{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:18:02Z","timestamp":1784305082011,"version":"3.55.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,4,29]],"date-time":"2023-04-29T00:00:00Z","timestamp":1682726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA043703"],"award-info":[{"award-number":["P30 CA043703"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U48 DP005030-05S1"],"award-info":[{"award-number":["U48 DP005030-05S1"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["U48 DP006404-03S7"],"award-info":[{"award-number":["U48 DP006404-03S7"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R15 NR017792"],"award-info":[{"award-number":["R15 NR017792"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UH3-DE025487"],"award-info":[{"award-number":["UH3-DE025487"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The American Society","award":["132678-RSGI-19-213-01-CPHPS"],"award-info":[{"award-number":["132678-RSGI-19-213-01-CPHPS"]}]},{"name":"The American Society","award":["RWIA-20-111-02 RWIA"],"award-info":[{"award-number":["RWIA-20-111-02 RWIA"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Older patients with myelodysplastic syndromes (MDS), particularly those with no or one cytopenia and no transfusion dependence, typically have an indolent course. Approximately, half of these receive the recommended diagnostic evaluation (DE) for MDS. We explored factors determining DE in these patients and its impact on subsequent treatment and outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and Methods<\/jats:title>\n                  <jats:p>We used 2011-2014 Medicare data to identify patients \u226566 years of age diagnosed with MDS. We used Classification and Regression Tree (CART) analysis to identify combinations of factors associated with DE and its impact on subsequent treatment. Variables examined included demographics, comorbidities, nursing home status, and investigative procedures performed. We conducted a logistic regression analysis to identify correlates associated with receipt of DE and treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 16 851 patients with MDS, 51% underwent DE. patients with MDS with no cytopenia (n = 3908) had the lowest uptake of DE (34.7%). Compared to patients with no cytopenia, those with any cytopenia had nearly 3 times higher odds of receiving DE [adjusted odds ratio (AOR), 2.81: 95% CI, 2.60-3.04] and the odds were higher for men than for women [AOR, 1.39: 95%CI, 1.30-1.48] and for Non-Hispanic Whites [vs. everyone else (AOR, 1.17: 95% CI, 1.06-1.29)]. The CART showed DE as the principal discriminating node, followed by the presence of any cytopenia for receiving MDS treatment. The lowest percentage of treatment was observed in patients without DE, at 14.6%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this select older patients with MDS, we identified disparities in accurate diagnosis by demographic and clinical factors. Receipt of DE influenced subsequent treatment but not survival.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyad114","type":"journal-article","created":{"date-parts":[[2023,4,30]],"date-time":"2023-04-30T00:56:13Z","timestamp":1682816173000},"page":"901-910","source":"Crossref","is-referenced-by-count":3,"title":["Patterns of Diagnostic Evaluation and Determinants of Treatment in Older Patients With Non-transfusion Dependent Myelodysplastic Syndromes"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8325-2603","authenticated-orcid":false,"given":"Sudipto","family":"Mukherjee","sequence":"first","affiliation":[{"name":"Leukemia Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weichuan","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine , Cleveland, OH , USA"},{"name":"Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas K","family":"Schiltz","sequence":"additional","affiliation":[{"name":"Frances P. Bolton School of Nursing, Case Western Reserve University , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt C","family":"Stange","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cullen","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron T","family":"Gerds","sequence":"additional","affiliation":[{"name":"Leukemia Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hetty E","family":"Carraway","sequence":"additional","affiliation":[{"name":"Leukemia Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhay","family":"Singh","sequence":"additional","affiliation":[{"name":"Leukemia Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali S","family":"Advani","sequence":"additional","affiliation":[{"name":"Leukemia Program, Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkael A","family":"Sekeres","sequence":"additional","affiliation":[{"name":"Division of Hematology, Sylvester Comprehensive Cancer Center, University of Florida , Miami, FL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siran M","family":"Koroukian","sequence":"additional","affiliation":[{"name":"Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine , Cleveland, OH , USA"},{"name":"Population Cancer Analytics Shared Resource, Case Comprehensive Cancer Center , Cleveland, OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,29]]},"reference":[{"issue":"7","key":"2023100311182155500_CIT0001","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1001\/jamainternmed.2014.1541","article-title":"Measuring low-value care in medicare","volume":"174","author":"Schwartz","year":"2014","journal-title":"JAMA Int Med"},{"issue":"8","key":"2023100311182155500_CIT0002","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1007\/s11606-019-05064-w","article-title":"Are we choosing wisely? older adults\u2019 cancer 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