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
2023
Disparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma
Chow R, Long J, Hassan S, Wheeler S, Spees L, Leapman M, Hurwitz M, McManus H, Gross C, Dinan M. Disparities in immune and targeted therapy utilization for older US patients with metastatic renal cell carcinoma. JNCI Cancer Spectrum 2023, 7: pkad036. PMID: 37202354, PMCID: PMC10276895, DOI: 10.1093/jncics/pkad036.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, Renal CellEthnicityFemaleHumansKidney NeoplasmsMaleMedicareUnited StatesWhiteConceptsOral anticancer agentsTherapy utilizationMedicare beneficiariesNon-Hispanic white raceMetastatic renal cell carcinomaNon-Hispanic black raceOlder US patientsUS Medicare beneficiariesRenal cell carcinomaLogistic regression modelsTherapy receiptMultivariable adjustmentSystemic therapyMale sexUS patientsCell carcinomaStudy criteriaBlack raceFemale sexPatient raceWhite raceImmunotherapyOutcomes persistSexPatients
2022
End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy
Dzimitrowicz H, Wilson L, Jackson B, Spees L, Baggett C, Greiner M, Kaye D, Zhang T, George D, Scales C, Pritchard J, Leapman M, Gross C, Dinan M, Wheeler S. End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy. JCO Oncology Practice 2022, 19: e213-e227. PMID: 36413741, PMCID: PMC9970274, DOI: 10.1200/op.22.00401.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsDays of lifeRenal cell carcinomaEOL careSystemic therapySEER-MedicareHospital deathCell carcinomaLife careIntensive care unit admissionCancer informationAggressive EOL careHigh-quality EOLOral anticancer therapySystemic therapy useCare unit admissionMultivariable logistic regressionQuality of endUnit admissionED visitsOlder patientsYounger patientsHospital admissionTherapy useConcurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis
Check D, Baggett C, Kim K, Merlin J, Oeffinger K, Winn A, Roberts M, Robinson T, Dinan M. Concurrent prescribing of opioids with other sedating medications after cancer diagnosis: a population-level analysis. Supportive Care In Cancer 2022, 30: 9781-9791. PMID: 36396793, DOI: 10.1007/s00520-022-07439-y.Peer-Reviewed Original ResearchConceptsConcurrent prescribingSedating medicationsPatient characteristicsMedication-related eventsRetrospective cohort studyNon-metastatic cancerPopulation-based assessmentCancer registry dataMental health conditionsSubstance use disordersPrivate insurance claimsConcurrent prescriptionsCohort studyHispanic patientsSymptom managementRelative riskRegistry dataGabapentinoidsOpioidsPrescribingUse disordersPatientsPoisson regressionPrior useMedicationsRacial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History
Poghosyan H, Dinan MA, Tamamyan G, Nelson L, Jeon S. Racial and Ethnic Variation in COVID-19 Vaccination Uptake Among Medicare Beneficiaries with Cancer History. Journal Of Racial And Ethnic Health Disparities 2022, 10: 2354-2362. PMID: 36149576, PMCID: PMC9510246, DOI: 10.1007/s40615-022-01415-2.Peer-Reviewed Original ResearchConceptsNon-Hispanic white beneficiariesCancer historyVaccine doseMedicare beneficiariesWhite beneficiariesVaccine uptakeHispanic beneficiariesMultivariable logistic regression analysisCOVID-19 vaccination uptakeSelf-reported cancer historyCOVID-19 vaccine uptakeSelf-reported receiptCOVID-19 vaccination ratesLogistic regression analysisNon-Hispanic blacksSelf-reported raceUnvaccinated beneficiariesVaccination uptakeVaccine dosesVaccination ratesVaccine confidenceVaccine availabilitySupplement surveyCross-sectional dataEthnic variationOral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC)
Dinan MA, Wilson LE, Greiner MA, Spees LP, Pritchard JE, Zhang T, Kaye D, George D, Scales CD, Baggett CD, Gross CP, Leapman MS, Wheeler SB. Oral Anticancer Agent (OAA) Adherence and Survival in Elderly Patients With Metastatic Renal Cell Carcinoma (mRCC). Urology 2022, 168: 129-136. PMID: 35878815, PMCID: PMC9588695, DOI: 10.1016/j.urology.2022.07.012.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaOral anticancer agentsRenal cell carcinomaCell carcinomaMedicare beneficiariesPocket costsOdds of adherenceRetrospective cohort studyDisease-specific survivalReal-world adherenceRCC-specific survivalProportion of daysNon-significant trendAdherent useOAA therapyCohort studyElderly patientsMultivariable analysisStudy criteriaUnivariate analysisOAA treatmentPatientsCarcinomaAdherenceSurvivalMediators 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 diagnosisPatient- And Provider-Level Predictors of Survival Among Patients With Metastatic Renal Cell Carcinoma Initiating Oral Anticancer Agents
