Scientific Highlights—January 2014

Let’s use a four-letter word: cost

Before starting treatment, cancer patients and oncologists want to discuss the total costs and patient “cost shares” of various options, found Nora Henrikson, PhD. But both groups lack timely access to cost information, she reported with Leah Tuzzio, MPH; Elizabeth Trice Loggers, MD, PhD; Janice Miyoshi; and Diana Buist, PhD. E-publishing November 26 in Supportive Care in Cancer, they concluded that system-level change to improve price transparency is important for meaningful communication about cost. See abstract.

TEAMcare patients eat healthier and are more active

TEAMcare, a model that integrated mental and physical health care for Group Health patients with depression and diabetes and/or coronary heart disease, individualized goal-setting to change health behaviors. Analyzing continuous outcomes over a year, Dori Rosenberg, PhD, found intervention participants were more likely to eat healthy and be physically active than were those receiving usual care. She e-published November 4 in General Hospital Psychiatry with Elizabeth Lin, MD, MPH; Do Peterson, MS; Evette Ludman, PhD; Michael Von Korff, ScD; and Wayne Katon, MD. See abstract.

Higher risk for ovarian cancer linked to denser breasts

Breast density on mammography seemed to be a modest risk factor for ovarian cancer in women aged 50-59 in a Breast Cancer Surveillance Consortium (BCSC) study that included Group Health patients. According to Karen Wernli, PhD, hormones and growth factors that make breasts denser might raise the risk for ovarian cancer. She e-published December 5 in the Journal of the National Cancer Institute with Ellen O’Meara, PhD; Diana Miglioretti, PhD; Diana Buist, PhD, and BCSC colleagues at Veterans Affairs; University of California, San Francisco and Davis; Dartmouth Medical School; and the Universities of New Mexico, North Carolina, and Vermont. See abstract.

Osteoporosis-linked fractures know no season

Osteoporosis weakens aging women’s bones, predisposing them to fractures, often after falling. In a large, international study of women aged 55-plus, Andrea LaCroix, PhD, found these fractures happen in all seasons—at home and outdoors. Postmenopausal women need help reducing risk factors for fracture year-round, not just in winter, she concluded with colleagues at Columbia University; Fred Hutchinson Cancer Research Center; Cedars-Sinai Medical Center; Mercy Health; the Universities of Alabama, Massachusetts, and Pittsburgh; and in Belgium, Brazil, Canada, France, Germany, Italy, Spain, the Netherlands, and the United Kingdom. They published in PLoS One on December 11. See abstract.

Cancer survivors still consider specialists their main providers

More people are surviving cancer, and “shared care” between oncology and primary care is favored in integrated care. But even at Group Health, which is centered on primary care, many cancer survivors still consider cancer specialists as their main care providers a year after diagnosis, Jessica Chubak, PhD, found. She e-published this analysis of a nurse navigator intervention with Erin Aiello Bowles, MPH; Leah Tuzzio, MPH; Evette Ludman, PhD; Carolyn Rutter, PhD; Robert Reid, MD, PhD; and Ed Wagner, MD, MPH, in the Journal of Cancer Survivorship on December 19. See abstract.

Which Group Health patients complete their Health Profile?

Group Health patients who have completed their online Health Profile risk assessment tend to be middle-aged women with a recent well-care visit and fewer comorbid conditions, according to Diana Buist, PhD, MPH. With Nora Knight Ross, MA; Robert Reid, MD, PhD; and David Grossman, MD, MPH, she concluded that health systems need more outreach and engagement strategies to encourage target populations to use the assessments. They published in the December American Journal of Managed Care. See abstract.