title: Provider-based research networks and diffusion of surgical technologies among patients with early-stage kidney cancer.
abstract: BACKGROUND
  Provider-based research networks such as the National Cancer Institute's Community Clinical Oncology Program (CCOP) have been shown to facilitate the translation of evidence-based cancer care into clinical practice. This study compared the utilization of laparoscopy and partial nephrectomy among patients with early-stage kidney cancer according to their exposure to CCOP-affiliated providers.
  
  
  METHODS
  With linked Surveillance, Epidemiology, and End Results-Medicare data, patients with T1aN0M0 kidney cancer who had been treated with nephrectomy from 2000 to 2007 were identified. For each patient, the receipt of care from a CCOP physician or hospital and treatment with laparoscopy or partial nephrectomy were determined. Adjusted for patient characteristics (eg, age, sex, and marital status) and other organizational features (eg, community hospital and National Cancer Institute-designated cancer center), multivariate logistic regression was used to estimate the association between each surgical innovation and CCOP affiliation.
  
  
  RESULTS
  During the study interval, 1578 patients (26.8%) were treated by a provider with a CCOP affiliation. Trends in the utilization of laparoscopy and partial nephrectomy remained similar between affiliated and nonaffiliated providers (P ≥ .05). With adjustments for patient characteristics, organizational features, and clustering, no association was noted between CCOP affiliation and the use of laparoscopy (odds ratio [OR], 1.11; 95% confidence interval [CI], 0.81-1.53) or partial nephrectomy (OR, 1.04; 95% CI, 0.82-1.32) despite the more frequent receipt of these treatments in academic settings (P < .05).
  
  
  CONCLUSIONS
  At a population level, patients treated by providers affiliated with CCOP were no more likely to receive at least 1 of 2 surgical innovations for treatment of their kidney cancer, indicating perhaps a more limited scope to provider-based research networks as they pertain to translational efforts in cancer care.
authors.affiliation: Veterans Administration/Robert Wood Johnson Clinical Scholars Program, University of California Los Angeles, Los Angeles, California; Department of Urology, University of California Los Angeles, Los Angeles, California.
authors.forename: Hung-Jui
authors.initials: HJ
authors.lastname: Tan
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Meyer
authors.forename: Tzy-Mey
authors.initials: TM
authors.lastname: Kuo
authors.forename: Angela B
authors.initials: AB
authors.lastname: Smith
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Wheeler
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Nielsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004059:Diffusion of Innovation; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods / Q000592:standards; D008297:Male; D054547:National Cancer Institute (U.S.); D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods* / Q000592:standards; D018426:SEER Program; D057170:Translational Research, Biomedical; D014481:United States
keywords: diffusion of innovation; kidney neoplasm; laparoscopy; nephrectomy; provider-based research networks; translation research