2023
Statin use, survival and incidence of thrombosis among older patients with polycythemia vera and essential thrombocythemia
Podoltsev N, Wang R, Shallis R, Stempel J, Di M, Neparidze N, Zeidan A, Huntington S, Giri S, Hull S, Gore S, Ma X. Statin use, survival and incidence of thrombosis among older patients with polycythemia vera and essential thrombocythemia. Cancer Medicine 2023, 12: 18889-18900. PMID: 37702132, PMCID: PMC10557879, DOI: 10.1002/cam4.6528.Peer-Reviewed Original ResearchConceptsIncidence of thrombosisPolycythemia veraEssential thrombocythemiaStatin useOlder adultsEnd Results-Medicare databasePopulation-based cohort studyArterial thrombotic eventsSurvival of patientsUse of statinsClaims-based studyRisk of thrombosisCardiovascular morbidityCause mortalityTreatment weighting (IPTW) approachCohort studyOlder patientsOverall survivalThrombotic eventsVenous thrombosisPatient populationPrevious registryStatinsTherapeutic strategiesET subgroupOlder patients with chronic myeloid leukemia face suboptimal molecular testing and tyrosine kinase inhibitor adherence
Shallis R, Wang R, Zeidan A, Huntington S, Neparidze N, Stempel J, Mendez L, Di M, Ma X, Podoltsev N. Older patients with chronic myeloid leukemia face suboptimal molecular testing and tyrosine kinase inhibitor adherence. Blood Advances 2023, 7: 3213-3224. PMID: 36939371, PMCID: PMC10338212, DOI: 10.1182/bloodadvances.2022009074.Peer-Reviewed Original ResearchConceptsChronic myeloid leukemiaTKI adherenceTKI initiationOlder patientsMyeloid leukemiaEnd Results-Medicare databaseTyrosine kinase inhibitor usePolymerase chain reaction testingQuantitative polymerase chain reaction testingOlder patient populationCare of patientsHealth care accessReal-world studyReal-world evidenceLow socioeconomic statusLow-income subsidyFirst yearInfluenza vaccinationInhibitor useWorse survivalTKI treatmentMultivariable analysisPatient populationOptimal monitoringCare accessSecond malignancies among older patients with classical myeloproliferative neoplasms treated with hydroxyurea
Wang R, Shallis R, Stempel JM, Huntington SF, Zeidan AM, Gore SD, Ma X, Podoltsev NA. Second malignancies among older patients with classical myeloproliferative neoplasms treated with hydroxyurea. Blood Advances 2023, 7: 734-743. PMID: 35917456, PMCID: PMC9989521, DOI: 10.1182/bloodadvances.2022008259.Peer-Reviewed Original ResearchConceptsSecond malignanciesAcute myeloid leukemiaOlder patientsMyelodysplastic syndromeMyeloproliferative neoplasmsHU usersHigh riskPolycythemia veraEssential thrombocythemiaRisk of SMAML/myelodysplastic syndromeClassical Philadelphia chromosome-negative myeloproliferative neoplasmsImpact of hydroxyureaRetrospective cohort studyUse of hydroxyureaPhiladelphia chromosome-negative myeloproliferative neoplasmsClassical myeloproliferative neoplasmsCumulative incidence probabilityCohort studyCytoreductive therapyPatient characteristicsMedian ageHU useMyeloid leukemiaSecondary myelofibrosisUse of Monitoring Tests Among Patients With Localized Prostate Cancer Managed With Observation
Leapman M, Wang R, Loeb S, Seibert T, Gaylis F, Lowentritt B, Brown G, Chen R, Lin D, Witte J, Cooperberg M, Catalona W, Gross C, Ma X. Use of Monitoring Tests Among Patients With Localized Prostate Cancer Managed With Observation. Journal Of Urology 2023, 209: 710-718. PMID: 36753746, DOI: 10.1097/ju.0000000000003159.Peer-Reviewed Original ResearchConceptsIntermediate-risk prostate cancerMixed-effects Poisson regressionPSA testingProstate biopsyProstate cancerEffects Poisson regressionMedicare beneficiariesPoisson regressionAdditional prostate biopsyRetrospective cohort studyProstate MRILocalized prostate cancerRepeat prostate biopsyRate of biopsyRace/ethnicityCensus tract povertyMedian followCohort studyMedian ageMonitoring testsProvider factorsPSA testClinical riskBiopsySociodemographic factors
