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 access
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 drugs
2019
Underutilization of guideline‐recommended supportive care among older adults with multiple myeloma in the United States
Giri S, Zhu W, Wang R, Zeidan A, Podoltsev N, Gore SD, Neparidze N, Ma X, Gross CP, Davidoff AJ, Huntington SF. Underutilization of guideline‐recommended supportive care among older adults with multiple myeloma in the United States. Cancer 2019, 125: 4084-4095. PMID: 31381151, DOI: 10.1002/cncr.32428.Peer-Reviewed Original ResearchConceptsBone-modifying drugsSupportive careMultiple myelomaInfluenza vaccinationAntiviral prophylaxisOlder adultsLower oddsEnd Results-Medicare databaseNon-Hispanic black patientsMultivariable logistic regression modelBaseline renal impairmentSupportive care useTreatment-related toxicityFacility-level characteristicsNon-Hispanic blacksOutcomes of interestCommunity-based settingsLogistic regression modelsRenal impairmentActive treatmentBlack patientsCare useConcomitant useProphylactic antiviralsReduced odds
2018
The impact of phlebotomy and hydroxyurea on survival and risk of thrombosis among older patients with polycythemia vera
Podoltsev NA, Zhu M, Zeidan AM, Wang R, Wang X, Davidoff AJ, Huntington SF, Giri S, Gore SD, Ma X. The impact of phlebotomy and hydroxyurea on survival and risk of thrombosis among older patients with polycythemia vera. Blood Advances 2018, 2: 2681-2690. PMID: 30333100, PMCID: PMC6199652, DOI: 10.1182/bloodadvances.2018021436.Peer-Reviewed Original ResearchConceptsRisk of thrombosisPV patientsOverall survivalThrombotic eventsMultivariable Cox proportional hazards modelsEnd Results-Medicare databaseHigh-risk PV patientsCox proportional hazards modelOlder adultsImpact of phlebotomyRetrospective cohort studyPopulation-based studyProportional hazards modelEffect of phlebotomyOutcomes of interestPolycythemia vera patientsContemporary clinical practiceImproved OSCohort studyCytoreductive therapyOlder patientsTherapeutic phlebotomyTreatment modalitiesCurrent guidelinesLower riskAssociation Between Prostate Magnetic Resonance Imaging and Observation for Low-risk Prostate Cancer
Leapman MS, Wang R, Park HS, Yu JB, Weinreb JC, Gross CP, Ma X. Association Between Prostate Magnetic Resonance Imaging and Observation for Low-risk Prostate Cancer. Urology 2018, 124: 98-106. PMID: 30107188, DOI: 10.1016/j.urology.2018.07.041.Peer-Reviewed Original ResearchConceptsLow-risk prostate cancerProstate magnetic resonance imagingMagnetic resonance imagingProstate cancerDefinitive treatmentPCa diagnosisEnd Results-Medicare databaseResonance imagingMultivariable logistic regression analysisPropensity scoreDiagnosis of PCaUse of MRIConditional logistic regression modelsLogistic regression analysisLogistic regression modelsInitial managementMultivariable analysisGreater oddsPatientsSocioeconomic statusDiagnosisHigher likelihoodRegression analysisDemographic factorsCancer
2017
Hypomethylating 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
Comparative Effectiveness of Azacitidine Versus Decitabine Among Older Adults Diagnosed with Higher-Risk Myelodysplastic Syndromes (HR-MDS)
Zeidan A, Long J, Hall J, Wang R, Huntington S, Abel G, Prebet T, Podoltsev N, Gross C, Gore S, Ma X, Davidoff A. Comparative Effectiveness of Azacitidine Versus Decitabine Among Older Adults Diagnosed with Higher-Risk Myelodysplastic Syndromes (HR-MDS). Blood 2015, 126: 3285. DOI: 10.1182/blood.v126.23.3285.3285.Peer-Reviewed Original ResearchHigh-risk myelodysplastic syndromeHR-MDS patientsKaplan-Meier survival curvesEnd of studyHMA initiationMedian OSClinical trialsComorbidity countHazard ratioHigh school educationClinical practiceMultivariate Cox proportional hazards modelSurvival curvesEnd Results-Medicare databaseMedian household incomeRandomized phase III trialReal-world clinical practiceCox proportional hazards modelOlder MDS patientsDisability Status ScoreRetrospective cohort studyOverall survival advantagePhase III trialsYear of diagnosisErythropoiesis-stimulating agentsLack of Association Between Costs of Care and Overall Survival (OS) Among Medicare Beneficiaries with Myelodysplastic Syndromes (MDS) in the United States (US)
