Validation of the Living With Cancer PRO Tool for Identifying Cancer Patients Appropriate for End of Life Care Consultations

End of life care discussions for patients with advanced malignancies are often delayed resulting in unwanted, wasteful treatment. Cota has developed a 7-item PRO instrument (Living With Cancer) to facilitate identification of patients in distress.

How RCCA Is Succeeding With the Oncology Care Model

As the healthcare industry transitions to the value payment models like MIPS and OCM set forth by MACRA, Regional Cancer Care Associates (RCCA)—one of the largest oncology physician networks in the United States—has partnered closely with Cota and emerged as a leader in high quality, value-based care.

Digital characterization of breast cancer phenotypes to identify variances in care and costs at scale

This study applies the novel Cota Nodal Address (CNA) digital system to a consecutive cohort of patients with breast cancer to identify population frequencies of subtypes and variances in treatment patterns and total costs of care for one year following diagnosis.

3 Key Attributes of Every Successful Value-Focused Oncology Practice

Oncology practices, especially providers participating in value-based reimbursement programs from the Centers for Medicare and Medicaid Services (CMS) like the Oncology Care Model (OCM), are under pressure to measure and improve performance. Three interdependent key factors—technological capabilities, people resources, and vision—are the shared characteristics of OCM practices best able to maximize program benefits and improve the patient experience.
March 16, 2017
Whitepaper

Prospective Assessment of the Value of Genomic Profiling in Metastatic Lung Cancer

This prospective observational study is designed to reveal genomic profiling patterns and the influence of testing on clinical and economic outcomes among patients with advanced lung cancer in real world settings
March 16, 2017
Research Abstract

Digital characterization of breast cancer phenotypes to identify variances in care and costs at scale

This study applies the novel Cota Nodal Address (CNA) digital system to a consecutive cohort of patients with breast cancer to identify population frequencies of subtypes and variances in treatment patterns and total costs of care for one year following diagnosis.
March 16, 2017
Research Abstract

Are patients with advanced cancer concerned about financial toxicity?

Cancer patients are more than twice as likely to enter bankruptcy as the general US population. It is unknown how often patients with metastatic cancer are concerned about the financial toxicities of treatment.
March 16, 2017
Research Abstract

Development of a Patient Reported Outcome Instrument to Facilitate Timing of End-of-Life Discussions in Patients with Advanced Cancers

Honoring the wishes of terminally ill cancer pts is a prime responsibility of oncologists, however end of life (EOL) discussions are frequently either never performed or delayed past the point of usefulness. Patients who discuss EOL issues with their medical team are more likely to avoid terminal hospitalizations, have improved emotional wellbeing and experience lower health care costs. Facilitators of timely EOL discussions including palliative care consultations would be beneficial.
March 16, 2017
Research Abstract

A new digital classification schema to detect treatment variances and enable value based payment reforms

Value based payment reforms which improve the outcome to cost ratio (paying for outcomes not for services) require detailed information on both elements. Although the digitalization of medicine via the EHR may facilitate data collection, the imprecise ICD9 and ICD10 schemas hinder analysis (eg: all breast cancers are ICD9 174.9). A more precise classification schema that accounts for biologic variances to allow analysis (and reduction) of treatment variances is needed.
March 16, 2017
Research Abstract

Early economic benefits of gene expression profiling using a 21-gene panel among breast cancer patients

Gene expression profiling utilizing a 21-gene panel assay among breast cancer patients with early stage, axillary lymph node negative, hormone receptor positive, HER2/neu oncogene negative tumors is able to identify a cohort with excellent long term outcomes without adjuvant chemotherapy. Although economic models have suggested acceptable QALY ratios, “real world” confirmation is scant and few studies have focused on the short-term costs important in value-based payment reform.
March 16, 2017
Research Abstract

Genomic profiling of non-small cell lung cancer in the community setting

Genotyping in patients with advanced NSCLC may identify mutations amenable to targeted therapy. We identified in a 2010-2014 community series a 60% testing rate for EGFR/ALK among stage IV patients (Gutierrez ASCO 2015; e19113). 2014 guidelines added 5 additional targets for testing.
March 16, 2017
Research Abstract

Growth factor use and costs in breast cancer patients undergoing adjuvant therapy

Myeloid growth factor support (GFs) reduces the incidence/duration of neutropenia and facilitates dose intensity. GFs is recommended by ASCO guidelines when the risk of chemotherapy induced febrile neutropenia (FN) exceeds 20% and may be considered for 10-20% FN risks. Most adjuvant breast cancer regimens fall into the 10-20% category.
March 16, 2017
Research Abstract

Are Cancer Patients Concerned About Burdening Their Families?

