title: Pathways, outcomes, and costs in colon cancer: retrospective evaluations in 2 distinct databases.
abstract: OBJECTIVE
  The goal of this study was to use 2 separate databases to evaluate the clinical outcomes and the economic impact of adherence to Level I Pathways, an evidence-based oncology treatment program in the treatment of colon cancer.
  
  
  METHODS
  The first study used clinical records from an electronic health record (EHR) database to evaluate survival according to pathway status in patients with colon cancer. Disease-free survival in patients receiving adjuvant treatment and overall survival in patients receiving first-line therapy for metastatic disease was calculated. The second study used claims data from a national administrative claims database to examine direct medical costs and use, including the cost of chemotherapy and of chemotherapy-related hospitalizations according to pathway status.
  
  
  RESULTS
  Overall costs from the national claims database-including total cost per case and chemotherapy costs-were lower for patients treated according to Level I Pathways (on- Pathway) compared with patients not treated according to Level I Pathways. Use of pathways was also associated with a shorter duration of therapy and lower rate of chemotherapy-related hospital admissions. Survival for patients on- Pathways in the EHR database was comparable with that in the published literature.
  
  
  CONCLUSIONS
  Results from 2 distinct databases suggest that treatment of patients with colon cancer on-Pathways costs less; use of these pathways demonstrates clinical outcomes consistent with published evidence.
authors.affiliation: Texas Oncology, Suite 500, 12221 Merit Dr, Dallas, TX 75251, USA. russell.hoverman@usoncology.com
authors.forename: J Russell
authors.initials: JR
authors.lastname: Hoverman
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Cartwright
authors.forename: Debra A
authors.initials: DA
authors.lastname: Patt
authors.forename: Janet L
authors.initials: JL
authors.lastname: Espirito
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Clayton
authors.forename: Jody S
authors.initials: JS
authors.lastname: Garey
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Kopp
authors.forename: Michael
authors.initials: M
authors.lastname: Kolodziej
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Neubauer
authors.forename: Kathryn
authors.initials: K
authors.lastname: Fitch
authors.forename: Bruce
authors.initials: B
authors.lastname: Pyenson
authors.forename: Roy A
authors.initials: RA
authors.lastname: Beveridge
mesh_terms: D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000191:economics*; D003365:Costs and Cost Analysis; D019091:Critical Pathways; D016208:Databases, Factual; D057286:Electronic Health Records; D006801:Humans; D008485:Medical Audit; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States