2022
Mediators of Racial Disparity in the Use of Prostate Magnetic Resonance Imaging Among Patients With Prostate Cancer
Leapman MS, Dinan M, Pasha S, Long J, Washington SL, Ma X, Gross CP. Mediators of Racial Disparity in the Use of Prostate Magnetic Resonance Imaging Among Patients With Prostate Cancer. JAMA Oncology 2022, 8: 687-696. PMID: 35238879, PMCID: PMC8895315, DOI: 10.1001/jamaoncol.2021.8116.Peer-Reviewed Original ResearchConceptsProstate magnetic resonance imagingMagnetic resonance imagingPopulation-based cohort studyProstate cancerWhite patientsRacial disparitiesCohort studyMRI useIndividual-level socioeconomic statusEligible male patientsSocioeconomic statusNeighborhood-level socioeconomic statusLocalized prostate cancerProstate cancer diagnosisObserved racial disparitiesProstate magnetic resonanceMediation analysisPathologic factorsMale patientsUS SurveillanceBlack patientsMedicare databaseMAIN OUTCOMEUS adultsNew diagnosis
2021
Clinical effectiveness of DNA methyltransferase inhibitors and lenalidomide in older patients with refractory anemia with ring sideroblasts: a population-based study in the United States
Wang X, Zeidan AM, Wang R, Bewersdorf JP, Zhang C, Podoltsev NA, Huntington SF, Gore SD, Ma X. Clinical effectiveness of DNA methyltransferase inhibitors and lenalidomide in older patients with refractory anemia with ring sideroblasts: a population-based study in the United States. Leukemia & Lymphoma 2021, 62: 2438-2447. PMID: 33899659, DOI: 10.1080/10428194.2021.1913142.Peer-Reviewed Original ResearchConceptsPopulation-based studyDNA methyltransferase inhibitorRARS patientsRefractory anemiaRing sideroblastsRed blood cell transfusion independenceEnd Results-Medicare databaseLower-risk myelodysplastic syndromesPopulation-based cohortMethyltransferase inhibitorRBC-TIMedian durationMedian survivalOlder patientsTransfusion independenceTreatment initiationMyelodysplastic syndromeClinical effectivenessBetter survivalLenalidomideTreatment groupsPatientsRS statusOlder adultsAnemiaPatterns of Care for Older Patients With Myelofibrosis: A Population-based Study
Meckstroth S, Wang R, Ma X, Podoltsev N. Patterns of Care for Older Patients With Myelofibrosis: A Population-based Study. Clinical Lymphoma Myeloma & Leukemia 2021, 21: e551-e558. PMID: 33648884, DOI: 10.1016/j.clml.2021.01.025.Peer-Reviewed Original ResearchConceptsPatterns of careOlder patientsEnd Results-Medicare databaseJAK inhibitor eraHigh-risk patientsPopulation-based studyUse of ruxolitinibJAK inhibitor ruxolitinibUnited States FoodRuxolitinib approvalMedian ageMedian timeTreatment patternsD claimsCurrent treatmentInhibitor ruxolitinibPatientsBetter outcomesClinical experienceDrug AdministrationMedicare Part BMyelofibrosisRuxolitinibStates FoodNew drugsRegional Adoption of Commercial Gene Expression Testing for Prostate Cancer
Leapman MS, Wang R, Ma S, Gross CP, Ma X. Regional Adoption of Commercial Gene Expression Testing for Prostate Cancer. JAMA Oncology 2021, 7: 52-58. PMID: 33237277, PMCID: PMC7689565, DOI: 10.1001/jamaoncol.2020.6086.Peer-Reviewed Original ResearchConceptsProstate cancerCohort studyGenomic testingTissue-based genomic testsProportion of patientsDynamic cohort studyProstate cancer careProstate cancer screeningHospital referral region levelCommercial health insuranceGene expression testingEligible patientsMedian ageCancer careCancer screeningInclusion criteriaFindings highlight factorsHRR levelMAIN OUTCOMEAdministrative claimsGroup 2Group 1Medicare beneficiariesPatientsMedian household income
