2020
Physician trajectories of abandoning long‐course breast radiotherapy and their cost impact
Xu X, Soulos PR, Herrin J, Wang S, Pollack CE, Evans SB, Yu JB, Gross CP. Physician trajectories of abandoning long‐course breast radiotherapy and their cost impact. Health Services Research 2020, 56: 497-506. PMID: 33070305, PMCID: PMC8143683, DOI: 10.1111/1475-6773.13572.Peer-Reviewed Original ResearchConceptsPhysician peer groupsWhole breast irradiationCF-WBIRisk-adjusted ratesBreast radiotherapyPractice patternsLow useChronic Conditions Data WarehouseDistinct practice patternsPatients' clinical characteristicsSetting of radiotherapyAdjuvant breast radiotherapyYears of ageDistinct trajectoriesImportant cost implicationsHigher useAdjuvant radiotherapyClinical characteristicsEligible womenBreast cancerCost implicationsLatent class growth analysisService beneficiariesMedicare programRadiotherapy
2019
Peer Influence on Physician Use of Shorter Course External Beam Radiation Therapy for Patients with Breast Cancer
Yu JB, Pollack CE, Herrin J, Soulos PR, Zhu W, Xu X, Gross CP. Peer Influence on Physician Use of Shorter Course External Beam Radiation Therapy for Patients with Breast Cancer. Practical Radiation Oncology 2019, 10: 75-83. PMID: 31785370, PMCID: PMC7061062, DOI: 10.1016/j.prro.2019.11.001.Peer-Reviewed Original ResearchConceptsAdjuvant external beam radiation therapyExternal beam radiation therapyPhysician peer groupsPalliative external beam radiation therapyBeam radiation therapyBreast cancerAdjuvant therapyBone metastasesPatient receiptRadiation therapyBreast-conserving surgeryMixed-effects logistic regressionPatient-sharing relationshipsPalliative therapyCancer careMedicare beneficiariesPatientsPhysician useTherapyLogistic regressionShort courseCancerPhysiciansGroup rateMetastasisFollow-up Care for Breast Cancer Survivors
Ruddy KJ, Herrin J, Sangaralingham L, Freedman RA, Jemal A, Haddad TC, Allen SV, Hieken T, Boughey JC, Ganz PA, Havyer RD, Shah ND. Follow-up Care for Breast Cancer Survivors. Journal Of The National Cancer Institute 2019, 112: 111-113. PMID: 31613369, PMCID: PMC7849972, DOI: 10.1093/jnci/djz203.Peer-Reviewed Original ResearchConceptsBreast cancer survivorsCancer survivorsUS commercial insurance databaseCurative-intent surgeryCommercial insurance databasePrimary care providersEndocrine therapyIntent surgeryImpairs outcomeSurvivorship guidelinesInsurance databaseNonwhite raceAnnual followBreast cancerCare providersClaims dataClinical practiceOlder ageSurgeryWomenSurvivorsYear 2ChemotherapyPatientsOncologistsAssociation Between Degrees of Separation in Physician Networks and Surgeons’ Use of Perioperative Breast Magnetic Resonance Imaging
Shi Y, Pollack CE, Soulos PR, Herrin J, Christakis NA, Xu X, Gross CP. Association Between Degrees of Separation in Physician Networks and Surgeons’ Use of Perioperative Breast Magnetic Resonance Imaging. Medical Care 2019, 57: 460-467. PMID: 31008899, PMCID: PMC6522278, DOI: 10.1097/mlr.0000000000001123.Peer-Reviewed Original ResearchConceptsBreast magnetic resonance imagingMagnetic resonance imagingPerioperative magnetic resonance imagingMRI useResonance imagingSurgeons' useBreast cancer carePatient-sharing networksPractice of surgeonsPairs of surgeonsUnproven benefitRetrospective studyPhysician pairsCancer carePractice patternsBreast cancerMRI utilizationMedicare dataSurgical colleaguesPatientsSurgeonsStudy periodPhysician networksCareAssociationPersistent Use of Extended Fractionation Palliative Radiotherapy for Medicare Beneficiaries With Metastatic Breast Cancer, 2011 to 2014
Yu JB, Pollack CE, Herrin J, Zhu W, Soulos PR, Xu X, Gross CP. Persistent Use of Extended Fractionation Palliative Radiotherapy for Medicare Beneficiaries With Metastatic Breast Cancer, 2011 to 2014. American Journal Of Clinical Oncology 2019, 42: 493-499. PMID: 31033511, PMCID: PMC6538429, DOI: 10.1097/coc.0000000000000548.Peer-Reviewed Original ResearchConceptsPalliative radiotherapyBone metastasesMedicare beneficiariesBreast cancerAssociation of clinicalProportion of patientsChoice of treatmentHospital-based practiceService Medicare beneficiariesSingle-fraction treatmentProvider financial incentivesLogistic regression modelsDifferent fractionation schemesProlonged courseRadiation courseRadiotherapy usePayer perspectiveProvider characteristicsMean costMultiple guidelinesPatientsRadiotherapyMetastasisCancerNumber of daysAbandonment trajectories of conventionally fractionated adjuvant radiotherapy in breast cancer care.
