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Aaron Mitchell Profile picture
Aaron Mitchell
@TheWonkologist
Medical oncologist and health services researcher @MSKCancerCenter. Health care costs, oncology reimbursement reform, PokemonGo. No COI. Ravenclaw.
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Oct 25, 2023 • 25 tweets • 7 min read
Our new study is out today in The BMJ @bmj_latest!

Can receiving drug industry money lead oncologists to provide WORSE care?
The answer we found appears to be “yes”…

🧵 to follow
1/
 bmj.com/content/383/bm…
Image First, some context. We previously reviewed all studies asking, "can industry money lead doctors to provide DIFFERENT care?" The answer to that question, as we reported in
@AnnalsofIM , is a resounding "YES"

2/
Sep 29, 2023 • 17 tweets • 4 min read
Lot's of good discussion on this recent, important study in @JCO_ASCO led by my colleague @ErinGillespieMD. Honored to have had the chance to make a (small!) contribution.

My 2 cents on how we should interpret the findings...
1/ This study met its primary endpoint:
RT to asymptomatic, high-risk bone lesions appears to prevent SREs. This is a promising and exciting finding.
SREs can result in devastating loss in quality of life for patients, and any tools to prevent them are welcome.
2/
Jul 22, 2022 • 21 tweets • 8 min read
"Should pharma paying physicians be illegal?"

This is the wrong question. We should be asking:
"Given that pharma paying physicians is already illegal, why does it continue?"

As @AmeetSarpatwari @peterbachmd and I argue today in @JHPPL:
read.dukeupress.edu/jhppl/article/…

🧵 1/ Our argument focuses on the anti-kickback statute (AKS).

CMS OIG has outlined what qualifies as a potentially-prosecutable kickback under AKS. And it prosecutes egregious examples of pharma bribes. But its definition of "kickback" applies much more broadly

2/
Dec 4, 2020 • 8 tweets • 3 min read
Intravesical nadofaragene for BCG-refractory NMIBC.
A single-arm trial.
I have a couple of questions.
thelancet.com/journals/lanon…
1/ Historical context for this trial is important. In 2014, @US_FDA convened a meeting of clinical experts to advise on trial design for non-muscle-invasive bladder cancer, an area of unmet clinical need.
pubmed.ncbi.nlm.nih.gov/24332121/
2/
Nov 24, 2020 • 21 tweets • 9 min read
"Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing?"
Our latest on physician-industry COI is out today in @AnnalsofIM!

Not to bury the lede, the answer is "yes."
Thread to follow.
acpjournals.org/doi/10.7326/M2…
1/ First things first, huge thanks to everyone on the research team: Niti Trivedi, Susan Chimonas, Sara Tabatabai, Johanna Goldberg @mskcc_library, Renee Gennarelli, @ldiaz1, @DKorenstein. This was an enormous amount of work that we are all proud of.
2/
Aug 6, 2020 • 9 tweets • 4 min read
Our new paper in @JNCCN yesterday examines trends in the number of women serving on @NCCN Guidelines panels in recent years:
jnccn.org/view/journals/…
@peterbachmd @DeyPranam
1/ We manually extracted the membership from the Guidelines committees for the 21 most prevalent cancers in the US.
First, the good news.
The proportion of women increased, up to about 32% from 22% over just the last 6 years.
2/
May 24, 2020 • 8 tweets • 3 min read
“How is this legal?”
I reliably get this reaction when I explain aspects of oncology to friends&family, both medical and non.

In my mind, the fact that current practices run afoul of commonly-held ethical sensibilities is a clear mandate for change.
1/ What do I mean, specifically?
I’m referring to the “open secrets” of oncology, which we take for granted but which many people (in my experience) find appalling:
2/
Jan 5, 2020 • 8 tweets • 5 min read
Re-upping our @JAMAOnc systematic review on its 1-year publication anniversary. We searched for studies that asked the question, “do oncologists make treatment decisions based on how lucrative different treatments are?”
1/
 jamanetwork.com/journals/jamao… We found that the majority of studies (15 of 18) asking this question concluded that yes, personal and/or practice revenue is a consideration in choosing anti cancer treatments.
2/
Jul 31, 2019 • 13 tweets • 4 min read
I don't wish this idea would go away. I wish this idea would increase.

Unnecessary stress tests:
jamanetwork.com/journals/jama/…
1/ Chemotherapy to patients at the end of life:
ncbi.nlm.nih.gov/pubmed/22942834
2/
Nov 13, 2018 • 8 tweets • 3 min read
I'm sensing a new wave of reports on cancer "overtaking" or "surpassing" heart disease as leading cause of death in the US.
Here's your friendly reminder that this is a story about which cause of death is decreasing more quickly. Source for graph is CDC:
cdc.gov/mmwr/preview/m…
I've been looking for a version with more recent data than 2011...if anyone out there has one, please send!
Nov 8, 2018 • 10 tweets • 5 min read
1/ Time for a quick lit review on whether docs getting money from drug companies influences their prescribing behavior!
#healthpolicy #COI 2/ Among similar TNF-alpha blockers, physicians who got paid by one company were more likely to use that company's drug over others.
ncbi.nlm.nih.gov/pubmed/30324292 @AdeAdamson