br Overview of disease severity measures disseminated with
16. Overview of disease severity measures disseminated with the nationwide inpatient sample (NIS) and kids’ inpatient database (KID). Rockville, MD: AHRQ; 2005.
17. Moore BJ, White S, Washington R, Coenen N, Elixhauser A. Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser comorbidity index. Med Care 2017;55:698–705.
21. Parsons LS. Performing AMG-176 1: N case-control match on propensity score. Proceedings of the 29th annual SAS users group international conference 2004 p. 165-29.
22. Age-adjusted SEER incidence and U.S. death rates and 5-year relative survival (percent) by primary cancer site, sex and time period. SEER cancer statistics review (CSR) 1975–2014. National Cancer Institute; 2014.
24. Secemsky EA, Rosenfield K, Kennedy KF, Jaff M, Yeh RW. High burden of 30-day readmissions after acute venous thromboembolism in the United States. J Am Heart Assoc 20187:.
25. Schwarze ML, Nabozny MJ, Steffens NM. Cardiopulmonary resuscitation and benefit to patients with metastatic cancer—reply. JAMA Intern Med 2016;176:142–3.
28. Iliescu C, Grines CL, Herrmann J, et al. SCAI expert consensus statement: evaluation, management, and special considerations of cardio-oncology patients in the cardiac catheterization laboratory (endorsed by the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencionista). Catheter Cardiovasc Interv 2016;87:895–9.
29. Iliescu C, Balanescu DV, Donisan T, et al. Safety of diagnostic and therapeutic cardiac catheterization in cancer patients with acute coronary syndrome and chronic thrombocytopenia. Am J Cardiol 2018;122:1465–70.
30. Hess CN, Roe MT, Clare RM, et al. Relationship between cancer and cardiovascular outcomes following percutaneous coronary intervention. J Am Heart Assoc 20154:.
31. Patel N, Patel NJ, Macon CJ, et al. Trends and outcomes of coronary angiography and percutaneous coronary intervention after out-of-hospital cardiac arrest associated with ventricular fibrillation or pulseless ventricular tachycardia. JAMA Cardiol 2016;1:890–9. Health Services Research
Contemporary Management of Incident Prostate Cancer in Large Community Urology Practices in the United States
Jeremy B. Shelton, Phil Buffington, Richard Augspurger, Franklin Gaylis, Todd Cohen, Bryan Mehlhaff, Ronald Suh, Timothy J. Bradford, Lorna Kwan, Alec S. Koo, and Neal Shore
OBJECTIVE To characterize the contemporary management of prostate cancer patients in large community
practices. The optimal management of incident prostate cancer has changed in the last decades to
include active surveillance for a large number of men. At the same time, many community practi-
ces have merged into larger groups. The adoption of evidence-based guidelines is of increasing
importance, but poorly understood in this newer practice setting. METHODS We conducted a retrospective chart review of men ≤75 years old with very low, low, and interme-
diate risk incident prostate cancer diagnosed between December 1, 2012 and March 31, 2014, in
9 geographically distributed large urology practices. We used descriptive statistics and multivari-
able regression to assess predictors of primary management choice. RESULTS 2029 men were in the study cohort. A majority were white (68.7%). Total of 45.7% had interme-
was the initial treatment for 74.7% of men with very low risk disease, 43.5% of men with low risk
disease and 10.8% of men with intermediate risk disease. The probability of choosing surgery vs
radiation for men with lower and intermediate risk disease was 0.54 (95% confidence interval:
practices largely followed clinical characteristics, widespread adoption of active surveillance,
and equal use of surgery and radiation. However, some variation by practice suggested a need
The optimal management of newly diagnosed pros-tate cancer has changed substantially in the last decades to recognize the importance of active sur-veillance (AS) and observation for a large number of men within the biologic spectrum of lower risk (National Comprehensive Cancer Network (NCCN) very low and low risk) prostate cancer.1,2 Multiple studies have exam-ined the initially slow rate of adoption of guideline recom-mendations to offer AS to men with lower risk prostate cancer, though few studies have focused entirely on com-munity (private) practices, and those that have, focused
From the Department of Urology, UCLA, Los Angeles, CA; the Urology Group, Cincinnati, OH; the Urology Center of Colorado, Denver, CO; the Genesis Healthcare Partners, San Diego, CA; the Carolina Urology Partners, Charlotte, NC; the Oregon Urology Institute, Springfield, OR; the Urology of Indiana, Indianapolis, IN; the Virginia Urology, VA; the Department of Urology, UCLA, the Skyline Urology, Los Angeles, CA; and the Atlantic Urology Clinics, Myrtle Beach, SC