2024
Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma
Rahman S, Long J, Westvold S, Leapman M, Spees L, Hurwitz M, McManus H, Gross C, Wheeler S, Dinan M. Area Vulnerability and Disparities in Therapy for Patients With Metastatic Renal Cell Carcinoma. JAMA Network Open 2024, 7: e248747. PMID: 38687479, PMCID: PMC11061765, DOI: 10.1001/jamanetworkopen.2024.8747.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaArea-level measuresRenal cell carcinomaPatient-level factorsSystemic therapyEthnic disparitiesRelative risk ratiosSocially vulnerable areasCell carcinomaMeasures of social vulnerabilityMedicare beneficiariesCohort studyFee-for-service Medicare Parts AOdds ratioReceipt of systemic therapyLogistic regressionArea-level characteristicsAssociated with lack of treatmentNon-Hispanic blacksRetrospective cohort studyIndividual-level demographicsNon-Hispanic whitesAssociated with disparitiesUS Medicare beneficiariesMeasures of disadvantage
2021
Patterns and Predictors of Oral Anticancer Agent Use in Diverse Patients With Metastatic Renal Cell Carcinoma
Wheeler SB, Spees LP, Jackson BE, Baggett CD, Wilson LE, Greiner MA, Kaye DR, Zhang T, George D, Scales CD, Pritchard JE, Dinan MA. Patterns and Predictors of Oral Anticancer Agent Use in Diverse Patients With Metastatic Renal Cell Carcinoma. JCO Oncology Practice 2021, 17: e1895-e1904. PMID: 34138665, PMCID: PMC8678030, DOI: 10.1200/op.20.01082.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaIndex dateCell carcinomaRisk ratioPatterns of usePatients age 80Patients age 18Population-based studyAdjusted risk differenceOral therapyPatient characteristicsContinuous enrollmentHigh frailtyAge 80Agent useRisk differencePatientsDiverse patientsComorbiditiesAge 18Regulatory approvalCarcinomaLog-Poisson model
2019
Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer.
Moss HA, Havrilesky LJ, Wang FF, Georgieva MV, Hendrix LH, Dinan MA. Simulated Costs of the ASCO Patient-Centered Oncology Payment Model in Medicare Beneficiaries With Newly Diagnosed Advanced Ovarian Cancer. JCO Oncology Practice 2019, 15: e1018-e1027. PMID: 31613721, PMCID: PMC10445789, DOI: 10.1200/jop.19.00026.Peer-Reviewed Original ResearchConceptsAdvanced ovarian cancerOvarian cancerAlternative payment modelsNeoadjuvant chemotherapy patientsEmergency department visitsSEER-Medicare dataMean total costOutpatient emergency department visitsPayment modelsHealth care servicesCost-efficient careAvoidable spendingNeoadjuvant chemotherapyReal-world practiceDepartment visitsChemotherapy patientsCancer careMedicare beneficiariesHospitalizationCare servicesPatientsService MedicareChemotherapySurgeryPotential cost savingsLow-Risk Thyroid Cancer in Elderly: Total Thyroidectomy/RAI Predominates but Lacks Survival Advantage
Zambeli-Ljepović A, Wang F, Dinan MA, Hyslop T, Roman SA, Sosa J, Scheri RP. Low-Risk Thyroid Cancer in Elderly: Total Thyroidectomy/RAI Predominates but Lacks Survival Advantage. Journal Of Surgical Research 2019, 243: 189-197. PMID: 31185435, PMCID: PMC6773493, DOI: 10.1016/j.jss.2019.05.029.Peer-Reviewed Original ResearchConceptsDisease-specific survivalPapillary thyroid cancerExtent of surgeryTotal thyroidectomyTumor sizeThyroid cancerLow-risk papillary thyroid cancerEnd Results-Medicare databaseLow-risk thyroid cancerOlder adultsNational treatment patternsRadioactive iodine administrationUnderwent total thyroidectomyLarger tumor sizeMultivariable logistic regressionQuality of lifeMost older adultsPostoperative RAIRAI administrationCompletion thyroidectomyExcellent prognosisOlder patientsExtensive surgeryFavorable prognosisMedian ageChemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011.