A diagnosis of advanced cancer frequently thrusts family members into the role of caregiver. Although caregiver burdens have been well documented, less is known about the level of concern borne by the cancer patient in placing a family member in this role – known as selfperceived burden (SPB).
March 16, 2017
Research Abstract

Prevalence of clinically meaningful prognostic variability in cancer: An analysis using a new taxonomy system

Precise characterizations of tumor type to permit “precision” medicine are required for optimal outcomes and to facilitate payment reforms. ICD9 codes lump multiple cancer subtypes together (eg: all lung cancers ICD9 162.x). To enable comparisons of similar tumor types a new taxonomy system, amenable to computerized searching, has been created that embraces the complexity of cancer.
March 16, 2017
Research Abstract

Validation of the Living With Cancer PRO Tool for Identifying Cancer Patients Appropriate for End of Life Care Consultations

End of life care discussions for patients with advanced malignancies are often delayed resulting in unwanted, wasteful treatment. Cota has developed a 7-item PRO instrument (Living With Cancer) to facilitate identification of patients in distress.
March 16, 2017
Research Abstract

Utilization and clinical impact of genomic profiling for EGFR and ALK in nonsquamous non-small cell lung cancer (NSCLC) in the community setting

Targeted therapies may increase survival in metastatic NSCLC. Thus, genomic profiling is recommended to aid treatment selection. Utilization & impact of testing in community (non-research) settings is underexplored.
March 16, 2017
Research Abstract

Adherence to the 2013 CAP/IASLC/AMP Molecular Testing Guidelines in Non-Small Cell Lung Cancer in the Community Setting: Opportunities for Improvement

The 2013 CAP/IASLC/AMP joint guidelines call for EGFR/ALK testing in all patients (pts) with stage IV NSCLC with adenocarcinoma components. In 2014 the NCCN guidelines added emerging actionable targets. The adoption rate of guidelines in community practice has not been fully explored for these two sets of guideline endorsements.
March 16, 2017
Research Abstract

Real-World Comparative Effectiveness of Albumin-Bound Paclitaxel Plus Carboplatin Versus Solvent-Based Paclitaxel Plus Carboplatin

In a subset analysis of a multinational phase III randomized clinical trial, weekly albumin-bound paclitaxel + carboplatin demonstrated a higher response rate than solvent-based paclitaxel + carboplatin every 3 weeks, with less grade ≥3 neuropathy and arthralgia, but more thrombocytopenia and anemia in patients with advanced squamous cell carcinoma non–small cell lung cancer. NCCN Guidelines support the use of nab-P/C, but there is limited published experience with this combination in real-world settings.
March 14, 2017
Research Abstract

Impact of Charlson Comorbidity Index (CCI) and Refining the MIPI Index in Mantle Cell Lymphoma (MCL)

The outcome of MCL patients (pts) has improved over the last three decades, although this is debated outside clinical trials (Chandran, Leuk Lymphoma Aug 2012; Smith, Br J Cancer. April 2015). The Mantle Cell International Prognostic Index (MIPI) (Hoster, Blood Jan 2008) is based on 4 variables which predict survival: age (host factor), PS (tumor/host), LDH (tumor burden) and WBC (leukemic phase).
March 14, 2017
Research Abstract

How RCCA Is Succeeding With the Oncology Care Model

As the healthcare industry transitions to the value payment models like MIPS and OCM set forth by MACRA, Regional Cancer Care Associates (RCCA)—one of the largest oncology physician networks in the United States—has partnered closely with Cota and emerged as a leader in high quality, value-based care.
March 13, 2017
Client Story

