Liu Yu, Howard David, Shih Ya-Chen Tina
Sam Houston State University, Huntsville, TX, USA.
Emory University, Atlanta, GA, USA.
Inquiry. 2025 Jan-Dec;62:469580251342466. doi: 10.1177/00469580251342466. Epub 2025 May 31.
Physicians' referral networks influence the information they obtain from peers and how fast they adopt new treatment modality. This study employs a cross-sectional design. We examined how urologists' referral network connections via primary care physicians influence the adoption of active surveillance for localized prostate cancer, using SEER-Medicare data (2001-2015). We developed a referral network index to measure urologists' connections outside their practice. Multinomial logistic regression estimated the likelihood of active surveillance adoption, adjusting for patient, urologist, and market factors. Findings revealed that each standard deviation increase in a urologist's referral network index was associated with a 1.90 percentage point rise in the likelihood of adopting active surveillance, with a more pronounced effect observed post-2010. The study concludes that primary care physicians may function as critical "information hubs," accelerating the diffusion of new treatment modalities among urologists, particularly following clinical guideline updates.
医生的转诊网络会影响他们从同行那里获取的信息，以及他们采用新治疗方式的速度。本研究采用横断面设计。我们利用监测、流行病学和最终结果（SEER）医保数据（2001 - 2015年），研究了泌尿科医生通过初级保健医生建立的转诊网络联系如何影响对局限性前列腺癌采用主动监测的情况。我们开发了一个转诊网络指数来衡量泌尿科医生在其执业范围之外的联系。多项逻辑回归估计了采用主动监测的可能性，并对患者、泌尿科医生和市场因素进行了调整。研究结果显示，泌尿科医生的转诊网络指数每增加一个标准差，采用主动监测的可能性就会提高1.90个百分点，2010年之后这种影响更为明显。该研究得出结论，初级保健医生可能起到关键的“信息枢纽”作用，加速新治疗方式在泌尿科医生中的传播，尤其是在临床指南更新之后。
