA NIH HHS P01 AG005842NIA NIH HHS P01AG005842
6 · The paper itself

Abstract

backgroundVariation in de-adoption of ineffective or unsafe treatments is not well-understood. We examined de-adoption of erythropoiesis-stimulating agents (ESA) in anemia treatment among patients with chronic kidney disease (CKD) following new clinical evidence of harm and ineffectiveness (the TREAT trial) and the FDA's revision of its safety warning.

methodWe used a segmented regression approach to estimate changes in use of epoetin alfa (EPO) and darbepoetin alfa (DPO) in the commercial, Medicare Advantage (MA) and Medicare fee-for-service (FFS) populations. We also examined how changes in both trends and levels of use were associated with physicians' characteristics.

resultsUse of DPO and EPO declined over the study period. There were no consistent changes in DPO trend across insurance groups, but the level of DPO use decreased right after the FDA revision in all groups. The decline in EPO use trend was faster after the TREAT trial for all groups. Nephrologists were largely more responsive to evidence than primary care physicians. Differences by physician's gender, and age were not consistent across insurance populations and types of ESA.

conclusionsPhysician specialty has a dominant role in prescribing decision, and that specializations with higher use of treatment (nephrologists) were more responsive to new evidence of unsafety and ineffectiveness.

Indexed as

AnemiaDarbepoetin alfaDiffusion of InnovationEpoetin AlfaHematinicsHumansPractice Guidelines as TopicPractice Patterns, Physicians'Regression AnalysisRenal Insufficiency, ChronicSafety-Based Drug WithdrawalsUnited StatesUnited States Food and Drug AdministrationDarbepoetin alfaEpoetin AlfaHematinicsDe-adoptionMedical safetyMedication utilizationPhysician prescribing

Identifiers

PMID34419007
PMCPMC8379779
OpenAlexW3194278915

What OpenQuestion holds

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LicenceCC BY
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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.