@article{221abce279c74547a65e97496dc4bdf8,
title = "Surgeon peer network characteristics and adoption of new imaging techniques in breast cancer: A study of perioperative MRI",
abstract = "Background: 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{\textquoteright} patient-sharing networks and subsequent use of MRI. Methods: 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. Results: 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). Conclusion: The characteristics of a surgeon's peer network are associated with their patients{\textquoteright} subsequent receipt of perioperative MRI.",
keywords = "Medicare, breast cancer, diagnostic imaging, magnetic resonance imaging, social networking",
author = "Tannenbaum, {Sara S.} and Soulos, {Pamela R.} and Jeph Herrin and Pollack, {Craig E.} and Xiao Xu and Christakis, {Nicholas A.} and Forman, {Howard P.} and Yu, {James B.} and Killelea, {Brigid K.} and Wang, {Shi Yi} and Gross, {Cary P.}",
note = "Funding Information: Dr Wang receives research support from Genentech. The source of support was not used for any portion of the current manuscript. Dr Yu is a consultant for Augmenix Inc Dr Pollack has stock ownership in Gilead Pharmaceuticals. Dr Killelea is a consultant for Genentech. Drs. Gross and Yu and Ms Soulos receive research funding from 21st Century Oncology LLC. Dr Gross has also received funding from Medtronic and Johnson & Johnson. Ms Tannenbaum and Drs. Herrin, Christakis, Forman, and Xu report no relationships or activities that could appear to have influenced the submitted work. Funding Information: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA190017. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The collection Funding Information: Funding information Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA190017. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The collection of the California cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute's Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Northern California Cancer Center, contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention's National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred The authors acknowledge the efforts of the Applied Research Program, NCI; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. The interpretation and reporting of the SEER-Medicare data are the sole responsibility of the authors. Funding Information: of the California cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute{\textquoteright}s Surveillance, Epidemiology and End Results Program under contract N01‐PC‐35136 awarded to the Northern California Cancer Center, contract N01‐PC‐35139 awarded to the University of Southern California, and contract N02‐PC‐15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention{\textquoteright}s National Program of Cancer Registries, under agreement #U55/CCR921930‐02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred Publisher Copyright: {\textcopyright} 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.",
year = "2018",
month = dec,
doi = "10.1002/cam4.1821",
language = "English (US)",
volume = "7",
pages = "5901--5909",
journal = "Cancer medicine",
issn = "2045-7634",
publisher = "John Wiley and Sons Ltd",
number = "12",
}