Prospective Assessment of the Value of Genomic Profiling in Metastatic Lung Cancer

This prospective observational study is designed to reveal genomic profiling patterns and the influence of testing on clinical and economic outcomes among patients with advanced lung cancer in real world settings
March 16, 2017
Research Abstract

Digital characterization of breast cancer phenotypes to identify variances in care and costs at scale

This study applies the novel Cota Nodal Address (CNA) digital system to a consecutive cohort of patients with breast cancer to identify population frequencies of subtypes and variances in treatment patterns and total costs of care for one year following diagnosis.
March 16, 2017
Research Abstract

Are patients with advanced cancer concerned about financial toxicity?

Cancer patients are more than twice as likely to enter bankruptcy as the general US population. It is unknown how often patients with metastatic cancer are concerned about the financial toxicities of treatment.
March 16, 2017
Research Abstract

Development of a Patient Reported Outcome Instrument to Facilitate Timing of End-of-Life Discussions in Patients with Advanced Cancers

Honoring the wishes of terminally ill cancer pts is a prime responsibility of oncologists, however end of life (EOL) discussions are frequently either never performed or delayed past the point of usefulness. Patients who discuss EOL issues with their medical team are more likely to avoid terminal hospitalizations, have improved emotional wellbeing and experience lower health care costs. Facilitators of timely EOL discussions including palliative care consultations would be beneficial.
March 16, 2017
Research Abstract

A new digital classification schema to detect treatment variances and enable value based payment reforms

Value based payment reforms which improve the outcome to cost ratio (paying for outcomes not for services) require detailed information on both elements. Although the digitalization of medicine via the EHR may facilitate data collection, the imprecise ICD9 and ICD10 schemas hinder analysis (eg: all breast cancers are ICD9 174.9). A more precise classification schema that accounts for biologic variances to allow analysis (and reduction) of treatment variances is needed.
March 16, 2017
Research Abstract

Early economic benefits of gene expression profiling using a 21-gene panel among breast cancer patients

Gene expression profiling utilizing a 21-gene panel assay among breast cancer patients with early stage, axillary lymph node negative, hormone receptor positive, HER2/neu oncogene negative tumors is able to identify a cohort with excellent long term outcomes without adjuvant chemotherapy. Although economic models have suggested acceptable QALY ratios, “real world” confirmation is scant and few studies have focused on the short-term costs important in value-based payment reform.
March 16, 2017
Research Abstract

Genomic profiling of non-small cell lung cancer in the community setting

Genotyping in patients with advanced NSCLC may identify mutations amenable to targeted therapy. We identified in a 2010-2014 community series a 60% testing rate for EGFR/ALK among stage IV patients (Gutierrez ASCO 2015; e19113). 2014 guidelines added 5 additional targets for testing.
March 16, 2017
Research Abstract

Growth factor use and costs in breast cancer patients undergoing adjuvant therapy

Myeloid growth factor support (GFs) reduces the incidence/duration of neutropenia and facilitates dose intensity. GFs is recommended by ASCO guidelines when the risk of chemotherapy induced febrile neutropenia (FN) exceeds 20% and may be considered for 10-20% FN risks. Most adjuvant breast cancer regimens fall into the 10-20% category.
March 16, 2017
Research Abstract

Are Cancer Patients Concerned About Burdening Their Families?

A diagnosis of advanced cancer frequently thrusts family members into the role of caregiver. Although caregiver burdens have been well documented, less is known about the level of concern borne by the cancer patient in placing a family member in this role – known as selfperceived burden (SPB).
March 16, 2017
Research Abstract

Prevalence of clinically meaningful prognostic variability in cancer: An analysis using a new taxonomy system

Precise characterizations of tumor type to permit “precision” medicine are required for optimal outcomes and to facilitate payment reforms. ICD9 codes lump multiple cancer subtypes together (eg: all lung cancers ICD9 162.x). To enable comparisons of similar tumor types a new taxonomy system, amenable to computerized searching, has been created that embraces the complexity of cancer.
March 16, 2017
Research Abstract

