Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI.
Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI.
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乳腺癌外科医生同伴网络特征和新成像技术的采用：围手术期 MRI 的研究。
DOI：
10.1002/cam4.1821
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发表时间：
2018-12
期刊：
影响因子：
4
通讯作者：
Gross CP
中科院分区：
文献类型：
--
作者：
Tannenbaum SS;Soulos PR;Herrin J;Pollack CE;Xu X;Christakis NA;Forman HP;Yu JB;Killelea BK;Wang SY;Gross CP
尽管证据模棱两可，围手术期 MRI 已在乳腺癌实践中传播。我们使用一种新颖的社交网络方法来评估外科医生患者共享网络的特征与 MRI 的后续使用之间的关系。我们从监测、流行病学和最终结果 (SEER)-医疗保险数据库中确定了一组 0-III 期乳腺癌女性患者。我们使用这些患者和 5% Medicare 样本中的非癌症患者的索赔数据来识别 2004 年至 2006 年 (T1) 期间共享患者的医生同行群体。我们使用多变量分层模型来识别与在 T1 中未使用 MRI 的外科医生在 T2（2007-2009）中使用 MRI 相关的同侪群体特征。我们的 T1 样本包括 15,149 名乳腺癌患者，由 390 个医师组的 2439 名外科医生进行治疗。在T1期间，9.1%的患者接受了MRI检查；不同同龄群体中 MRI 的使用率从 0% 到 100%（IQR 0%、8.5%）不等。调整临床特征后，在 T1 中初级保健医生 (PCP) 比例较高的组中接受外科医生治疗的患者在 T2 中接受 MRI 的可能性较小（PCP 增加 10% 时 OR = 0.81，95% CI = 0.71, 0.93）。外科医生的传递性（即外科医生的聚集）与 MRI 接收显着相关（P = 0.013）；外科医生属于 T1 传递性较高组的患者更有可能在 T2 接受 MRI（聚类增加 10% 的 OR = 1.29，95% CI = 1.06、1.58）。外科医生同伴网络的特征与其患者随后接受的围手术期 MRI 相关。
Perioperative MRI has disseminated into breast cancer practice despite equivocal evidence. We used a novel social network approach to assess the relationship between the characteristics of surgeons’ patient‐sharing networks and subsequent use of MRI. We identified a cohort of female patients with stage 0‐III breast cancer from the Surveillance, Epidemiology, and End Results (SEER)‐Medicare database. We used claims data from these patients and non‐cancer patients from the 5% Medicare sample to identify peer groups of physicians who shared patients during 2004‐2006 (T1). We used a multivariable hierarchical model to identify peer group characteristics associated with uptake of MRI in T2 (2007‐2009) by surgeons who had not used MRI in T1. Our T1 sample included 15 149 patients with breast cancer, treated by 2439 surgeons in 390 physician groups. During T1, 9.1% of patients received an MRI; the use of MRI varied from 0% to 100% (IQR 0%, 8.5%) across peer groups. After adjusting for clinical characteristics, patients treated by surgeons in groups with a higher proportion of primary care physicians (PCPs) in T1 were less likely to receive MRI in T2 (OR = 0.81 for 10% increase in PCPs, 95% CI = 0.71, 0.93). Surgeon transitivity (ie, clustering of surgeons) was significantly associated with MRI receipt (P = 0.013); patients whose surgeons were in groups with higher transitivity in T1 were more likely to receive MRI in T2 (OR = 1.29 for 10% increase in clustering, 95% CI = 1.06, 1.58). The characteristics of a surgeon's peer network are associated with their patients’ subsequent receipt of perioperative MRI.
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影响因子：
--
作者：
Bilimoria, Karl Y.;Cambic, Angela;Bethke, Kevin P.
通讯作者：
Bethke, Kevin P.
影响因子：
4.5
作者：
Pollack, Craig Evan;Wang, Hao;Armstrong, Katrina
通讯作者：
Armstrong, Katrina
影响因子：
158.5
作者：
Christakis, Nicholas A.;Fowler, James H.
通讯作者：
Fowler, James H.
DOI：
10.1073/pnas.0601602103
发表时间：
2006-06-06
影响因子：
11.1
作者：
Newman, M. E. J.
通讯作者：
Newman, M. E. J.
影响因子：
120.7
作者：
Matlock, Daniel D.;Groeneveld, Peter W.;Magid, David J.
通讯作者：
Magid, David J.