Xu X, Soulos P, Herrin J, Wang S, Pollack C, Evans S, Gross C, Yu J. Abandonment trajectories of conventionally fractionated adjuvant radiotherapy in breast cancer care. Journal Of Clinical Oncology 2019, 37: 531-531. DOI: 10.1200/jco.2019.37.15_suppl.531.Peer-Reviewed Original ResearchPhysician peer groupsBreast cancer careAdjuvant radiotherapyCancer careHigher useNational Medicare claimsPatient risk factorsDistinct trajectoriesYears of ageLow useDifferent baseline levelsRisk-adjusted ratesPatient cohortRisk factorsBreast cancerCost implicationsMedicare claimsBaseline levelsRadiotherapyMedicare perspectiveCFRTCurve analysisPhysiciansPatientsLatent growth curve analysis
2018
An empiric approach to identifying physician peer groups from claims data: An example from breast cancer care
Herrin J, Soulos PR, Xu X, Gross CP, Pollack CE. An empiric approach to identifying physician peer groups from claims data: An example from breast cancer care. Health Services Research 2018, 54: 44-51. PMID: 30488484, PMCID: PMC6338298, DOI: 10.1111/1475-6773.13095.Peer-Reviewed Original ResearchConceptsPhysician peer groupsClaims dataEnd Results-MedicareBreast cancer careAdministrative claims dataHospital-based groupEmpiric approachCancer careBreast cancerHospital groupPatientsPatient volumePhysiciansEmpirical groupGroup reliabilityPhysician inclusionPercentGroupMedian overlapT1CancerPeer groupEpidemiologySurgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI
Tannenbaum SS, Soulos PR, Herrin J, Pollack CE, Xu X, Christakis NA, Forman HP, Yu JB, Killelea BK, Wang S, Gross CP. Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI. Cancer Medicine 2018, 7: 5901-5909. PMID: 30444005, PMCID: PMC6308117, DOI: 10.1002/cam4.1821.Peer-Reviewed Original ResearchConceptsPrimary care physiciansPatient-sharing networksBreast cancerPerioperative MRISubsequent receiptNon-cancer patientsBreast cancer practiceMultivariable hierarchical modelsUse of MRIClinical characteristicsCare physiciansFemale patientsCancer practiceMedicare databaseNew imaging techniquesMedicare sampleStage 0Claims dataPatientsPhysician groupsMRISurgeonsCancerEquivocal evidencePhysiciansPersistent Use of Extended Fractionation Palliative Radiation Therapy for Medicare Beneficiaries with Metastatic Breast Cancer: 2011-2014
Yu J, Pollack C, Herrin J, Zhu W, Soulos P, Xu X, Gross C. Persistent Use of Extended Fractionation Palliative Radiation Therapy for Medicare Beneficiaries with Metastatic Breast Cancer: 2011-2014. International Journal Of Radiation Oncology • Biology • Physics 2018, 102: e425. DOI: 10.1016/j.ijrobp.2018.07.1241.Peer-Reviewed Original ResearchPhysician peer group characteristics and timeliness of breast cancer surgery
Bachand J, Soulos PR, Herrin J, Pollack CE, Xu X, Ma X, Gross CP. Physician peer group characteristics and timeliness of breast cancer surgery. Breast Cancer Research And Treatment 2018, 170: 657-665. PMID: 29693229, PMCID: PMC6048589, DOI: 10.1007/s10549-018-4789-8.Peer-Reviewed Original ResearchConceptsPhysician peer groupsSurgical delayProvider densityPatient racial compositionBreast cancerEnd Results-Medicare dataBreast cancer patientsBreast cancer surgeryResultsThe study sampleConclusionsThe likelihoodBlack patientsCancer surgeryCancer patientsSurgeryPatientsStudy sampleWomenCancerAssociationGroupGroup characteristicsPurposeLittleInterdisciplinary groupPeer groupEpidemiology
