title: Translating research into practice: the role of provider-based research networks in the diffusion of an evidence-based colon cancer treatment innovation.
abstract: BACKGROUND
  Provider-based research networks (PBRNs)--collaborative research partnerships between academic centers and community-based practitioners--are a promising model for accelerating the translation of research into practice; however, empirical evidence of accelerated translation is limited. Oxaliplatin in adjuvant combination chemotherapy is an innovation with clinical trial-proven survival benefit compared with prior therapies. The goal of this study is to examine the diffusion of oxaliplatin into community practice, and whether affiliation with the National Cancer Institute's (NCI's) Community Clinical Oncology Program (CCOP)--a nationwide cancer-focused PBRN--is associated with accelerated innovation adoption.
  
  
  METHODS
  This retrospective observational study used linked Surveillance, Epidemiology, and End Results-Medicare and NCI CCOP data to examine Medicare participants with stage III colon cancer initiating treatment in 2003 through 2006, the years surrounding oxaliplatin's Food and Drug Administration approval. A fixed-effects analysis examined chemotherapy use among patients treated outside academic centers at CCOP-affiliated practices compared with non-CCOP practices. Two-group modeling controlled for multiple levels of clustering, year of chemotherapy initiation, tumor characteristics, patient age, race, comorbidity, Medicaid dual-eligibility status, and education.
  
  
  RESULTS
  Of 4055 community patients, 35% received 5-fluoruracil, 20% received oxaliplatin, 7% received another chemotherapy, and 38% received no chemotherapy. Twenty-five percent of CCOP patients received oxaliplatin, compared with 19% of non-CCOP patients. In multivariable analysis, CCOP exposure was associated with higher odds of receiving guideline-concordant treatment in general, and oxaliplatin specifically.
  
  
  CONCLUSIONS
  These findings contribute to a growing set of evidence linking PBRNs with a greater probability of receiving treatment innovations and high-quality cancer care, with implications for clinical and research policy.
authors.affiliation: Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599-7411, USA. wrc4@email.unc.edu
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Meyer
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.forename: Bahjat
authors.initials: B
authors.lastname: Qaqish
authors.forename: Hanna K
authors.initials: HK
authors.lastname: Sanoff
authors.forename: Richard M
authors.initials: RM
authors.lastname: Goldberg
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Weiner
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D035843:Biomedical Research; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000601:surgery; D004059:Diffusion of Innovation; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D006278:Medicare / Q000706:statistics & numerical data; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D012189:Retrospective Studies; D057170:Translational Research, Biomedical; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D011725:Pyridines; C431073:oxiplatin; D005472:Fluorouracil