Dinan MA, Wilson LE, Reed SD. Chemotherapy Costs and 21-Gene Recurrence Score Genomic Testing Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005 to 2011. Journal Of The National Comprehensive Cancer Network 2019, 17: 245-254. PMID: 30865923, DOI: 10.6004/jnccn.2018.7097.Peer-Reviewed Original ResearchConceptsLow-risk diseaseHigh-risk patientsHigh-risk diseaseRS testingMedicare beneficiariesPrimary analysisEstrogen receptor-positive breast cancerReceptor-positive breast cancerLower chemotherapy useIntermediate-risk diseaseIntermediate-risk patientsRetrospective cohort studyGenomic testingSEER-Medicare dataChemotherapy useCohort studyMultivariable analysisBreast cancerChemotherapy costsLow overall useMAIN OUTCOMEMedicare populationPatientsHigher overall costsDisease
2018
Advanced imaging and hospice use in end-of-life cancer care
Dinan MA, Curtis LH, Setoguchi S, Cheung WY. Advanced imaging and hospice use in end-of-life cancer care. Supportive Care In Cancer 2018, 26: 3619-3625. PMID: 29728843, DOI: 10.1007/s00520-018-4223-0.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overBlack or African AmericanBreast NeoplasmsColorectal NeoplasmsComorbidityDiagnostic ImagingFemaleHospice CareHospicesHumansLung NeoplasmsMaleMedicareMiddle AgedNeoplasmsOutcome Assessment, Health CareProstatic NeoplasmsReferral and ConsultationRetrospective StudiesSEER ProgramTerminal CareUnited StatesConceptsHospital referral regionsHospice enrollmentComputerized tomographyHospice useLife careReferral regionsAdvanced imagingPopulation-based retrospective studyHigh rateLate hospice enrollmentLife cancer careMultivariable logistic regressionSEER-Medicare dataMagnetic resonance imagingPositron emission tomographyEnd of lifeGreater comorbidityReal-world practiceAggressive endBlack patientsMultivariable analysisRetrospective studyResultsA totalStudy criteriaCancer careAssociation between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008–2011
Wilson LE, Pollack CE, Greiner MA, Dinan MA. Association between physician characteristics and the use of 21-gene recurrence score genomic testing among Medicare beneficiaries with early-stage breast cancer, 2008–2011. Breast Cancer Research And Treatment 2018, 170: 361-371. PMID: 29536319, DOI: 10.1007/s10549-018-4746-6.Peer-Reviewed Original ResearchConceptsMedical oncologistsPhysician characteristicsBreast cancerGenomic testingMedicare beneficiariesAmerican Medical Association Physician Master FileNode-negative breast cancerEarly-stage breast cancerReceipt of testingMethodsRetrospective cohort studyYear of diagnosisPhysician-level factorsPhysician-level characteristicsMultivariable regression modelsAdjuvant chemotherapyCohort studyRS testingOptimal careResultsA totalStudy criteriaSurgical oncologySurgical proceduresHigher oddsMAIN OUTCOMELower odds
2017
Algorithms for prediction of the Oncotype DX recurrence score using clinicopathologic data: a review and comparison using an independent dataset
Harowicz MR, Robinson TJ, Dinan MA, Saha A, Marks JR, Marcom PK, Mazurowski MA. Algorithms for prediction of the Oncotype DX recurrence score using clinicopathologic data: a review and comparison using an independent dataset. Breast Cancer Research And Treatment 2017, 162: 1-10. PMID: 28064383, PMCID: PMC5909985, DOI: 10.1007/s10549-016-4093-4.Peer-Reviewed Original ResearchConceptsIntermediate-risk diseaseOncotype DX recurrence scoreHigh-risk diseaseDX recurrence scoreODX RSReceptor statusRecurrence scoreSurrogate markerProgesterone receptor statusInvasive breast cancerEstrogen receptor statusHigh-risk groupOngoing clinical trialsMagee EquationsPresence of patientsAdjuvant chemotherapyClinicopathologic dataRetrospective studyTumor sizeHER2 statusHistopathologic variablesClinical trialsBreast cancerPatient managementAdditional independent validation
2015
Knowledge of pathologically versus clinically negative lymph nodes is associated with reduced use of radioactive iodine post-thyroidectomy for low-risk papillary thyroid cancer
