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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 13 of 13 Research Studies DisplayedBaskin AS, Wang T, Bredbeck BC
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
This study describes trends in contralateral prophylactic mastectomy (CPM) utilization for small unilateral breast cancer instead of breast-conserving surgery (BCS) which is recommended. The authors used the National Cancer Database to identify women with unilateral, T1 breast cancer. Of the total cohort of 765,487, 69% underwent BCS and 31% chose mastectomy. Of 176,673 women aged 70 years or older, 75% underwent BCS and 25% chose mastectomy. CPM rates have increased in both cohorts since 2006. Patient factors such as younger age, white rate, private insurance, tumor factors, and facility factors were associated with increased CPM rates compared with unilateral mastectomy.
Citation: Baskin AS, Wang T, Bredbeck BC .
Trends in contralateral prophylactic mastectomy utilization for small unilateral breast cancer.
J Surg Res 2021 Jun;262:71-84. doi: 10.1016/j.jss.2020.12.057..
Keywords: Cancer: Breast Cancer, Cancer, Women, Surgery, Prevention, Healthcare Utilization
Wang T, Baskin A, Miller J
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Guidelines allow for the omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy in women >/= 70 years of age with hormone receptor-positive (HR +) breast cancer. Despite this, national data suggest these procedures have not been widely de-implemented. The objectives of this study were to evaluate trends in SLNB and post-lumpectomy radiotherapy utilization in patients who were eligible for omission and evaluate patient preferences as a target for de-implementation of low-value care.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin A, Miller J .
Trends in breast cancer treatment de-implementation in older patients with hormone receptor-positive breast cancer: a mixed methods study.
Ann Surg Oncol 2021 Feb;28(2):902-13. doi: 10.1245/s10434-020-08823-w..
Keywords: Elderly, Cancer: Breast Cancer, Cancer, Healthcare Utilization, Practice Patterns, Women
Dinan MA, Wilson LE, Reed SD
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
This study looked at trends in the association of 21-gene assay testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption from 2001 to 2011. The investigators looked at updated SEER-Medicare data from 2004 and 2011. The cohort included 26,009 patients who met inclusion criteria. Assay use was associated with a decrease in absolute percentage use of chemotherapy by 4.5%, which became even more pronounced from 2008-2011 with a decrease of 6.8%.
AHRQ-funded; HS022189.
Citation: Dinan MA, Wilson LE, Reed SD .
Association of 21-gene assay (OncotypeDX) testing and receipt of chemotherapy in the Medicare breast cancer patient population following initial adoption.
Clin Breast Cancer 2020 Dec;20(6):487-94.e1. doi: 10.1016/j.clbc.2020.05.010..
Keywords: Cancer: Breast Cancer, Cancer, Treatments, Genetics, Medicare, Women, Healthcare Utilization
Franc BL, Thombley R, Luo BL, Franc BL, Thombley R, Luo R, Luo Y
Identifying tests related to breast cancer care in claims data.
The goal of this study was to develop a method for calculating rates of testing for breast cancer recurrence in patients who have already undergone initial treatment for breast cancer. Rates were calculated from a cohort of Medicare breast cancer patients and an age-matched noncancer cohort. They calculated testing rates in the breast cancer cohort above the background rate in the noncancer population. There were similar estimates of testing prevalence and frequency in the two groups, with exception of prevalence of computed tomography (CT).
AHRQ-funded; HS024936.
Citation: Franc BL, Thombley R, Luo BL, Franc BL, Thombley R, Luo R, Luo Y .
Identifying tests related to breast cancer care in claims data.
Breast J 2020 Jun;26(6):1227-30. doi: 10.1111/tbj.13691..
Keywords: Cancer: Breast Cancer, Cancer, Imaging, Diagnostic Safety and Quality, Healthcare Utilization
Maclean JC, Halpern MT, Hill SC
AHRQ Author: Hill SC
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
The purpose of this study was to quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data from the Medicaid State Drug Utilization Database was used. Findings showed that Medicaid expansion may have had a meaningful impact on the ability of lower-income women to access effective hormonal therapies used to treat breast cancer.
AHRQ-authored.
Citation: Maclean JC, Halpern MT, Hill SC .
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
Health Serv Res 2020 Jun;55(3):399-410. doi: 10.1111/1475-6773.13289..
Keywords: Medicaid, Cancer: Breast Cancer, Cancer, Medication, Policy, Women, Healthcare Utilization, Access to Care, Health Insurance
Knerr S, Bowles EJA, Leppig KA
Trends in BRCA test utilization in an integrated health system, 2005-2015.
The authors reported 10-year trends in BRCA testing in an integrated health-care system with long-standing access to genetic services. They found that many eligible women did not receive BRCA testing despite having insurance coverage and access to specialty genetic services, thus underscoring challenges to primary and secondary hereditary cancer prevention.
AHRQ-funded; HS022982.
Citation: Knerr S, Bowles EJA, Leppig KA .
Trends in BRCA test utilization in an integrated health system, 2005-2015.
J Natl Cancer Inst 2019 Aug;111(8):795-802. doi: 10.1093/jnci/djz008..
