Chunyan Yang, Jill D Sharkey, Lauren A Reed, Chun Chen, Erin Dowdy
Bullying victimization and student engagement in elementary, middle, and high schools: Moderating role of school climate
School psychology quarterly : the official journal of the Division of School Psychology, American Psychological Association
aimed assess geographic physicianlevel variation hypofractionated wholebreast irradiation hfwbi use earlystage breast cancer patients united states evaluated association hfwbi use demographic factors accounting variations performed retrospective study earlystage breast cancer patients using private employersponsored insurance claims 2008 2017 patients clustered according geographic level radiation oncologist bayesian crossclassified multilevel logistic models used examine geographic heterogeneity variation radiation oncologists simultaneously intracluster correlation coefficient icc median odds ratios mor calculated quantify variation different levels also used crossclassified model identify patient demographic factors associated receiving hfwbi study included 79747 women 740 received conventionally fractionated wholebreast irradiation cfwbi 27999 women 260 underwent hfwbi hfwbi adoption increased significantly across time 20082017 variation hfwbi utilization attributed mostly physicianlevel variability mor 259 variability hfwbi utilization across corebased statistical areas cbsas mor 155 found strongest among geographic classifications accounting variability cbsas radiation oncologists age receiving chemotherapy several communitylevel factors including distance home facility community education level racial composition found associated hfwbi utilization study demonstrated geographic physicianlevel heterogeneity use hfwbi among earlystage breast cancer patients hfwbi utilization also found associated patient communitylevel characteristics given observed physicianlevel variability intervention continuing medical education could help doctors better understand advantages hfwbi promote adoption hfwbi us influence physicianlevel characteristics hfwbi utilization merits study