Evidence map›Paper›PMID 36169753›Full record

ArticleAnnals of surgical oncology2023

Palliative Therapies in Metastatic Pancreatic Cancer: Does Medicaid Expansion Make a Difference?

Hamza Khan, Deepa Cherla, Krista Mehari, Manish Tripathi, Thomas W Butler, Errol D Crook, Martin J Heslin, Fabian M Johnston, Annabelle L Fonseca

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

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.0field-weighted citation impact, top 9% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Disparities in access to surgical resection in patients with pancreatic cancer - a systematic review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2025
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Hamza KhanDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Deepa CherlaDepartment of Surgery, The University of South Alabama, Mobile, AL, USA.
Krista MehariDepartment of Psychology, The University of South Alabama, Mobile, AL, USA.
Manish TripathiKellogg School of Management, Northwestern University, Chicago, IL, USA.
Thomas W ButlerDepartment of Internal Medicine, The University of South Alabama, Mobile, AL, USA.
Errol D CrookDepartment of Internal Medicine, The University of South Alabama, Mobile, AL, USA.
Martin J HeslinDepartment of Surgery, The University of South Alabama, Mobile, AL, USA.
Fabian M JohnstonDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Annabelle L FonsecaDepartment of Surgery, The University of South Alabama, Mobile, AL, USA. afonseca@health.southalabama.edu.
University of South Alabama · USJohns Hopkins Medicine · USJohns Hopkins University · USNorthwestern University · US

Funding

Clinical and Laboratory Research Training for Surgical OncologistsT32CA126607 · NCI · JOHNS HOPKINS UNIVERSITY · PI CAMERON, ANDREW M. · 2008 to 2024
$6.0M
Using Modifiable Factors to Predict Risk of non-Guideline Concordant Treatment in Foregut Cancers: A Novel Implementation Science-based approachK23MD018383 · NIMHD · UNIVERSITY OF SOUTH ALABAMA · PI Annabelle L Fonseca · 2023 to 2026
$647k
NCI NIH HHS T32 CA126607NIMHD NIH HHS K23 MD018383
6 · The paper itself

Abstract

backgroundThe aim of this study was to evaluate the impact of medicaid expansion (ME) on receipt of palliative therapies in metastatic pancreatic cancer patients. PATIENTS AND

methodsA difference-in-differences (DID) approach was used to analyze patients with metastatic pancreatic cancer identified from the National Cancer Database diagnosed during two time periods: pre-expansion (2010-2012) and post-expansion (2014-2016). Patients diagnosed while residing in ME states were compared with those in non-ME states. Multivariable logistic regression was used to identify predictors of receipt of palliative therapies.

resultsOf 87,738 patients overall, 7483(18.1%) received palliative therapies in the pre-expansion, while 10,211(21.5%) received palliative therapies in the post-expansion period. In the pre-expansion period, treatment at a high-volume facility (HVF) (odds ratio [OR] 1.10, 95% confidence interval [CI] 1.02-1.18) and non-west geographic location were predictive of increased palliative therapies. In the post-expansion period, treatment at an HVF (OR 1.09, 95% CI 1.02-1.16), geographic location, and living in an ME state at the time of diagnosis (OR 1.14, 95% CI 1.06-1.22) were predictive of increased palliative therapies. Older age, highest quartile median income (zip-code based), and treatment at a nonacademic facility were independently associated with decreased palliative therapies in both periods. DID analysis demonstrated that patients with metastatic pancreatic cancer living in ME states had increased receipt of palliative therapies relative to those in non-ME states (DID = 2.68, p < 0.001).

conclusionsThe overall utilization of palliative therapies in metastatic pancreatic cancer is low. Multiple sociodemographic disparities exist in the receipt of palliative therapies. ME is associated with increased receipt of palliative therapies in patients with metastatic pancreatic cancer.

Indexed as

Pancreatic NeoplasmsHumans

Identifiers

PMID36169753
PMCPMC11539046
OpenAlexW4297459790

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.