2020
Clinical outcomes of older patients with AML receiving hypomethylating agents: a large population-based study in the United States
Zeidan AM, Wang R, Wang X, Shallis RM, Podoltsev NA, Bewersdorf JP, Huntington SF, Neparidze N, Giri S, Gore SD, Davidoff AJ, Ma X. Clinical outcomes of older patients with AML receiving hypomethylating agents: a large population-based study in the United States. Blood Advances 2020, 4: 2192-2201. PMID: 32433746, PMCID: PMC7252544, DOI: 10.1182/bloodadvances.2020001779.Peer-Reviewed Original ResearchConceptsAcute myeloid leukemiaDecitabine-treated patientsTransfusion independenceRed blood cell transfusion independenceLarge population-based studyOlder AML patientsRBC transfusion independenceEnd Results-MedicarePopulation-based studyStandard of careAgent azacitidineMedian survivalOlder patientsIntensive therapyAML patientsClinical outcomesClinical benefitMyeloid leukemiaMortality riskPatientsAzacitidineDecitabineOlder adultsOne-thirdMeaningful differences
2019
Hypomethylating agent (HMA) therapy use and survival in older adults with Refractory Anemia with Excess Blasts (RAEB) in the United States (USA): a large propensity score-matched population-based study†
Davidoff AJ, Hu X, Bewersdorf JP, Wang R, Podoltsev NA, Huntington SF, Gore SD, Ma X, Zeidan AM. Hypomethylating agent (HMA) therapy use and survival in older adults with Refractory Anemia with Excess Blasts (RAEB) in the United States (USA): a large propensity score-matched population-based study†. Leukemia & Lymphoma 2019, 61: 1178-1187. PMID: 31878809, PMCID: PMC7735409, DOI: 10.1080/10428194.2019.1703970.Peer-Reviewed Original ResearchConceptsHigh-risk myelodysplastic syndromeExcess blastsRefractory anemiaOverall survival benefitRetrospective cohort studyMedian OSOS benefitRAEB patientsCohort studySurvival benefitTherapy useMyelodysplastic syndromeClinical trialsLower riskMedicare dataPatientsPropensity scoreOlder adultsDiagnosisAnemiaQuartileUnited StatesAssociationEnd resultOSAssociation of provider experience and clinical outcomes in patients with myelodysplastic syndromes receiving hypomethylating agents
Zeidan AM, Hu X, Zhu W, Stahl M, Wang R, Huntington SF, Giri S, Bewersdorf JP, Podoltsev NA, Gore SD, Ma X, Davidoff AJ. Association of provider experience and clinical outcomes in patients with myelodysplastic syndromes receiving hypomethylating agents. Leukemia & Lymphoma 2019, 61: 397-408. PMID: 31570040, PMCID: PMC7732188, DOI: 10.1080/10428194.2019.1663423.Peer-Reviewed Original ResearchConceptsMyelodysplastic syndromeOverall survivalHMA cyclesHMA therapyProvider experienceCox proportional hazards modelOlder MDS patientsMedian overall survivalPercent of patientsSEER-Medicare dataMultivariate logistic regressionProportional hazards modelHMA initiationClinical outcomesMDS patientsClinical trialsMedian numberHMA treatmentHazards modelPatientsSignificant associationLogistic regressionPopulation-level survivalSurvivalSyndromeRBC transfusion independence among lower risk MDS patients receiving hypomethylating agents: a population-level analysis
