title: The role of organizational affiliations and research networks in the diffusion of breast cancer treatment innovation.
abstract: BACKGROUND
  The National Institutes of Health (NIH) sees provider-based research networks and other organizational linkages between academic researchers and community practitioners as promising vehicles for accelerating the translation of research into practice. This study examines whether organizational research affiliations and teaching affiliations are associated with accelerated diffusion of sentinel lymph node biopsy (SLNB), an innovation in the treatment of early-stage breast cancer.
  
  
  METHODS
  Surveillance Epidemiology and End Results-Medicare data were used to examine the diffusion of SLNB for treatment of early-stage breast cancer among women aged 65 years and older diagnosed between 2000 and 2002, shortly after Medicare approved and began reimbursing for the procedure.
  
  
  RESULTS
  In this population, patients treated at an organization affiliated with a research network--the American College of Surgeons Oncology Group (ACOSOG) or other National Cancer Institute (NCI) cooperative groups--were more likely to receive the innovative treatment (SLNB) than patients treated at unaffiliated organizations (odds ratio: 2.70, 95% confidence interval: 1.77-4.12; odds ratio: 1.84, 95% confidence interval: 1.26-2.69, respectively). Neither hospital teaching status nor surgical volume was significantly associated with differences in SLNB use.
  
  
  CONCLUSIONS
  Patients who receive cancer treatment at organizations affiliated with cancer research networks have an enhanced probability of receiving SLNB, an innovative procedure that offers the promise of improved patient outcomes. Study findings support the NIH Roadmap and programs such as the NCI's Community Clinical Oncology Program, as they seek to accelerate the translation of research into practice by simultaneously accelerating and broadening cancer research in the community.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27516, USA. wrc4@email.unc.edu
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.forename: Katherine
authors.initials: K
authors.lastname: Reeder-Hayes
authors.forename: John
authors.initials: J
authors.lastname: Bainbridge
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Meyer
authors.forename: Keith D
authors.initials: KD
authors.lastname: Amos
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Weiner
authors.forename: Paul A
authors.initials: PA
authors.lastname: Godley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D004059:Diffusion of Innovation; D005260:Female; D006302:Health Services Research; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D007373:Interinstitutional Relations; D016014:Linear Models; D016015:Logistic Models; D008495:Medical Oncology / Q000458:organization & administration; D006278:Medicare / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009935:Organizational Affiliation; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D018426:SEER Program; D021701:Sentinel Lymph Node Biopsy / Q000706:statistics & numerical data*; D012955:Societies, Medical / Q000458:organization & administration; D057170:Translational Research, Biomedical / Q000458:organization & administration*; D014481:United States / Q000453:epidemiology