Ruel E, Thomas S, Dinan MA, Perkins JM, Roman SA, Sosa JA. Knowledge of pathologically versus clinically negative lymph nodes is associated with reduced use of radioactive iodine post-thyroidectomy for low-risk papillary thyroid cancer. Endocrine 2015, 52: 579-586. PMID: 26708045, PMCID: PMC4880494, DOI: 10.1007/s12020-015-0826-0.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overCarcinomaCarcinoma, PapillaryCombined Modality TherapyDatabases, FactualFemaleHumansIodine RadioisotopesKnowledgeLymph NodesLymphatic MetastasisMaleMiddle AgedPostoperative PeriodPrognosisRadiotherapy DosageRisk FactorsSurvival AnalysisThyroid Cancer, PapillaryThyroid NeoplasmsThyroidectomyConceptsNegative lymph nodesPapillary thyroid cancerLow-risk papillary thyroid cancerLymph nodesCN0 patientsRAI useThyroid cancerPostoperative radioactive iodine administrationTrue nodal statusExcised lymph nodesLow-risk patientsLymph node statusRadioactive iodine administrationNegative surgical marginsOdds of receiptSurgical pathology specimensCut-point analysisPN0 patientsPN0 statusPostoperative RAIRAI administrationCervical lymphMultivariable adjustmentTotal thyroidectomyNodal statusAssociation Between Use of the 21-Gene Recurrence Score Assay and Receipt of Chemotherapy Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005-2009
Dinan MA, Mi X, Reed SD, Lyman GH, Curtis LH. Association Between Use of the 21-Gene Recurrence Score Assay and Receipt of Chemotherapy Among Medicare Beneficiaries With Early-Stage Breast Cancer, 2005-2009. JAMA Oncology 2015, 1: 1098. PMID: 26313372, DOI: 10.1001/jamaoncol.2015.2722.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAntineoplastic AgentsBiomarkers, TumorBreast NeoplasmsChemotherapy, AdjuvantChi-Square DistributionFemaleGene Expression ProfilingGenetic Predisposition to DiseaseGenetic TestingGuideline AdherenceHumansInsurance BenefitsMedicareMultivariate AnalysisNeoplasm Recurrence, LocalNeoplasm StagingOdds RatioPatient SelectionPhenotypePractice Guidelines as TopicPredictive Value of TestsRetrospective StudiesRisk AssessmentRisk FactorsSEER ProgramTime FactorsTreatment OutcomeUnited StatesConceptsReceipt of chemotherapyLower chemotherapy useHigh-risk diseasePatients 70 yearsChemotherapy useBreast cancerRecurrence scoreMedicare beneficiariesNational Comprehensive Cancer Network guidelinesEarly-stage breast cancerConsideration of chemotherapyLow-risk diseaseOverall chemotherapy useIncident breast cancerLow-risk patientsRetrospective cohort studyHigh-risk patientsPrespecified subgroup analysisUse of chemotherapyAdditional prognostic informationEnd Results (SEER) dataInvasive breast cancerRS assayNCCN riskAdjuvant chemotherapyResource Use in the Last Year of Life Among Patients Who Died With Versus of Prostate Cancer
Dinan MA, Li Y, Zhang Y, Stewart SB, Curtis LH, George DJ, Reed SD. Resource Use in the Last Year of Life Among Patients Who Died With Versus of Prostate Cancer. Clinical Genitourinary Cancer 2015, 14: 28-37.e2. PMID: 26382223, PMCID: PMC4698191, DOI: 10.1016/j.clgc.2015.07.006.Peer-Reviewed Original ResearchConceptsEnd Results-Medicare dataEnd of lifeProstate cancerOutpatient settingOutpatient useRetrospective analysisMore hospicesLower mean inpatient costsSkilled nursing facility daysIntensive care unit daysIntensive care unit useJudicious careAndrogen deprivation therapyOverall health care costsUse of chemotherapyMean inpatient costsMultiple invasive proceduresHealth care costsSignificant financial burdenDeprivation therapyNoncancer causesICU useSingle strongest predictorUnit daysInpatient costsLongitudinal Trends in Costs of Palliative Radiation for Metastatic Prostate Cancer
