Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Care Quality in Veterans Dying of Cancer Studied

Health Aff; 2018 Jan; Gidwani-Marszowski, et al

Veterans dying of cancer who were treated under Medicare fee-for-service were more likely to receive high-intensity care than those treated under VA direct care, according to a recent analysis.Investigators evaluated veterans treated under the 2 systems between 2010 and 2014. Among the results:

  • Medicare-treated veterans were more likely to receive chemotherapy, and experience hospital stays, ICU admission, more days in the hospital, and in-hospital death.
  • They were significantly less likely than to have multiple emergency department visits.

The authors noted that higher-intensity end-of-life care in Medicare-treated veterans may be due to Medicare fee-for-service financial incentives that do not exist in the VA's integrated system. They suggested that this could be minimized through the development of coordination and quality monitoring programs.


Gidwani-Marszowski R, Needleman J, Mor V, et al. Quality of end-of-life care is higher in the VA compared to care paid for by traditional Medicare. Health Aff. 2018 Jan;37(1):95-103. doi:10.1377/hlthaff.2017.0883.

This Week's Must Reads

Six factors predict urothelial cancer response, Pond GR et al. GU Cancers Symposium Abstract 413

Combo bests single therapy in metastatic RCC, Motzer RJ et al. GU Cancers Symposium Abstract 578

Chemo is best course in resected urothelial disease, Birtle A et al. Genitourinary Cancers Symposium. Abstract 407.

Selecting chemoradiation in bladder cancer, Coen, J. et al, 2018 Genitourinary Cancers Symposium, Abstract 408.

When to choose surgery or surveillance in RCC, Hakimi A et al. J Urol. 2018 Feb 26 doi: 10.1016/j.juro.2018.02.3087.

Must Reads in Practice Management

Oncologists can learn a lot from Twitter about lung cancer patients, Sutton J. et al., J Am Coll Radiol. 2018 Jan. doi: 10.1016/j.jacr.2017.09.043.

Financial transparency by oncology clinical pathway vendors, Daly, B et al. JAMA Oncol. 2018;4(2):255-257 doi:10.1001/jamaoncol.2017.4473

Support for gender equity led to more women in academic roles, Devine et al. J Exp Soc Psychol. [in press]

Insurance against cyberhacks of medical records, Beazley breach insights - January 2018

In-office chemo costs less, Winn A et al., JAMA Oncol. 2018 Feb 22. doi: 10.1001/jamaoncol.2017.5544.