Spees LP, Dinan MA, Jackson BE, Baggett CD, Wilson LE, Greiner MA, Kaye DR, Zhang T, George DJ, Scales CD, Pritchard JE, Leapman M, Gross CP, Wheeler SB. Patient- And Provider-Level Predictors of Survival Among Patients With Metastatic Renal Cell Carcinoma Initiating Oral Anticancer Agents. Clinical Genitourinary Cancer 2022, 20: e396-e405. PMID: 35595633, PMCID: PMC9529768, DOI: 10.1016/j.clgc.2022.04.010.Peer-Reviewed Original ResearchConceptsOral anticancer agentsCause mortalityReal-world populationHazard ratioComplex patientsMetastatic renal cell carcinoma patientsFDA approvalMetastatic renal cell carcinomaRenal cell carcinoma patientsProvider-level predictorsRetrospective cohort studyCell carcinoma patientsPatients' clinical characteristicsProvider-level factorsPivotal clinical trialsState Cancer RegistryRenal cell carcinomaCox hazard modelHigh-quality careAnticancer agentsProvider Enumeration SystemMRCC patientsClinical characteristicsCohort studyPatient characteristicsPatient, provider, and hospital factors associated with oral anti-neoplastic agent initiation and adherence in older patients with metastatic renal cell carcinoma
Kaye DR, Wilson LE, Greiner MA, Spees LP, Pritchard JE, Zhang T, Pollack CE, George D, Scales CD, Baggett CD, Gross CP, Leapman MS, Wheeler SB, Dinan MA. Patient, provider, and hospital factors associated with oral anti-neoplastic agent initiation and adherence in older patients with metastatic renal cell carcinoma. Journal Of Geriatric Oncology 2022, 13: 614-623. PMID: 35125336, PMCID: PMC9232903, DOI: 10.1016/j.jgo.2022.01.008.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaCancer-specific survivalMedical oncologistsRenal cell carcinomaHospital factorsHospital characteristicsOlder patientsCell carcinomaOAA treatmentDiagnosis of mRCCHigh-quality cancer careOlder adultsDecreased relative riskHigh-poverty zip codesYears of ageAnti-neoplastic agentsMRCC diagnosisSpecialty accessSurvival persistCause mortalityCancer providersPatient factorsMetastatic diagnosisCancer careRelative riskEvaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma
Miller SM, Wilson LE, Greiner MA, Pritchard JE, Zhang T, Kaye DR, Cohen HJ, Becher RD, Maerz LL, Dinan MA. Evaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma. Journal Of Geriatric Oncology 2022, 13: 635-643. PMID: 34996724, PMCID: PMC9232862, DOI: 10.1016/j.jgo.2021.12.012.Peer-Reviewed Original ResearchConceptsMetastatic renal cell carcinomaNon-cancer controlsRenal cell carcinomaMRCC diagnosisMild cognitive impairmentCell carcinomaRisk factorsCognitive impairmentOlder adultsProportional hazards modelNew cancer treatmentsCohort entryOlder patientsSurgical therapyMAIN OUTCOMEExclusion criteriaAgent useDisease processHazards modelPatientsMedicare datasetCancer treatmentDiagnosisDementiaCarcinoma
2021
Analysis of Sociodemographic, Clinical, and Genomic Factors Associated With Breast Cancer Mortality in the Linked Surveillance, Epidemiology, and End Results and Medicare Database
Robinson TJ, Wilson LE, Marcom PK, Troester M, Lynch CF, Hernandez BY, Parrilla E, Brauer HA, Dinan MA. Analysis of Sociodemographic, Clinical, and Genomic Factors Associated With Breast Cancer Mortality in the Linked Surveillance, Epidemiology, and End Results and Medicare Database. JAMA Network Open 2021, 4: e2131020. PMID: 34714340, PMCID: PMC8556625, DOI: 10.1001/jamanetworkopen.2021.31020.Peer-Reviewed Original ResearchConceptsResidual tissue repositoryBreast cancer outcomesSEER-Medicare dataCancer outcomesCox proportional hazards regression modelHealth servicesEstrogen receptor-positive invasive breast cancerSymptomatic detectionBreast cancer-specific survivalPopulation-based cohort studyEstrogen receptor-positive tumorsProportional hazards regression modelsExploratory genomic analysisSEER-Medicare cohortCancer-specific survivalSocioeconomic statusHigh-grade diseaseInvasive breast cancerReceptor-positive tumorsSubset of womenBreast cancer mortalityAdvanced disease stageHazards regression modelsClaims-based algorithmGrowth factor β activation
