Physician's peer exposure and the adoption of a new cancer treatment modality.
Physician's peer exposure and the adoption of a new cancer treatment modality.
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DOI：
10.1002/cncr.29409
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发表时间：
2015-08-15
期刊：
影响因子：
6.2
通讯作者：
Gross CP
中科院分区：
文献类型：
--
作者：
Pollack CE;Soulos PR;Gross CP
New technologies—often with limited evidence to support their effectiveness—frequently diffuse into clinical practice and increase the costs of cancer care. We studied whether physician peer exposure was associated with the subsequent adoption of a new approach to adjuvant radiation therapy (brachytherapy) for the treatment of women with early stage breast cancer. We performed a retrospective cohort study using SEER-Medicare data. Data from 2003–2004 was used to classify surgeons as early brachytherapy adopters and, among non-early adopters, whether they shared patients with early adopters (peer exposure). Data from 2005–2006 was used to examine whether women were more likely to receive brachytherapy if their surgeons were exposed to early adopters. Overall, the proportion of women receiving brachytherapy increased from 3.2% in 2003–2004 to 4.7% in 2005–2006. In this latter period, 2,087 patients were assigned to 328 non-early adopting surgeons. In unadjusted analyses, patients whose surgeons were connected to early adopters during 2003–2004 were significantly more likely to receive brachytherapy in 2005–2006 compared to those whose surgeons were not connected to early adopters (8.0% versus 4.1%, p=0.003). In adjusted analyses, the predicted probability of receiving brachytherapy in patients whose surgeon did have an early adopting peer was 3.9% vs. 1.0% among those whose surgeons did not have an early adopting peer(p=0.03). Exposure to peers who were early adopters of brachytherapy was associated with a surgeon’s subsequent uptake of brachytherapy. This study provides an example of a novel approach to examining the diffusion of innovation in cancer care.
