Abandonment of high-dose chemotherapy/hematopoietic cell transplants for breast cancer following negative trial results.

摘要: There is an extensive literature on the adoption and diffusion of new health care technologies, but relatively few studies examine abandonment technologies found to be ineffective (Rye Kimberly 2007). The general perception that occurs slowly (RAND 2010). For example, a 1983 National Heart, Lung, Blood Institute clinical trial reported intermittent positive pressure breathing therapy did not reduce mortality or improve quality life for patients with chronic obstructive pulmonary disease (The IPPB Trial Group 1983). By 1986, use remained at about 50 percent level (Duffy Farley 1992). Of 37 hospitals offered in 1893, 23 continued offer it 1986. In this paper we high-dose chemotherapy followed by autologous hematopoietic stem cell transplantation (HDC/HCT) women breast cancer. Initially, technology evaluations Blue Cross Shield Association other groups raised concerns value procedure, matters unsettled through 1990s until randomized trials demonstrated procedure was no better than standard outpatient chemotherapy. Although results from were released over 10 years ago, useful revisit example light current debate comparative effectiveness research its potential impact practice patterns costs. objectives study understand HDC/HCT, relationship between hospital characteristics process.