Zeidan AM, Zhu W, Stahl M, Wang R, Huntington SF, Giri S, Podoltsev NA, Gore SD, Ma X, Davidoff AJ. RBC transfusion independence among lower risk MDS patients receiving hypomethylating agents: a population-level analysis. Leukemia & Lymphoma 2019, 60: 3181-3187. PMID: 31170846, DOI: 10.1080/10428194.2019.1622700.Peer-Reviewed Original ResearchConceptsRBC transfusion independenceLR-MDS patientsTransfusion independenceHMA initiationRBC transfusionClinical effectivenessReal-life clinical effectivenessRed blood cell transfusionLower-risk myelodysplastic syndromesLow-risk MDS patientsRisk MDS patientsBlood cell transfusionRisk myelodysplastic syndromesHMA therapyLR-MDSCell transfusionMost patientsDisease courseMDS patientsMedicare databaseMyelodysplastic syndromePopulation-level estimatesLower oddsTransfusionPatients
2018
Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End‐of‐Life Care
Wang S, Hsu SH, Huang S, Doan KC, Gross CP, Ma X. Regional Practice Patterns and Racial/Ethnic Differences in Intensity of End‐of‐Life Care. Health Services Research 2018, 53: 4291-4309. PMID: 29951996, PMCID: PMC6232508, DOI: 10.1111/1475-6773.12998.Peer-Reviewed Original ResearchConceptsIntensity of endHospital referral regionsRegional practice patternsPractice patternsLife careEthnic differencesLife care expendituresLocal practice patternsCancer decedentsMedicare databaseRacial/Ethnic DifferencesReferral regionsCare expendituresCareEnd resultDifferencesEpidemiologyDecedents
2017
Regional Medicare Expenditures and Survival Among Older Women With Localized Breast Cancer
Tannenbaum S, Soulos PR, Herrin J, Mougalian S, Long JB, Wang R, Ma X, Gross CP, Xu X. Regional Medicare Expenditures and Survival Among Older Women With Localized Breast Cancer. Medical Care 2017, 55: 1030-1038. PMID: 29068906, PMCID: PMC5863278, DOI: 10.1097/mlr.0000000000000822.Peer-Reviewed Original ResearchConceptsBreast cancer careHospital referral regionsNonmetastatic breast cancerBreast cancerCancer careMedicare beneficiariesMedicare expendituresCancer expendituresBetter survivalEnd Results-MedicareRetrospective cohort studyPatients 3 yearsClinical characteristicsCohort studyOverall survivalCancer stagePatient outcomesOutcome measuresReferral regionsOlder womenSignificant associationStage IIBivariate analysisCancerQuintileHealth Care Use by Older Adults With Acute Myeloid Leukemia at the End of Life
Wang R, Zeidan AM, Halene S, Xu X, Davidoff AJ, Huntington SF, Podoltsev NA, Gross CP, Gore SD, Ma X. Health Care Use by Older Adults With Acute Myeloid Leukemia at the End of Life. Journal Of Clinical Oncology 2017, 35: jco.2017.72.714. PMID: 28783450, PMCID: PMC5648174, DOI: 10.1200/jco.2017.72.7149.Peer-Reviewed Original ResearchConceptsAcute myeloid leukemiaDays of lifeEnd of lifeLife careHospice careOlder patientsHospice enrollmentMyeloid leukemiaIntensive care unit admissionMultivariable logistic regression analysisOlder adultsLate hospice enrollmentCare unit admissionRetrospective cohort studyUse of chemotherapyIntensive care unitHealth care useLogistic regression analysisYears of ageUnit admissionAggressive treatmentCohort studyOverall cohortAML diagnosisCare unitHypomethylating agent therapy use and survival in older patients with chronic myelomonocytic leukemia in the United States: A large population‐based study
Zeidan AM, Hu X, Long JB, Wang R, Ma X, Podoltsev NA, Huntington SF, Gore SD, Davidoff AJ. Hypomethylating agent therapy use and survival in older patients with chronic myelomonocytic leukemia in the United States: A large population‐based study. Cancer 2017, 123: 3754-3762. PMID: 28621841, PMCID: PMC6540984, DOI: 10.1002/cncr.30814.Peer-Reviewed Original ResearchConceptsChronic myelomonocytic leukemiaRisk of deathSupportive careEnd Results-Medicare databaseOlder adultsMedian OS timeOverall survival benefitCohort of patientsProportional hazards modelUse of HMAsMedian OSAgent therapySurvival benefitOS timeCMML patientsMyelomonocytic leukemiaHazards modelHMA treatmentPatientsTemporal improvementSecondary analysisPropensity scoreLimited evidenceSurvival changesApproval