Validation of the Living With Cancer PRO Tool for Identifying Cancer Patients Appropriate for End of Life Care Consultations

End of life care discussions for patients with advanced malignancies are often delayed resulting in unwanted, wasteful treatment. Cota has developed a 7-item PRO instrument (Living With Cancer) to facilitate identification of patients in distress.
March 16, 2017
Research Abstract

Utilization and clinical impact of genomic profiling for EGFR and ALK in nonsquamous non-small cell lung cancer (NSCLC) in the community setting

Targeted therapies may increase survival in metastatic NSCLC. Thus, genomic profiling is recommended to aid treatment selection. Utilization & impact of testing in community (non-research) settings is underexplored.
March 16, 2017
Research Abstract

Adherence to the 2013 CAP/IASLC/AMP Molecular Testing Guidelines in Non-Small Cell Lung Cancer in the Community Setting: Opportunities for Improvement

The 2013 CAP/IASLC/AMP joint guidelines call for EGFR/ALK testing in all patients (pts) with stage IV NSCLC with adenocarcinoma components. In 2014 the NCCN guidelines added emerging actionable targets. The adoption rate of guidelines in community practice has not been fully explored for these two sets of guideline endorsements.
March 16, 2017
Research Abstract

Real-World Comparative Effectiveness of Albumin-Bound Paclitaxel Plus Carboplatin Versus Solvent-Based Paclitaxel Plus Carboplatin

In a subset analysis of a multinational phase III randomized clinical trial, weekly albumin-bound paclitaxel + carboplatin demonstrated a higher response rate than solvent-based paclitaxel + carboplatin every 3 weeks, with less grade ≥3 neuropathy and arthralgia, but more thrombocytopenia and anemia in patients with advanced squamous cell carcinoma non–small cell lung cancer. NCCN Guidelines support the use of nab-P/C, but there is limited published experience with this combination in real-world settings.
March 14, 2017
Research Abstract

Impact of Charlson Comorbidity Index (CCI) and Refining the MIPI Index in Mantle Cell Lymphoma (MCL)

The outcome of MCL patients (pts) has improved over the last three decades, although this is debated outside clinical trials (Chandran, Leuk Lymphoma Aug 2012; Smith, Br J Cancer. April 2015). The Mantle Cell International Prognostic Index (MIPI) (Hoster, Blood Jan 2008) is based on 4 variables which predict survival: age (host factor), PS (tumor/host), LDH (tumor burden) and WBC (leukemic phase).
March 14, 2017
Research Abstract

3 Key Attributes of Every Successful Value-Focused Oncology Practice

Oncology practices, especially providers participating in value-based reimbursement programs from the Centers for Medicare and Medicaid Services (CMS) like the Oncology Care Model (OCM), are under pressure to measure and improve performance. Three interdependent key factors—technological capabilities, people resources, and vision—are the shared characteristics of OCM practices best able to maximize program benefits and improve the patient experience.
March 16, 2017
Whitepaper

Digital characterization of breast cancer phenotypes to identify variances in care and costs at scale

This study applies the novel Cota Nodal Address (CNA) digital system to a consecutive cohort of patients with breast cancer to identify population frequencies of subtypes and variances in treatment patterns and total costs of care for one year following diagnosis.
March 16, 2017
Research Abstract

A new digital classification schema to detect treatment variances and enable value based payment reforms

Value based payment reforms which improve the outcome to cost ratio (paying for outcomes not for services) require detailed information on both elements. Although the digitalization of medicine via the EHR may facilitate data collection, the imprecise ICD9 and ICD10 schemas hinder analysis (eg: all breast cancers are ICD9 174.9). A more precise classification schema that accounts for biologic variances to allow analysis (and reduction) of treatment variances is needed.
March 16, 2017
Research Abstract

How RCCA Is Succeeding With the Oncology Care Model

As the healthcare industry transitions to the value payment models like MIPS and OCM set forth by MACRA, Regional Cancer Care Associates (RCCA)—one of the largest oncology physician networks in the United States—has partnered closely with Cota and emerged as a leader in high quality, value-based care.
March 13, 2017
Client Story
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