Robinson TJ, Dinan MA, Li Y, Lee WR, Reed SD. Longitudinal Trends in Costs of Palliative Radiation for Metastatic Prostate Cancer. Journal Of Palliative Medicine 2015, 18: 933-939. PMID: 26241733, PMCID: PMC4638209, DOI: 10.1089/jpm.2015.0171.Peer-Reviewed Original ResearchConceptsMetastatic prostate cancerProstate cancer metastasisRadiation therapyTreatment courseProstate cancerBony metastasesEnd Results-Medicare dataRadiation treatmentCancer metastasisCost-effective palliationPalliative radiation therapyPalliative radiation treatmentGeneral patient populationShort treatment courseHospital-based settingStudy inclusion criteriaTotal Medicare paymentsRadiation treatment courseRadiation therapy techniquesLack of evidencePalliative radiationPalliative settingPalliative treatmentClinical benefitPatient populationInitial Trends in the Use of the 21-Gene Recurrence Score Assay for Patients With Breast Cancer in the Medicare Population, 2005-2009
Dinan MA, Mi X, Reed SD, Hirsch BR, Lyman GH, Curtis LH. Initial Trends in the Use of the 21-Gene Recurrence Score Assay for Patients With Breast Cancer in the Medicare Population, 2005-2009. JAMA Oncology 2015, 1: 158-166. PMID: 26181015, DOI: 10.1001/jamaoncol.2015.43.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBiomarkers, TumorBreast NeoplasmsChemotherapy, AdjuvantChi-Square DistributionFemaleGene Expression ProfilingGenetic Predisposition to DiseaseGuideline AdherenceHealthcare DisparitiesHumansMedicareMultivariate AnalysisNeoplasm Recurrence, LocalNeoplasm StagingOdds RatioPhenotypePractice Guidelines as TopicPractice Patterns, Physicians'Predictive Value of TestsRacial GroupsResidence CharacteristicsRetrospective StudiesRisk AssessmentRisk FactorsSEER ProgramTime FactorsTreatment OutcomeUnited StatesConceptsIntermediate-risk diseaseBreast cancerRecurrence scoreClinical practiceNode-negative breast cancerNational Comprehensive Cancer NetworkAdjuvant chemotherapy useIncident breast cancerComprehensive Cancer NetworkEnd Results (SEER) dataHigh-grade diseaseRetrospective observational studyRoutine clinical practiceTumor histologic characteristicsMedicare coverage decisionsAdjuvant chemotherapyChemotherapy useN1 diseaseMost patientsComorbid conditionsMultivariable analysisRS assayClinical variablesStudy criteriaBlack raceAdjuvant Radioactive Iodine Therapy Is Associated With Improved Survival for Patients With Intermediate-Risk Papillary Thyroid Cancer
Ruel E, Thomas S, Dinan M, Perkins JM, Roman SA, Sosa JA. Adjuvant Radioactive Iodine Therapy Is Associated With Improved Survival for Patients With Intermediate-Risk Papillary Thyroid Cancer. The Journal Of Clinical Endocrinology & Metabolism 2015, 100: 1529-1536. PMID: 25642591, PMCID: PMC4399282, DOI: 10.1210/jc.2014-4332.Peer-Reviewed Original ResearchConceptsRadioactive iodine therapyPapillary thyroid cancerIntermediate-risk papillary thyroid cancerAdjuvant radioactive iodine therapyIntermediate-risk PTC patientsImproved overall survivalIntermediate-risk patientsOverall survivalRisk of deathRAI therapyIodine therapyPTC patientsThyroid cancerAmerican Thyroid Association riskLong-term prognosisAmerican Joint CommissionCommon endocrine malignancyPaucity of dataTotal thyroidectomyAdult patientsMultivariate adjustmentClinical factorsAggressive variantStage T3Patient group
2014
Redistribution of Health Care Costs after the Adoption of Positron Emission Tomography among Medicare Beneficiaries with Non–Small-Cell Lung Cancer, 1998–2005
Dinan MA, Curtis LH, Carpenter WR, Biddle AK, Abernethy AP, Patz EF, Schulman KA, Weinberger M. Redistribution of Health Care Costs after the Adoption of Positron Emission Tomography among Medicare Beneficiaries with Non–Small-Cell Lung Cancer, 1998–2005. Journal Of Thoracic Oncology 2014, 9: 512-518. PMID: 24736074, DOI: 10.1097/jto.0000000000000102.Peer-Reviewed Original ResearchConceptsCell lung cancerTotal health care costsHealth care costsPositron emission tomographyProportion of patientsRate of surgeryMedicare beneficiariesLung cancerCare costsEmission tomographySurgical resectionInpatient costsRetrospective cohort studyYear of diagnosisMain outcome measuresCohort studyTreatment patternsOutcome measuresRadiation therapyChemotherapyPatientsRadiotherapyStudy periodCancerMedicare approval
