Evidence map›Paper›PMID 37146728›Full record

ArticleUrology2023

Practice Competition and Treatment of Newly Diagnosed Prostate Cancer.

Avinash Maganty, Brent K Hollenbeck, Samuel R Kaufman, Mary K Oerline, Lillian Y Lai, Megan E V Caram, Vahakn B Shahinian

Abstract read
In one paragraph

Article in Urology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. 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

7 authors.

Avinash MagantyDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI. Electronic address: avmagant@med.umich.edu.
Brent K HollenbeckDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Samuel R KaufmanDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Mary K OerlineDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Lillian Y LaiDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Megan E V CaramDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI.
Vahakn B ShahinianDow Division of Health Services Research, Department of Urology, University of Michigan, Ann Arbor, MI; Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.

Funding

Advanced Training in Urologic OncologyT32CA180984 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Ganesh S Palapattu, VAHAKN B SHAHINIAN · 2014 to 2026
$3.4M
Impact of the Merit-Based Incentive Payment System on the Quality of Prostate Cancer CareF32CA275021 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MAGANTY, AVINASH · 2022 to 2022
$86k
NCI NIH HHS F32 CA275021NCI NIH HHS T32 CA180984
6 · The paper itself

Abstract

objectiveTo examine the effect of urology practice market competition on use of treatment in men with newly diagnosed prostate cancer.

methodsWe performed a retrospective national cohort study of 48,067 Medicare beneficiaries with newly diagnosed prostate cancer between 2014 and 2018. The primary exposure was urology practice-level market competition. Markets were established by the flow of patients to a practice using a variable radius approach. Practice level competition was measured annually using the Herfindahl-Hirschman Index. The primary outcome was use of treatment for prostate cancer (ie, surgery, radiation, or cryotherapy) stratified by 10-year risk of noncancer mortality.

resultsBetween 2014 and 2018, there was a decrease in the total percent of urologists practicing in small single-specialty groups (49%-41%) with an increase in multispecialty practices (38%-47%). After adjusting for demographic and clinical characteristics, a lower percentage of men underwent treatment in practices with low competition relative to those managed in practices with high competition (70% vs 67.0%, P < .001). Among men with the highest risk of noncancer mortality, those managed in practices in the least competitive markets were less likely to receive treatment relative to men managed by practices in the most competitive markets (48% vs 60%, P-value<.001).

conclusionReduction in competition between urology practices is not associated with greater use of treatment in men with newly diagnosed prostate cancer, particularly in those with a high risk of noncancer mortality.

Indexed as

MedicareProstatic NeoplasmsAgedCohort StudiesHumansMaleRetrospective StudiesUnited States

Identifiers

PMID37146728
PMCPMC10524390

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.