Craig Earle

..Whether the concept of overly aggressive treatment represents a quality-of-care issue that is acceptable to all involved stakeholders is an open question...

..Many of the issues faced by Ontario are relevant beyond Canada, including in the United States during this period of health care reform...

..In this article, we review some of the challenges to providing survivorship care and discuss efforts to prioritize the most essential elements...

..Using data from a large, multi-regional, population-based cohort, we describe the rate of surveillance colonoscopy and its association with geographic, sociodemographic, clinical, and health services characteristics...

..This retrospective cohort study evaluated healthcare resource use among US Medicare beneficiaries diagnosed with CRC between 1992 and 2002...

..The purpose of this study was to estimate the relative impact of changes in demographics, stage at detection, treatment mix, and medical technology on 5-year survival among older colorectal cancer (CRC) patients...

..Failing to meet the benchmark of 12 lymph nodes in resection specimens is an indication for adjuvant chemotherapy in stage II colon cancer...

..To identify the frequency of and factors associated with changes in employment among cancer survivors...

..abstract:..

..The purpose of this study was to identify and validate common symptom clusters in a large population-based cohort of ambulatory cancer subjects...

..This article describes the trajectory of ESAS and PPS scores 6 months before death...

..The purpose of this study was to measure opioid prescription (OP) rates in elderly cancer outpatients around the time of assessment for pain and to evaluate factors associated with receiving OPs for those with severe pain...

..Disparities in treatment and mortality for colorectal cancer (CRC) may reflect differences in access to specialized care or other characteristics of the area where an individual lives...

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..This study describes the use of surveillance over time, with a particular focus on racial/ethnic disparities, and also examines the role of area characteristics, such as capacity for CRC screening, on surveillance...

..Understanding the longitudinal transitions of performance status among persons with cancer can assist providers in determining the appropriate time to initiate palliative care support...

..The purpose of this study is to determine the relationship between individual patient symptoms and symptom severity, with the likelihood of an emergency department (ED) visit...

..However, little research has examined the association of the PPS with hazard of death in ambulatory populations...

..The objective of this study was to develop a secure protocol for linking data from different registries and to allow on-going monitoring of HPV vaccine effectiveness...

..We compared aggressiveness of end-of-life care of older metastatic cancer patients treated in the Veterans Health Administration (VHA) and those under fee-for-service Medicare arrangements...

..Existing protocols for addressing these concerns can result in reduced analysis accuracy and can allow sensitive information to leak...

..To examine racial and ethnic variation in use of hospice and high-intensity care in patients with terminal illness...

..To determine the extent to which unexplained variation in the use of chemotherapy for advanced lung cancer is due to access to oncologists' services as opposed to treatment decisions made after seeing an oncologist...

..Limited capacity for endoscopy in areas in which African Americans and Hispanics live may be a reason for persistent disparities in colorectal cancer (CRC) screening and stage at diagnosis...

..In a broad cross-section of cancer outpatients, the authors describe the ESAS and PPS scores and their relation to patient characteristics...

..This study was designed to evaluate the role of access to care and postsurgical recovery on delays in adjuvant chemotherapy for rectal cancer...

..To characterize the aggressiveness of end-of-life cancer treatment for older adults on Medicare, and its relationship to the availability of healthcare resources...

..This article reviews the elements of the proposed survivorship care plan and discusses areas of research and development needed to make them part of standard oncology practice...

..They are more likely not to have surgery recommended, and more likely to refuse surgery. Additional research should focus on the physician-patient encounter as a potential source of racial disparities...

..To evaluate measures that could use existing administrative data to assess the intensity of end-of-life cancer care...

..Special attention and education are needed to ensure that survivors receive optimal medical services...

..We aimed to assess if an association between SES and HCC survival existed in the Canadian context...

..Because we found only modest improvement in the quality of studies, we suggest that journals provide specific guidance for reporting CUA and assure that authors adhere to guidelines for conducting and reporting economic evaluations...

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..Providers have been reluctant to disclose patient data for public-health purposes. Even if patient privacy is ensured, the desire to protect provider confidentiality has been an important driver of this reluctance...

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..Research questions that remain to be answered with respect to survivorship care plans and other aspects of survivorship care are discussed...

..Life-sustaining medical care of patients with advanced cancer at the end of life (EOL) is costly. Patient-physician discussions about EOL wishes are associated with lower rates of intensive interventions...

..Our study examines the relationship between the percentage of black patients treated at a hospital to determine whether it affects the likelihood of obtaining cancer-directed surgery for patients with non-small-cell lung cancer (NSCLC)...

..We sought to study the receipt of PMRT in elderly women in this period, using a population-based cohort of women with breast cancer...

..Although hospice care can alleviate suffering at the end of life for patients with cancer, it remains underutilized, particularly by African Americans and Hispanics...

..To compare expectations for cancer survivorship care between patients and their physicians and between primary care providers (PCPs) and oncologists...

..The IOM stated that survivorship care plans 'have strong face validity and can reasonably be assumed to improve care unless and until evidence accumulates to the contrary.'..

..Assessing the value of these treatments is compromised by a paucity of data on the impact of recurrence on economic costs and survival. The purpose of this study was to shed light on these issues...

