Quality of treatment selection for Medicare beneficiaries with cancer.

摘要: 140Background: Because NCCN guidelines recommend multiple chemotherapy regimens, guideline-concordant treatments often differ substantially in clinical benefit. Variation in treatment quality – whether patients receive the most highly-recommended treatment option for their cancer – has not been assessed broadly across cancer types. Methods: Population-based cohort study using linked SEER-Medicare and NCCN Evidence Blocks (EB) data, 2015-2017. We reviewed historical NCCN Guidelines and ranked recommended treatments according to their EB scores. We then identified indications for initial systemic therapy in which 1) ≥1 treatment dominated (higher Efficacy AND Safety scores); 2) indication was identifiable in SEER-Medicare (eg, not biomarker-defined); 3) NCCN EB and ASCO Value Framework were in agreement regarding the optimal treatment, and 4) sufficient SEER-Medicare cases from …