Zeidan A, Wang R, Davidoff A, Gore S, Soulos P, Huntington S, Gross C, Ma X. Lack of Association Between Costs of Care and Overall Survival (OS) Among Medicare Beneficiaries with Myelodysplastic Syndromes (MDS) in the United States (US). Blood 2015, 126: 873. DOI: 10.1182/blood.v126.23.873.873.Peer-Reviewed Original ResearchDisability Status ScoreOverall survivalMyelodysplastic syndromeMDS patientsCost of careStudy cohortLack of associationHistologic subtypeStatus scoreMedicare beneficiariesEnd Results-Medicare databaseProportional hazards regression modelsOverall study cohortMedian overall survivalOutcomes of patientsElixhauser comorbidity scoreDate of diagnosisEntire study cohortKaplan-Meier methodHazards regression modelsDisease-related costsNon-white raceEnd of studyDate of deathMedicare Part AMyelodysplastic Syndromes and Acute Myeloid Leukemia in Prostate Cancer Patients after Radiotherapy, a Population-Based Study
Wang R, Zeidan A, Soulos P, Yu J, Davidoff A, Gore S, Gross C, Ma X. Myelodysplastic Syndromes and Acute Myeloid Leukemia in Prostate Cancer Patients after Radiotherapy, a Population-Based Study. Blood 2015, 126: 3295. DOI: 10.1182/blood.v126.23.3295.3295.Peer-Reviewed Original ResearchMDS/AMLProstate cancer patientsIntensity-modulated radiotherapyProstate cancer diagnosisImpact of radiotherapyCancer patientsMyelodysplastic syndromeProstate cancerMyeloid malignanciesSecond malignanciesHazard ratioCancer diagnosisRadiation modalitiesEnd Results-Medicare databaseElderly prostate cancer patientsRisk of MDSMultivariate modelRetrospective cohort studyRole of radiotherapyElixhauser comorbidity scoreAcute myeloid leukemia diagnosisHistory of anemiaAcute myeloid leukemiaEnd of studyExternal beam radiotherapy
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
2013
Trends and clinical implications of preoperative breast MRI in Medicare beneficiaries with breast cancer
Killelea BK, Long JB, Chagpar AB, Ma X, Soulos PR, Ross JS, Gross CP. Trends and clinical implications of preoperative breast MRI in Medicare beneficiaries with breast cancer. Breast Cancer Research And Treatment 2013, 141: 155-163. PMID: 23942872, PMCID: PMC3893026, DOI: 10.1007/s10549-013-2656-1.Peer-Reviewed Original ResearchConceptsPreoperative breast magnetic resonance imagingBreast magnetic resonance imagingBreast-conserving surgeryMagnetic resonance imagingBreast cancerSurgical approachBilateral cancerMRI useOlder womenAssociation of MRIEnd Results-Medicare databasePreoperative MRI useContralateral prophylactic mastectomyType of surgeryCohort of womenBilateral mastectomyUnilateral mastectomyProphylactic mastectomyMastectomyMedicare beneficiariesSurgeryResonance imagingClinical implicationsCancerInvasive surgeryThe Cost of Breast Cancer Screening in the Medicare Population
Gross CP, Long JB, Ross JS, Abu-Khalaf MM, Wang R, Killelea BK, Gold HT, Chagpar AB, Ma X. The Cost of Breast Cancer Screening in the Medicare Population. JAMA Internal Medicine 2013, 173: 220-226. PMID: 23303200, PMCID: PMC3638736, DOI: 10.1001/jamainternmed.2013.1397.Peer-Reviewed Original ResearchConceptsBreast cancer screeningCancer screeningTreatment costsBetter breast cancer outcomesEnd Results-Medicare databaseService MedicareHigh screening costsWomen ages 66Breast cancer outcomesInitial cancer treatmentHospital referral region levelWomen 75 yearsInitial treatment costsEarly-stage cancerDigital screening mammographyCancer outcomesCancer incidenceCancer stageLowest quartileAge 66Breast cancerOlder womenMedicare populationComputer-aided detectionTreatment expenditures