Keywords: Cancer: Breast Cancer, Cancer: Ovarian Cancer, Cancer, Genetics, Screening, Prevention, Healthcare Utilization, Healthcare Delivery, Women
Richards CA, Rundle AG, Wright JD
Association between hospital financial distress and immediate breast reconstruction surgery after mastectomy among women with ductal carcinoma in situ.
Hospital financial distress may reduce the services a hospital can offer, particularly unprofitable ones. This study examined the association between hospital financial distress (HFD) and receipt of immediate breast reconstruction surgery after mastectomy among women diagnosed with ductal carcinoma in situ (DCIS). It concluded that the financial strength of the hospital where a patient receives treatment is associated with receipt of immediate breast reconstruction surgery.
AHRQ-funded; HS021709.
Citation: Richards CA, Rundle AG, Wright JD .
Association between hospital financial distress and immediate breast reconstruction surgery after mastectomy among women with ductal carcinoma in situ.
JAMA Surg 2018 Apr;153(4):344-51. doi: 10.1001/jamasurg.2017.5018.
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Keywords: Cancer: Breast Cancer, Healthcare Costs, Healthcare Utilization, Healthcare Cost and Utilization Project (HCUP), Surgery
Kohler RE, Goyal RK, Lich KH
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
The objective of this study was to examine health care utilization and expenditures as a function of patient-centered medical home (PCMH) enrollment among breast cancer patients in North Carolina’s Medicaid program. It found that PCMH enrollment was significantly associated with greater outpatient service use, but there was no difference in the probability of inpatient hospitalizations or ED visits.
AHRQ-funded; HS019468.
Citation: Kohler RE, Goyal RK, Lich KH .
Association between medical home enrollment and health care utilization and costs among breast cancer patients in a state Medicaid program.
Cancer 2015 Nov 15;121(22):3975-81. doi: 10.1002/cncr.29596..
Keywords: Cancer, Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Patient-Centered Healthcare
Wang X, Du XL
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
The researchers assessed socio-demographic, geographic, and other variations in the receipt of hormone therapy among patients with hormone receptor-positive breast cancer as well as adherence to hormone therapy within 1-year follow-up. They found that found that increasing age was significantly associated with a decreased receipt of hormone therapy and aromatase inhibitors in all hormone receptor-positive breast cancer patients after adjusting for other factors regardless of whether chemotherapy was received.
AHRQ-funded; HS018956.
Citation: Wang X, Du XL .
Socio-demographic and geographic variations in the utilization of hormone therapy in older women with breast cancer after Medicare Part-D coverage.
Med Oncol 2015 May;32(5):154. doi: 10.1007/s12032-015-0599-6..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Social Determinants of Health
Drake BF, Abadin SS, Lyons S
Mammograms on-the-go-predictors of repeat visits to mobile mammography vans in St Louis, Missouri, USA: a case-control study.
The purpose of this study was to determine the extent to which women use mobile mammography vans for breast cancer screening and what factors are associated with repeat visits to these vans. Women who were aged 50–65, uninsured, or African-American had higher odds of a repeat visit to the mobile mammography van compared with women who were aged 40–50, insured, or Caucasian.
AHRQ-funded; HS022330.
Citation: Drake BF, Abadin SS, Lyons S .
Mammograms on-the-go-predictors of repeat visits to mobile mammography vans in St Louis, Missouri, USA: a case-control study.
BMJ Open 2015 Mar 20;5(3):e006960. doi: 10.1136/bmjopen-2014-006960..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Screening, Women, Healthcare Utilization, Imaging
Wheeler SB, Kohler RE, Reeder-Hayes KE
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
The researchers sought to characterize endocrine therapy (ET) use in a low-income Medicaid-insured population in North Carolina. They found that, of 222 women meeting the inclusion criteria, only 50 percent filled a prescription for ET. Results suggest substantial underutilization of ET in this population.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kohler RE, Reeder-Hayes KE .
Endocrine therapy initiation among Medicaid-insured breast cancer survivors with hormone receptor-positive tumors.
J Cancer Surviv 2014 Dec;8(4):603-10. doi: 10.1007/s11764-014-0365-3..
Keywords: Cancer: Breast Cancer, Healthcare Utilization, Medicaid, Medication, Patient-Centered Outcomes Research
Thompson CA, Gomez SL, Chan A
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
The researchers performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. They concluded that language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations.
AHRQ-funded; HS019815.
Citation: Thompson CA, Gomez SL, Chan A .
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2208-17. doi: 10.1158/1055-9965.epi-14-0487..
Keywords: Cancer: Breast Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Utilization, Screening
Wernli KJ, DeMartini WB, Ichikawa L
Patterns of breast magnetic resonance imaging use in community practice.
The researchers described patterns of breast MRI use in US community practice during the period 2005 through 2009. They found that the overall rate of breast MRI from 2005 through 2009 nearly tripled from 4.2 to 11.5 examinations per 1000 women, with the most rapid increase from 2005 to 2007.
AHRQ-funded; HS019482.
Citation: Wernli KJ, DeMartini WB, Ichikawa L .
Patterns of breast magnetic resonance imaging use in community practice.
JAMA Intern Med 2014 Jan;174(1):125-32. doi: 10.1001/jamainternmed.2013.11963..
Keywords: Cancer: Breast Cancer, Data, Healthcare Utilization, Imaging, Registries