Affiliation:
1. HealthCore, Inc., Wilmington, Delaware, USA
2. American Imaging Management, Chicago, Illinois, USA
3. University of Rochester Medical Center, Rochester, New York, USA
Abstract
Abstract
Background.
Degree of physician adherence to 2001 guidelines recommending routine testing of human epidermal growth factor receptor 2 (HER2) status among newly diagnosed, recurrent, and metastatic breast cancer (BC) cases, and frequency of trastuzumab use in HER2-positive patients are not well documented.
Methods.
Patients newly diagnosed with BC managed by an identifiable hematologist/oncologist between June 1, 2005 and June 30, 2006 were identified from an administrative claims database of three health plans (n = 3,521). From these, a subset of 380 patients was identified for medical chart review. HER2 testing (occurrence, type of test used), HER2 status (positive, negative, unknown), and trastuzumab usage were evaluated.
Results.
HER2 testing occurred in 88% of all newly diagnosed patients with BC and in 98.1% of those with stage 1 or higher breast cancer (n = 322), for whom testing is recommended. Among those with HER2 testing performed (n = 335), 21.5% were positive (HER2+), 77.3% were negative (HER2−), and 1.2% were unknown. Of the 52 patients who used trastuzumab, only one patient did not have documented HER2 overexpression. Of the 45 HER2+ women who had stage 2 or higher BC, 13% did not receive trastuzumab.
Conclusions.
HER2 testing status was extremely high among newly diagnosed BC patients treated by hematologists/oncologists in a managed care environment. There was almost no evidence of inappropriate prescribing of trastuzumab, but 1 of every 7.5 patients with HER2-overexpressing stage 2 or higher breast cancer did not receive the agent.
Publisher
Oxford University Press (OUP)
Reference45 articles.
1. The urgent need to improve health care quality. Institute of Medicine National Roundtable on Health Care Quality;Chassin;JAMA,1998
2. Healthcare Effectiveness Data & Information Set;National Committee for Quality Assurance (NCQA). HEDIS 2006;Technical Specifications,2005
3. Practice variation: implications for our health care system;Wennberg;Manag Care,2004
4. Practice guidelines: best hope for quality improvement in the 1990s;Chassin;J Occup Med,1990
Cited by
33 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献