..To examine influenza vaccination use in patients undergoing chemotherapy for advanced cancer...

..Disparities in cancer survival may be related to differences in stage. Segregation may be associated with disparities in stage, particularly for cancers for which screening promotes survival...

..To explore potential indicators of the quality of end-of-life services for cancer patients that could be monitored using existing administrative data...

..Guidelines recommend advanced care planning for terminally ill patients with <1 year to live. Few data are available regarding when physicians and their terminally ill patients typically discuss end-of-life issues...

..To compare prospectively and retrospectively defined benchmarks for the quality of end-of-life care, including a novel indicator for the use of opiate analgesia...

..To describe trends in the aggressiveness of end-of-life (EOL) cancer care in a universal health care system in Ontario, Canada, between 1993 and 2004, and to compare with findings reported in the United States...

..A systematic review was conducted to evaluate the literature regarding the impact of follow-up on colorectal cancer patient survival and, in a second phase, recommendations were developed...

..Progress was evaluated at a national level in resected patients, as measured by the proportion who received guideline-directed treatment and trends in survival...

..e., better outcomes). We examined associations between physician specialty and outcomes in a population-based cohort of elderly ovarian cancer surgery patients...

..Linking administrative data to registry data, as in the creation of the SEER (Surveillance, Epidemiology, and End Results) and Medicare data set, can provide the ability to infer the occurrence of relapse in selected situations...

..Although generally well-adjusted, a subset of cancer survivors have been observed to experience ongoing psychological distress. There has been little study of mental health care utilization among cancer survivors, however...

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..To evaluate the use and effectiveness of cancer-directed therapy in elderly patients with locally advanced pancreatic cancer (LAPC)...

..To fill this void, our study uses population-based data to evaluate longer-term treatment patterns, outcomes and costs among elderly Medicare beneficiaries following their diagnosis of CML...

..The number, nature, and costs of serious adverse effects experienced by younger women receiving chemotherapy for breast cancer outside of clinical trials are unknown...

..Questions have existed as to whether residential segregation is a mediator of racial/ethnic disparities in breast cancer care and breast cancer mortality, or has a differential effect by race/ethnicity...

..Many terminally ill patients enroll in hospice only in the final days before death or not at all. Discussing hospice with a health care provider could increase awareness of hospice and possibly result in earlier use...

..01). CONCLUSION: Morbidity after prostate brachytherapy was common, though invasive procedures were required infrequently. Invasive procedures for complications declined during the 1990s, suggesting technical improvement with experience...

..Whether these results apply to other cancer types is unknown but worthy of further study...

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..To investigate the combination of erlotinib, capecitabine, and oxaliplatin in patients who were previously treated for metastatic colorectal cancer...

..Blacks have a higher incidence of pancreatic adenocarcinoma and worse outcomes compared to whites. Identifying barriers in pancreatic cancer care may explain survival differences and provide areas for intervention...

..We sought to study the effect of distance to the nearest radiation treatment facility on the use of postmastectomy radiation therapy (PMRT) in elderly women...

..26 [1.07, 1.48]). Our analysis suggests that, at least among white women, SEER is a reliable data source with respect to lymphoid malignancies...

..To explore the associations among cancer survivorship discussions, patient-physician expectations, and receipt of follow-up care in cancer survivors...

..One category of outcomes amenable to research using Medicare claims is complications of cancer treatments: the unintentional, adverse side effects or sequelae of interventions used to treat or palliate cancer patients...

..To assess the quality of preventive health care, the role of health care participation, and the patient and provider characteristics associated with high-quality care for breast cancer survivors...

..Using administrative data is an efficient, population-based method to monitor quality of care which can compliment other methods, such as qualitative and purposefully collected clinical data...

..We aimed to develop and validate a simple risk score for surgical mortality that could be applied to administrative data...

..Administrative claims databases linked to tumor registry data provide an excellent opportunity for studying the follow-up care of cancer patients...

..As cancer patients transition from treatment to survivorship, the responsibility of primary care providers (PCPs) versus oncology specialists is unclear...

..To explore the mix of physician specialties that long-term survivors visit and how the mix relates to preventive care...

..The objective of this study was to assess stakeholder acceptability of QIs of end-of-life (EOL) care that potentially were measurable from population-based administrative health databases...

..The objective of this study was to examine the utilization patterns of palliative RT among elderly patients with Stage IV NSCLC and, in particular, to identify factors associated with its use...

..CONCLUSION: These results suggest that the health economic burden of SCCHN is substantial, with costs that are comparable with or higher than those of other solid tumors...

..We investigated racial disparities in access to surgical evaluation, receipt of surgery, and survival among elderly patients with locoregional esophageal cancer...

..Our findings can be used as a baseline against which the benefits of new therapies can be compared...

..Providers who were more generously reimbursed, however, prescribed more-costly chemotherapy regimens to metastatic breast, colorectal, and lung cancer patients...

..Payers and patients will benefit from these results when selecting providers, and institutions and networks will be able to use them to monitor performance. ..

..Once identified, reasons could be sought and appropriate interventions, such as increasing access to palliative services, could be instituted. ..