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Association Between Intensity of Posttreatment Surveillance Testing and Detection of Recurrence in Patients With Colorectal Cancer

Overview of attention for article published in JAMA: Journal of the American Medical Association, May 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (83rd percentile)

Mentioned by

news
14 news outlets
blogs
3 blogs
twitter
134 tweeters
facebook
1 Facebook page
googleplus
1 Google+ user

Citations

dimensions_citation
22 Dimensions

Readers on

mendeley
36 Mendeley
Title
Association Between Intensity of Posttreatment Surveillance Testing and Detection of Recurrence in Patients With Colorectal Cancer
Published in
JAMA: Journal of the American Medical Association, May 2018
DOI 10.1001/jama.2018.5816
Pubmed ID
Authors

Rebecca A. Snyder, Chung-Yuan Hu, Amanda Cuddy, Amanda B. Francescatti, Jessica R. Schumacher, Katherine Van Loon, Y. Nancy You, Benjamin D. Kozower, Caprice C. Greenberg, Deborah Schrag, Alan Venook, Daniel McKellar, David P. Winchester, George J. Chang

Abstract

Surveillance testing is performed after primary treatment for colorectal cancer (CRC), but it is unclear if the intensity of testing decreases time to detection of recurrence or affects patient survival. To determine if intensity of posttreatment surveillance is associated with time to detection of CRC recurrence, rate of recurrence, resection for recurrence, or overall survival. A retrospective cohort study of patient data abstracted from the medical record as part of a Commission on Cancer Special Study merged with records from the National Cancer Database. A random sample of patients (n=8529) diagnosed with stage I, II, or III CRC treated at a Commission on Cancer-accredited facilities (2006-2007) with follow-up through December 31, 2014. Intensity of imaging and carcinoembryonic antigen (CEA) surveillance testing derived empirically at the facility level using the observed to expected ratio for surveillance testing during a 3-year observation period. The primary outcome was time to detection of CRC recurrence; secondary outcomes included rates of resection for recurrent disease and overall survival. A total of 8529 patients (49% men; median age, 67 years) at 1175 facilities underwent surveillance imaging and CEA testing within 3 years after their initial CRC treatment. The cohort was distributed by stage as follows: stage I, 25.0%; stage II, 35.2%; and stage III, 39.8%. Patients treated at high-intensity facilities-4188 patients (49.1%) for imaging and 4136 (48.5%) for CEA testing-underwent a mean of 2.9 (95% CI, 2.8-2.9) imaging scans and a mean of 4.3 (95% CI, 4.2-4.4) CEA tests. Patients treated at low-intensity facilities-4341 patients (50.8%) for imaging and 4393 (51.5%) for CEA testing-underwent a mean of 1.6 (95% CI, 1.6-1.7) imaging scans and a mean of 1.6 (95% CI, 1.6-1.7) CEA tests. Imaging and CEA surveillance intensity were not associated with a significant difference in time to detection of cancer recurrence. The median time to detection of recurrence was 15.1 months (IQR, 8.2-26.3) for patients treated at facilities with high-intensity imaging surveillance and 16.0 months (IQR, 7.9-27.2) with low-intensity imaging surveillance (difference, -0.95 months; 95% CI, -2.59 to 0.68; HR, 0.99; 95% CI, 0.90-1.09) and was 15.9 months (IQR, 8.5-27.5) for patients treated at facilities with high-intensity CEA testing and 15.3 months (IQR, 7.9-25.7) with low-intensity CEA testing (difference, 0.59 months; 95% CI, -1.33 to 2.51; HR, 1.00; 95% CI, 0.90-1.11). No significant difference existed in rates of resection for cancer recurrence (HR for imaging, 1.22; 95% CI, 0.99-1.51 and HR for CEA testing, 1.12; 95% CI, 0.91-1.39) or overall survival (HR for imaging, 1.01; 95% CI, 0.94-1.08 and HR for CEA testing, 0.96; 95% CI, 0.89-1.03) among patients treated at facilities with high- vs low-intensity imaging or CEA testing surveillance. Among patients treated for stage I, II, or III CRC, there was no significant association between surveillance intensity and detection of recurrence. clinicaltrials.gov Identifier: NCT02217865.

Twitter Demographics

The data shown below were collected from the profiles of 134 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 36 100%

Demographic breakdown

Readers by professional status Count As %
Other 7 19%
Professor > Associate Professor 5 14%
Student > Ph. D. Student 5 14%
Student > Postgraduate 4 11%
Unspecified 3 8%
Other 12 33%
Readers by discipline Count As %
Medicine and Dentistry 25 69%
Unspecified 6 17%
Nursing and Health Professions 2 6%
Agricultural and Biological Sciences 2 6%
Sports and Recreations 1 3%
Other 0 0%

Attention Score in Context

This research output has an Altmetric Attention Score of 200. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2019.
All research outputs
#66,559
of 13,568,727 outputs
Outputs from JAMA: Journal of the American Medical Association
#1,395
of 25,856 outputs
Outputs of similar age
#3,187
of 270,574 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#57
of 354 outputs
Altmetric has tracked 13,568,727 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 25,856 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 47.7. This one has done particularly well, scoring higher than 94% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,574 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 354 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 83% of its contemporaries.