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 analysisCancerQuintileImpact of treatment regimen on acute care use during and after adjuvant chemotherapy for early-stage breast cancer
Ruddy KJ, Van Houten HK, Sangaralingham LR, Freedman RA, Thompson CA, Hashmi SK, Jemal A, Haddad TC, Mougalian S, Herrin J, Gross C, Shah N. Impact of treatment regimen on acute care use during and after adjuvant chemotherapy for early-stage breast cancer. Breast Cancer Research And Treatment 2017, 164: 515-525. PMID: 28493045, DOI: 10.1007/s10549-017-4280-y.Peer-Reviewed Original ResearchConceptsAcute care useEarly-stage breast cancerCare useBreast cancerAdjuvant chemotherapyContemporary adjuvant chemotherapyAcute care needsCommercial insurance databaseEmergency department visitsED visit ratesRate of hospitalizationOncology Care ModelChemotherapy initiationChemotherapy regimenEligible patientsED visitsDepartment visitsTreatment regimenAcute careInsurance databaseAdministration periodAdjusted ratesCare modelCare needsVisit ratesThe Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer
Pollack CE, Soulos PR, Herrin J, Xu X, Christakis NA, Forman HP, Yu JB, Killelea BK, Wang SY, Gross CP. The Impact of Social Contagion on Physician Adoption of Advanced Imaging Tests in Breast Cancer. Journal Of The National Cancer Institute 2017, 109: djw330. PMID: 28376191, PMCID: PMC6059114, DOI: 10.1093/jnci/djw330.Peer-Reviewed Original ResearchConceptsMagnetic resonance imagingBaseline usePositron emission tomography scanEnd Results-MedicareEmission tomography scanBreast cancer practiceImaging modalitiesAdvanced imaging testsHierarchical logistic regression modelsLogistic regression modelsPatient characteristicsUnproven benefitCancer practiceMRI/PETTomography scanBreast cancerMRI useImaging testsClinical practicePET useResonance imagingPET imagingPhysician peersPhysician adoptionBaseline period
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
2013
For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery
Sen S, Soulos PR, Herrin J, Roberts KB, Yu JB, Lesnikoski BA, Ross JS, Krumholz HM, Gross CP. For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery. Surgery 2013, 155: 776-788. PMID: 24787104, PMCID: PMC4008843, DOI: 10.1016/j.surg.2013.12.009.Peer-Reviewed Original ResearchConceptsHospital ownership statusBreast-conserving operationsBreast-conserving surgeryUse of brachytherapyRadiation therapyOperative careBreast cancerMedicare beneficiariesOverall useReceipt of brachytherapyAdjuvant radiation therapyInvasive breast cancerFemale Medicare beneficiariesGreater overall useYears of ageShort life expectancyRetrospective studyRT modalityProfit hospitalsExpensive modalityOlder womenBrachytherapy useBreast brachytherapyHospitalBrachytherapyVariation in Receipt of Radiation Therapy After Breast-conserving Surgery
Feinstein AJ, Soulos PR, Long JB, Herrin J, Roberts KB, Yu JB, Gross CP. Variation in Receipt of Radiation Therapy After Breast-conserving Surgery. Medical Care 2013, 51: 330-338. PMID: 23151590, PMCID: PMC3596448, DOI: 10.1097/mlr.0b013e31827631b0.Peer-Reviewed Original ResearchConceptsUse of RTShort life expectancyRadiation therapyBreast cancerLife expectancyPrimary surgeonStage I breast cancerEarly-stage breast cancerRadiation oncologist densityAdjuvant radiation therapyI breast cancerReceipt of radiationBreast-conserving surgeryImpact of physiciansHierarchical logistic regression modelsLogistic regression modelsLonger life expectancyLE patientsRetrospective cohortLE groupOlder womenPatientsTreatment ratesWomenCancer
