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Background
Patients with high‐risk prostate cancer (HRPC) have multiple accepted treatment options. Because there is no overall survival benefit of one option over another, appropriate treatment must consider patient life expectancy, quality of life, and cost.
Methods
The authors compared quality‐adjusted life years (QALYs) and cost effectiveness among treatment options for HRPC using a Markov...
Background
Dual‐eligible beneficiaries, who qualify for Medicare and Medicaid, are a vulnerable population with much to gain from efforts to improve quality. Integrated delivery networks and cancer centers, with their emphasis on care coordination and communication, may improve quality of care for dual‐eligible patients with cancer at the end of life.
Methods
This study used Surveillance, Epidemiology,...
BACKGROUND
Accountable care organizations (ACOs) have been shown to reduce prostate cancer treatment among men unlikely to benefit because of competing risks (ie, potential overtreatment). This study assessed whether the level of engagement in ACOs by urologists affected rates of treatment, overtreatment, and spending.
METHODS
A 20% sample of national Medicare data was used to identify men diagnosed...
BACKGROUND
Active surveillance (AS) for prostate cancer includes follow‐up with serial prostate biopsies. The optimal biopsy frequency during follow‐up has not been determined. The goal of this investigation was to use longitudinal AS biopsy data to assess whether the frequency of biopsy could be reduced without substantially prolonging the time to the detection of disease with a Gleason score ≥...
BACKGROUND
Accountable care organizations (ACOs) can improve prostate cancer care by decreasing treatment variations (ie, avoidance of treatment in low‐value settings). Herein, the authors performed a study to understand the effect of Medicare Shared Savings Program ACOs on prostate cancer care.
METHODS
Using a 20% Medicare sample, the authors identified men with newly diagnosed prostate cancer...
BACKGROUND
Both the Centers for Medicare and Medicaid Services' (CMS) Hospital Compare star rating and surgical case volume have been publicized as metrics that can help patients to identify high‐quality hospitals for complex care such as cancer surgery. The current study evaluates the relationship between the CMS' star rating, surgical volume, and short‐term outcomes after major cancer surgery....
BACKGROUND
To the authors’ knowledge, little is known regarding the relationship between patients’ and families’ satisfaction with aggressive end‐of‐life care. Herein, the authors examined the associations between episodes of aggressive care (ie, chemotherapy, mechanical ventilation, acute hospitalizations, and intensive care unit admissions) within the last 30 days of life and families’ evaluations...
BACKGROUNDUnlike Medicare, the Veterans Health Administration (VA) health care system does not require veterans with cancer to make the “terrible choice” between receipt of hospice services or disease‐modifying chemotherapy/radiation therapy. For this report, the authors characterized the VA's provision of concurrent care, defined as days in the last 6 months of life during which veterans simultaneously...
BACKGROUND
Integrating quality‐of‐life (QOL) outcomes into clinics may assist providers in identifying and responding to problems experienced by cancer survivors. To date, however, patient‐reported outcomes (PROs) such as QOL are used infrequently to guide care. We integrated QOL assessments into a prostate cancer survivorship clinic and compared recovery and satisfaction among men managed in the...
BACKGROUND:Because there is limited population‐based evidence supporting the comparative effectiveness of laparoscopic radical nephrectomy (LRN) after its widespread adoption, we compared trends in hospital‐based outcomes among patients with kidney cancer treated with LRN or open radical nephrectomy (ORN).
METHODS:Using linked SEER‐Medicare data, the authors identified patients with kidney cancer...
BACKGROUND:Contemporary therapy for medulloblastoma results in adverse neurocognitive effects on young children, particularly those under the age of 3. Stratification of patients by risk group may allow toxic treatment to be avoided.
METHODS:Seventy‐six patients diagnosed with medulloblastoma and enrolled on CCG‐9921 underwent central review of pathology, and histologic subtype was designated as...
BACKGROUND:In patients with chronic lymphocytic leukemia (CLL), treatment with lenalidomide induces a unique, previously uncharacterized, immune response called tumor flare reaction (TFR). The clinical significance of this reaction remains unknown.
METHODS:Forty‐five patients with CLL who were treated with lenalidomide in a phase 2 clinical trial were evaluated for the clinical features, intensity,...
BACKGROUND:Mortality from invasive bladder cancer is common, even with high‐quality care. Thus, the best opportunities to improve outcomes may precede the diagnosis. Although screening currently is not recommended, better medical care of patients who are at risk (ie, those with hematuria) has the potential to improve outcomes.
METHODS:The authors used the Surveillance, Epidemiology, and End Results‐Medicare...
BACKGROUND.The authors compared the types of treatments prostate cancer patients received from county hospitals and private providers as part of a statewide public assistance program.
METHODS.This was a cohort study of 559 men enrolled in a state‐funded program for low‐income patients known as Improving Access, Counseling, and Treatment for Californians With Prostate Cancer (IMPACT). Multinomial...
BACKGROUND:Multiple myeloma (MM) remains an incurable cancer. Treatment often is initiated at the time patients experience a progressive increase in tumor burden. The authors of this report investigated magnetic resonance imaging of the bone marrow (BM‐MRI) as a novel approach to quantify disease burden and validated a staging system by correlating BM‐MRI with common clinical and laboratory parameters...
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