Wide Variation in the Diffusion of a New Technology: Practice-Based Trends in Intensity-Modulated Radiation Therapy (IMRT) Use in the State of Michigan, With Implications for IMRT Use Nationally

Journal of Oncology Practice
Dean A ShumwayJames A Hayman

Abstract

To characterize the adoption and variation of intensity-modulated radiation therapy (IMRT) use in the state of Michigan. As a certificate-of-need state, Michigan requires every radiation oncology facility to report the number of external-beam and IMRT treatments delivered annually. We examined the percentage of treatments delivered using IMRT across centers from 2005 to 2012. We constructed a repeated-measures longitudinal linear regression model to evaluate bivariable and multiple variable associations with IMRT use. The median proportion of treatments delivered with IMRT rose from 16% in 2005 to 42% in 2012. All treatment centers in the state of Michigan possessed the capacity to deliver IMRT as of 2009. The fraction of treatments delivered with IMRT varied between 23% and 96% (standard deviation, 19%) in the lowest- and highest-use centers in 2012. Higher IMRT use was significantly associated with freestanding facilities and year of treatment, with a trend toward higher IMRT use in academic centers and low-volume facilities. IMRT use grew significantly across the state of Michigan over time, with four-fold variability among centers, which was related to facility characteristics. These data provide no indication of an ideal o...Continue Reading

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Feb 18, 2016·International Journal of Radiation Oncology, Biology, Physics·Timothy K NguyenAlexander V Louie
May 14, 2019·Journal of Medical Imaging and Radiation Oncology·Tanya Kairn, Scott B Crowe
Oct 28, 2019·Journal of the National Cancer Institute·Grace L Smith, Benjamin D Smith
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