2020
Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015
Wilson LE, Greiner MA, Altomare I, Rotter J, Dinan MA. Rapid rise in the cost of targeted cancer therapies for Medicare patients with solid tumors from 2006 to 2015. Journal Of Geriatric Oncology 2020, 12: 375-380. PMID: 33250425, DOI: 10.1016/j.jgo.2020.11.007.Peer-Reviewed Original ResearchConceptsProstate cancerCancer costsLung cancerBreast cancerProportion of patientsSystemic anticancer therapyPart D enrollmentNew malignanciesPatients 65Systemic therapyMedicare 5Colorectal cancerInvasive lungMedicare patientsCohort analysisMedicare populationMedicare beneficiariesPatientsSolid tumorsTherapyCancerAnticancer therapyCancer therapyFinancial burdenLungReal-world systemic therapy utilization in Medicare patients with locally advanced or metastatic urothelial carcinoma diagnosed between 2008 and 2012
Dinan MA, Georgieva MV, Li Y, Zhang T, Harrison M, Shenolikar R, Scales CD. Real-world systemic therapy utilization in Medicare patients with locally advanced or metastatic urothelial carcinoma diagnosed between 2008 and 2012. Journal Of Geriatric Oncology 2020, 12: 298-304. PMID: 32912737, DOI: 10.1016/j.jgo.2020.08.005.Peer-Reviewed Original ResearchConceptsMetastatic urothelial carcinomaSecond-line chemotherapyUrothelial carcinomaOlder patientsSystemic therapyTreatment optionsMedicare patientsReal-world treatment patternsGrade IV diseaseAdvanced urothelial carcinomaSecond-line treatmentPoor oncologic outcomesYear of diagnosisUpper urinary tractLimited treatment optionsAcademic cancer centerSEER-Medicare dataForm of chemotherapyNon-academic centersDoublet chemotherapyPlatinum doubletsNeoadjuvant chemotherapyLine therapyOncologic outcomesRenal diseaseAssociation of 21-Gene Assay (OncotypeDX) Testing and Receipt of Chemotherapy in the Medicare Breast Cancer Patient Population Following Initial Adoption
Dinan MA, Wilson LE, Reed SD, Griggs JJ, Norton EC. Association of 21-Gene Assay (OncotypeDX) Testing and Receipt of Chemotherapy in the Medicare Breast Cancer Patient Population Following Initial Adoption. Clinical Breast Cancer 2020, 20: 487-494.e1. PMID: 32653473, DOI: 10.1016/j.clbc.2020.05.010.Peer-Reviewed Original Research
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 savingsChemotherapy 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
Initial Adoption of Recombinant Human Thyroid-Stimulating Hormone Following Thyroidectomy in the Medicare Thyroid Cancer Patient Population
Dinan MA, Li Y, Reed SD, Sosa JA. Initial Adoption of Recombinant Human Thyroid-Stimulating Hormone Following Thyroidectomy in the Medicare Thyroid Cancer Patient Population. Endocrine Practice 2018, 25: 31-42. PMID: 30383499, DOI: 10.4158/ep-2018-0253.Peer-Reviewed Original ResearchConceptsRecombinant human thyroid-stimulating hormoneHuman thyroid-stimulating hormoneThyroid-stimulating hormoneMultivariable analysisPatient populationUse of rhTSHLower inpatient costsMean outpatient costsDistant metastatic diseaseDifferentiated thyroid cancerEmergency department visitsRadioactive iodine administrationCancer patient populationSEER-Medicare dataCostly hospital staysTotal inpatient daysHealthcare Common Procedure Coding SystemTotal Medicare paymentsNumber of outpatientsMedicare patient populationPositron emission tomographySimilar overall costsRAI administrationHospital stayMultiple comorbiditiesAdvanced 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
Trends in hospital-physician integration in medical oncology.
Clough JD, Dinan MA, Schulman KA. Trends in hospital-physician integration in medical oncology. The American Journal Of Managed Care 2017, 23: 624-627. PMID: 29087634.Peer-Reviewed Original ResearchConceptsHospital outpatient departmentsMedical oncologyHigh-volume specialtiesOutpatient departmentMedical oncologistsMedical oncology practiceHospital-physician integrationProportion of physiciansGreater absolute changeManagement visitsThoracic surgeryOncology practiceRetrospective analysisOncologyAbsolute changeOncologistsMajority of evaluationsPhysiciansHigher proportionSpecialtiesDepartmentState-level variationYearsProportionSurgery