2013
Variations in Use of PET among Medicare Beneficiaries with Non–Small Cell Lung Cancer, 1998–2007
Dinan MA, Curtis LH, Carpenter WR, Biddle AK, Abernethy AP, Patz EF, Schulman KA, Weinberger M. Variations in Use of PET among Medicare Beneficiaries with Non–Small Cell Lung Cancer, 1998–2007. Radiology 2013, 267: 807-817. PMID: 23418003, DOI: 10.1148/radiol.12120174.Peer-Reviewed Original ResearchConceptsNon-small cell lung cancerPositron emission tomographyUse of PETMedicare beneficiariesCases of NSCLCPET useDiagnosis of NSCLCEnd Results-Medicare dataMultivariable logistic regression analysisDuke University Health SystemHalf of patientsCell lung cancerExamination 2 monthsMultivariable regression analysisUniversity Health SystemLogistic regression analysisDemographic subgroupsRegression analysisInstitutional review boardNonblack patientsPrimary outcomeFinal cohortSurveillance EpidemiologyLung cancerRetrospective analysis
2012
Stage Migration, Selection Bias, and Survival Associated With the Adoption of Positron Emission Tomography Among Medicare Beneficiaries With Non–Small-Cell Lung Cancer, 1998-2003
Dinan MA, Curtis LH, Carpenter WR, Biddle AK, Abernethy AP, Patz EF, Schulman KA, Weinberger M. Stage Migration, Selection Bias, and Survival Associated With the Adoption of Positron Emission Tomography Among Medicare Beneficiaries With Non–Small-Cell Lung Cancer, 1998-2003. Journal Of Clinical Oncology 2012, 30: 2725-2730. PMID: 22753917, DOI: 10.1200/jco.2011.40.4392.Peer-Reviewed Original ResearchConceptsPositron emission tomographyOverall survivalStage migrationMedicare beneficiariesAdvanced diseasePET useEnd Results-Medicare dataEmission tomographyProportion of patientsStage IV diseaseCell lung cancerSelection biasUpstaging of diseaseGreater overall survivalStage-specific survivalStudy criteriaLung cancerSurvival AssociatedImproved outcomesRetrospective analysisStage distributionNSCLCPatientsDiseaseSurvivalChanges in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999–2007
Dinan MA, Robinson TJ, Zagar TM, Scales CD, Curtis LH, Reed SD, Lee WR, Schulman KA. Changes in Initial Treatment for Prostate Cancer Among Medicare Beneficiaries, 1999–2007. International Journal Of Radiation Oncology • Biology • Physics 2012, 82: e781-e786. PMID: 22331001, PMCID: PMC3418871, DOI: 10.1016/j.ijrobp.2011.11.024.Peer-Reviewed Original ResearchConceptsAndrogen deprivation therapyThree-dimensional conformal radiation therapyProportion of patientsInvasive radical prostatectomyOpen surgical approachProstate cancerIntensity-modulated radiation therapyRadiation therapyDeprivation therapyConformal radiation therapyRadical prostatectomySurgical approachMedicare populationRetrospective claims-based analysisIncident prostate cancerClaims-based analysisManagement of patientsLarge clinical trialsLocalized prostate cancerTreatment of patientsExternal beam radiotherapyHealth care costsActive therapyInitial treatmentOptimal therapy
2010
Changes in the Use and Costs of Diagnostic Imaging Among Medicare Beneficiaries With Cancer, 1999-2006
Dinan MA, Curtis LH, Hammill BG, Patz EF, Abernethy AP, Shea AM, Schulman KA. Changes in the Use and Costs of Diagnostic Imaging Among Medicare Beneficiaries With Cancer, 1999-2006. JAMA 2010, 303: 1625-1631. PMID: 20424253, DOI: 10.1001/jama.2010.460.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overDiagnostic ImagingFemaleHealth Care CostsHumansInsurance, Health, ReimbursementMaleMedicareNeoplasmsUnited StatesConceptsNon-Hodgkin lymphomaLung cancerMedicare beneficiariesBreast cancerCancer typesColorectal cancerProstate cancerImaging costsPositron emission tomography scanIncident breast cancerYear of diagnosisEmission tomography scanBone density studiesMean total costMagnetic resonance imagingPositron emission tomographyBone scanTreatment patternsIncident casesCancer careHalf of beneficiariesTomography scanUS CentersMean annual increaseResonance imaging