Evidence map›Paper›PMID 34555928›Full record

ArticleCirculation. Cardiovascular quality and outcomes2021

Physician Network Connections Associated With Faster De-Adoption of Dronedarone for Permanent Atrial Fibrillation.

Chad Stecher, Alexander Everhart, Laura Barrie Smith, Anupam Jena, Joseph S Ross, Nihar R Desai, Nilay Shah, Pinar Karaca-Mandic

Open access · bronzeAbstract read
In one paragraph

Article in Circulation. Cardiovascular quality and outcomes, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 36% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
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

8 authors at 6 institutions in 2 countries.

Chad StecherArizona State University, Phoenix (C.S.).ORCID 0000-0003-2218-3306
Alexander EverhartUniversity of Minnesota School of Public Health, Minneapolis (A.E.).ORCID 0000-0001-5192-6557
Laura Barrie SmithUrban Institute, Washington, DC (L.B.S.).ORCID 0000-0002-2693-1802
Anupam JenaHarvard Medical School, Boston, MA (A.J.).ORCID 0000-0002-9734-5122
Joseph S RossYale School of Public Health, New Haven, CT (J.S.R.).ORCID 0000-0002-9218-3320
Nihar R DesaiYale School of Medicine, New Haven, CT (J.S.R., N.R.D.).ORCID 0000-0003-2384-2545
Nilay ShahMayo Clinic Department of Health Sciences Research, Rochester, MN (N.S.).
Pinar Karaca-MandicNational Bureau of Economic Research, Cambridge, MA (A.J., P.K.-M.).ORCID 0000-0002-6682-1982
University of Minnesota · USYale University · USMayo Clinic in Florida · USNational Bureau of Economic Research · USUniversity of Phoenix · USUrban Institute · 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 Katherine Baicker · 1986 to 2026
$56.5M
Shared decision making for stroke prevention in atrial fibrillation (SDM4Afib)R01HL131535 · NHLBI · MAYO CLINIC ROCHESTER · PI MONTORI, VICTOR MANUEL · 2016 to 2020
$3.2M
Physician Determinants of Health Care Spending, Quality, and Patient OutcomesDP5OD017897 · OD · HARVARD MEDICAL SCHOOL · PI JENA, ANUPAM BAPU · 2013 to 2017
$2.1M
Leveraging Physician Networks to Improve Care and Outcomes for Low-Income PopulationsR01HL144644 · NHLBI · YALE UNIVERSITY · PI NDUMELE, CHIMA · 2019 to 2021
$1.6M
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 HS022882AHRQ HHS R01 HS025164AHRQ HHS R01 HS025402AHRQ HHS R03 HS025517FDA HHS U01 FD005938NCATS NIH HHS UL1 TR001863NHLBI NIH HHS R01 HL131535NHLBI NIH HHS R01 HL144644NHLBI NIH HHS R56 HL130496NIA NIH HHS P01 AG005842NIH HHS DP5 OD017897
6 · The paper itself

Abstract

backgroundPhysicians' professional networks are an important source of new medical information and have been shown to influence the adoption of new treatments, but it is unknown how physician networks impact the de-adoption of harmful practices.

methodsWe analyzed changes in physicians' use of dronedarone after the PALLAS trial (Palbociclib Collaborative Adjuvant Study; November 2011) showed that dronedarone increased the risk of death from cardiovascular events among patients with permanent atrial fibrillation. Deidentified administrative claims from the OptumLabs Data Warehouse were combined with physicians' demographic information from the Doximity database and publicly available data on physicians' patient-sharing relationships compiled by the Centers for Medicare and Medicaid Services. We used a linear probability model with an interrupted linear time trend specification to model the impact of the PALLAS trial on physicians' dronedarone usage between 2009 and 2014.

resultsBefore the PALLAS trial, the use of dronedarone was increasing by 0.22 percentage points per quarter (95% CI, 0.19-0.25) in our Medicare Advantage sample (N=343 429 patient-quarter observations) and 0.63 percentage points per quarter (95% CI, 0.52-0.75) in our commercially insured sample (N=44 402 patient-quarter observations). After the PALLAS trial and subsequent United States Food and Drug Administration black box warning, physicians in the Medicare Advantage sample with an above-median number of network connections to other physicians decreased their quarterly usage of dronedarone by 0.12 percentage points more per quarter (95% CI, -0.20 to -0.04;

conclusionsAfter controlling for a wide range of patient, physician, and geographic characteristics, physicians with a greater number of network connections were faster de-adopters of dronedarone for patients with permanent atrial fibrillation after the PALLAS trial and subsequent United States Food and Drug Administration black box warning detailed the harmfulness of dronedarone for these patients. Policies for improving physicians' responsiveness to new medical information should consider utilizing the influence of these important professional network relationships.

Indexed as

AmiodaroneAtrial FibrillationPhysiciansAgedAnti-Arrhythmia AgentsDronedaroneHumansMedicareUnited StatesAmiodaroneAnti-Arrhythmia AgentsDronedaroneatrial fibrillationdronedaroneguideline adherenceharm reductionpractice patterns, physicians

Identifiers

PMID34555928
PMCPMC8530939
OpenAlexW3200513035

What OpenQuestion holds

Textmetadata
LicenceTDM
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.