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Utilization of epidermal growth factor receptor (EGFR) testing in the United States: a case study of T3 translational research.


ABSTRACT: PURPOSE:We examined hospital use of the epidermal growth factor receptor assay in patients with lung cancer in the United States. Our goal was to inform the development of a model to predict phase 3 translation of guideline-directed molecular diagnostic tests. METHODS:This was a retrospective observational study. Using logistic regression, we analyzed the association between hospitals' institutional and regional characteristics and the likelihood that an epidermal growth factor receptor assay would be ordered. RESULTS:Significant institutional predictors included affiliation with an academic medical center (odds ratio, 1.48; 95% confidence interval, 1.20-1.83), participation in a National Cancer Institute clinical research cooperative group (odds ratio, 2.06, 1.66-2.55), and -availability of positron emission tomography scan (odds ratio, 1.44, 1.07-1.94) and cardiothoracic surgery (odds ratio, 1.90, 1.52-2.37) services. Significant regional predictors included metropolitan county (odds ratio, 2.08, 1.48-2.91), population with above-average education (odds ratio, 1.46, 1.09-1.96), and population with above-average income (odds ratio, 1.46, 1.04-2.05). Distance from a National Cancer Institute cancer center was a negative predictor (odds ratio, 0.996, 0.995-0.998), with a 34% decrease in likelihood for every 100 miles. CONCLUSION:In 2010, only 12% of US acute-care hospitals ordered the epidermal growth factor receptor assay, suggesting that most patients with lung cancer did not have access to this test. This case study illustrated the need for: (i) increased dissemination and implementation research, and (ii) interventions to improve adoption of guideline-directed molecular diagnostic tests by community hospitals.

SUBMITTER: Lynch JA 

PROVIDER: S-EPMC3800006 | biostudies-literature | 2013 Aug

REPOSITORIES: biostudies-literature

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Utilization of epidermal growth factor receptor (EGFR) testing in the United States: a case study of T3 translational research.

Lynch Julie A JA   Khoury Muin J MJ   Borzecki Ann A   Cromwell Jerry J   Hayman Laura L LL   Ponte Pat Reid PR   Miller Glenn A GA   Lathan Christopher S CS  

Genetics in medicine : official journal of the American College of Medical Genetics 20130228 8


<h4>Purpose</h4>We examined hospital use of the epidermal growth factor receptor assay in patients with lung cancer in the United States. Our goal was to inform the development of a model to predict phase 3 translation of guideline-directed molecular diagnostic tests.<h4>Methods</h4>This was a retrospective observational study. Using logistic regression, we analyzed the association between hospitals' institutional and regional characteristics and the likelihood that an epidermal growth factor re  ...[more]

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