2012
The Adoption of New Adjuvant Radiation Therapy Modalities Among Medicare Beneficiaries With Breast Cancer: Clinical Correlates and Cost Implications
Roberts KB, Soulos PR, Herrin J, Yu JB, Long JB, Dostaler E, Gross CP. The Adoption of New Adjuvant Radiation Therapy Modalities Among Medicare Beneficiaries With Breast Cancer: Clinical Correlates and Cost Implications. International Journal Of Radiation Oncology • Biology • Physics 2012, 85: 1186-1192. PMID: 23182396, PMCID: PMC3606652, DOI: 10.1016/j.ijrobp.2012.10.009.Peer-Reviewed Original ResearchConceptsExternal beam radiation therapyRadiation therapy modalitiesRadiation therapy costsBreast cancerRadiation therapyTherapy modalitiesTherapy costsBrachytherapy useRadiation oncologistsEnd Results-Medicare databaseConventional external beam radiation therapyAdoption of intensityBreast-conserving surgeryRadiation therapy useUse of IMRTBeam radiation therapyNewer radiation therapy modalitiesHierarchical logistic regressionHospital-based facilitiesTherapy useClinical factorsClinical correlatesTreatment optionsTreatment choicePhysician preferencePatterns of Use and Short-Term Complications of Breast Brachytherapy in the National Medicare Population From 2008–2009
Presley CJ, Soulos PR, Herrin J, Roberts KB, Yu JB, Killelea B, Lesnikoski BA, Long JB, Gross CP. Patterns of Use and Short-Term Complications of Breast Brachytherapy in the National Medicare Population From 2008–2009. Journal Of Clinical Oncology 2012, 30: 4302-4307. PMID: 23091103, PMCID: PMC3675700, DOI: 10.1200/jco.2012.43.5297.Peer-Reviewed Original ResearchConceptsWhole breast irradiationHospital referral regionsBone complicationsClinical characteristicsSkin complicationsEarly-stage breast cancerNational treatment patternsPercent of patientsShort-term complicationsBreast-conserving surgeryNational Medicare populationComplication rateTreatment patternsAge 66Breast cancerReferral regionsMedicare populationPatterns of useComplicationsMedicare beneficiariesTreatment groupsClinical practiceBreast brachytherapyBrachytherapyInstrumental variable analysisShort-term complications and use of breast brachytherapy in the national Medicare population in 2008-2009.
Presley C, Soulos P, Herrin J, Roberts K, Yu J, Killelea B, Lesnikoski B, Long J, Gross C. Short-term complications and use of breast brachytherapy in the national Medicare population in 2008-2009. Journal Of Clinical Oncology 2012, 30: 1030-1030. DOI: 10.1200/jco.2012.30.15_suppl.1030.Peer-Reviewed Original ResearchWhole breast irradiationHospital referral regionsBone complicationsClinical characteristicsSkin complicationsReferral regionsEarly-stage breast cancerNational treatment patternsOne-year overallReceipt of chemotherapyNumber of comorbiditiesShort-term complicationsDeep tissuesNational Medicare populationAdjuvant radiationComplication rateTreatment patternsDiagnosis codesBreast cancerMedicare claimsMedicare populationComplicationsMedicare beneficiariesTreatment groupsClinical practice