2016
Disease‐related costs of care and survival among Medicare‐enrolled patients with myelodysplastic syndromes
Zeidan AM, Wang R, Davidoff AJ, Ma S, Zhao Y, Gore SD, Gross CP, Ma X. Disease‐related costs of care and survival among Medicare‐enrolled patients with myelodysplastic syndromes. Cancer 2016, 122: 1598-1607. PMID: 26970288, PMCID: PMC5509410, DOI: 10.1002/cncr.29945.Peer-Reviewed Original ResearchConceptsMyelodysplastic syndromeEligible patientsHazard ratioMedicare beneficiariesMultivariate Cox proportional hazards modelEnd Results-Medicare databasePropensity score-matched groupsCox proportional hazards modelOverall study populationSubgroup of patientsConfidence intervalsCost-saving interventionEnd of studyProportional hazards modelElderly patientsOverall survivalDisease characteristicsMDS cohortPatient outcomesStudy populationInternational ClassificationWarrants additional researchHazards modelPatientsSurvival rate
2015
The Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer
Xu X, Herrin J, Soulos PR, Saraf A, Roberts KB, Killelea BK, Wang SY, Long JB, Wang R, Ma X, Gross CP. The Role of Patient Factors, Cancer Characteristics, and Treatment Patterns in the Cost of Care for Medicare Beneficiaries with Breast Cancer. Health Services Research 2015, 51: 167-186. PMID: 26119176, PMCID: PMC4722219, DOI: 10.1111/1475-6773.12328.Peer-Reviewed Original ResearchConceptsBreast cancer careHospital referral regionsCancer careMedicare expendituresBreast cancerRadiation therapyTreatment factorsMean Medicare expendituresEnd Results-MedicareSpecific treatment modalitiesContribution of patientCost of careHighest spending quintilePatient factorsTreatment patternsTumor characteristicsCancer characteristicsTreatment modalitiesReferral regionsMedicare beneficiariesQuintilePatientsCancerCareTherapyOlder Women With Localized Breast Cancer: Costs And Survival Rates Increased Across Two Time Periods
Feinstein AJ, Long J, Soulos PR, Ma X, Herrin J, Frick KD, Chagpar AB, Krumholz HM, Yu JB, Ross JS, Gross CP. Older Women With Localized Breast Cancer: Costs And Survival Rates Increased Across Two Time Periods. Health Affairs 2015, 34: 592-600. PMID: 25847641, DOI: 10.1377/hlthaff.2014.1119.Peer-Reviewed Original ResearchConceptsStage II diseaseStage III diseaseCancer-related costsCancer careBreast cancerMedian costSurvival rateEnd Results Program-MedicareFive-year survivalCancer care costsBreast surgerySurvival outcomesImproved outcomesOlder womenRadiation therapyCare costsStage IIDiseaseStudy periodWomenCancerCareSignificant national attentionOutcomesPercent
2014
Understanding Regional Variation in Medicare Expenditures for Initial Episodes of Prostate Cancer Care
Wang SY, Wang R, Yu JB, Ma X, Xu X, Kim SP, Soulos PR, Saraf A, Gross CP. Understanding Regional Variation in Medicare Expenditures for Initial Episodes of Prostate Cancer Care. Medical Care 2014, 52: 680-687. PMID: 25023913, PMCID: PMC4129645, DOI: 10.1097/mlr.0000000000000158.Peer-Reviewed Original ResearchConceptsAncillary proceduresPatient characteristicsTreatment modalitiesTreatment intensityEnd Results-Medicare databaseProstate cancer careSpecific treatment modalitiesContribution of patientHospital referral regionsInitial treatmentCancer careInitial episodeNoncancer controlsProstate cancerQuintile 5Referral regionsSubstantial geographic variationCare costsMedicare expendituresCostly modalityTreatment factorsMean expenditureLowest expenditure quintileSurgeryModalities