Deborah Kaye

Positions:

Assistant Professor of Surgery

Surgery, Urology
School of Medicine

Core Faculty Member, Duke-Margolis Center for Health Policy

Duke - Margolis Center For Health Policy
Institutes and Provost's Academic Units

Member in the Duke Clinical Research Institute

Duke Clinical Research Institute
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

B.A. 2002

Washington University in St. Louis

M.D. 2010

Medical College of Wisconsin

M.S. 2017

University of Michigan at Ann Arbor

Fellow, Clinical Research Training Program

National Institutes of Health

General Surgery Intern, Surgery

Johns Hopkins Medicine

Urology Resident

Johns Hopkins Medicine

Fellow, Society of Urologic Oncology, Urology

University of Michigan at Ann Arbor

Grants:

Disparities in the Use of Oral Anticancer Agents in Kidney Cancer

Administered By
Population Health Sciences
Awarded By
National Institutes of Health
Role
Collaborator
Start Date
End Date

Publications:

Association Between Early Confirmatory Testing and the Adoption of Active Surveillance for Men With Favorable-risk Prostate Cancer.

OBJECTIVE: To examine the relationship between the use and results of early confirmatory testing and persistence on active surveillance (AS). METHODS: We identified all men in the Michigan Urological Surgery Improvement Collaborative registry diagnosed with favorable-risk prostate cancer from June 2016 to June 2017. We next examined trends in the use of early confirmatory test(s), defined as repeat biopsy, prostate magnetic resonance imaging, or molecular classifiers obtained within 6 months of the initial cancer diagnosis, in patients with favorable-risk prostate cancer. We then compared the proportion of men remaining on AS 6 months after diagnosis according to reassuring vs nonreassuring results, also stratifying by age and Gleason score. RESULTS: Among 2529 patients, 32.7% underwent early confirmatory testing within 6 months of diagnosis. Its use increased from 25.4% in the second quarter of 2016 to 34.9% in the second quarter of 2017 (P = .025). Molecular classifiers were most frequently used (55%), followed by magnetic resonance imaging (34%) and repeat biopsy (11%). Sixty-four percent (n = 523) had a reassuring result. Rates of AS were higher for patients with early reassuring results; 82% remained on AS (n = 427) compared to 52% (n = 157) of those with nonreassuring results and 51% (n = 873) with no early confirmatory testing (P <.001). CONCLUSION: Rates of AS are higher among men with early reassuring results, supporting the clinical utility of these tests. Nonetheless, high rates of AS among patients with nonreassuring results underscore the complexity of shared decision-making in this setting.
Authors
Kaye, DR; Qi, J; Morgan, TM; Linsell, S; Lane, BR; Montie, JE; Cher, ML; Miller, DC; Michigan Urological Surgery Improvement Collaborative,
MLA Citation
Kaye, Deborah R., et al. “Association Between Early Confirmatory Testing and the Adoption of Active Surveillance for Men With Favorable-risk Prostate Cancer.Urology, vol. 118, Aug. 2018, pp. 127–33. Pubmed, doi:10.1016/j.urology.2018.04.038.
URI
https://scholars.duke.edu/individual/pub1426598
PMID
29792972
Source
pubmed
Published In
Urology
Volume
118
Published Date
Start Page
127
End Page
133
DOI
10.1016/j.urology.2018.04.038

A 66-year-old man with prostate-specific antigen recurrence and lung mass after radical prostatectomy.

Authors
Kaye, DR; Walsh, PC; Netto, GJ; Gonzalez-Roibon, N; Rodriguez, R
MLA Citation
Kaye, Deborah R., et al. “A 66-year-old man with prostate-specific antigen recurrence and lung mass after radical prostatectomy.Urology, vol. 80, no. 2, Aug. 2012, pp. 247–49. Pubmed, doi:10.1016/j.urology.2012.03.010.
URI
https://scholars.duke.edu/individual/pub1426612
PMID
22673543
Source
pubmed
Published In
Urology
Volume
80
Published Date
Start Page
247
End Page
249
DOI
10.1016/j.urology.2012.03.010

Costs of Cancer Care Across the Disease Continuum.

PURPOSE: The aim of this study was to estimate Medicare payments for cancer care during the initial, continuing, and end-of-life phases of care for 10 malignancies and to examine variation in expenditures according to patient characteristics and cancer severity. MATERIALS AND METHODS: We used linked Surveillance, Epidemiology and End Results-Medicare data to identify patients aged 66-99 years who were diagnosed with one of the following 10 cancers: prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian, from 2007 through 2012. We attributed payments for each patient to a phase of care (i.e., initial, continuing, or end of life), based on time from diagnosis until death or end of study interval. We summed payments for all claims attributable to the primary cancer diagnosis and analyzed the overall and phase-based costs and then by differing demographics, cancer stage, geographic region, and year of diagnosis. RESULTS: We identified 428,300 patients diagnosed with one of the 10 malignancies. Annual payments were generally highest during the initial phase. Mean expenditures across cancers were $14,381 during the initial phase, $2,471 for continuing, and $13,458 at end of life. Payments decreased with increasing age. Black patients had higher payments for four of five cancers with statistically significant differences. Stage III cancers posed the greatest annual cost burden for four cancer types. Overall payments were stable across geographic region and year. CONCLUSION: Considerable differences exist in expenditures across phases of cancer care. By understanding the drivers of such payment variations across patient and tumor characteristics, we can inform efforts to decrease payments and increase quality, thereby reducing the burden of cancer care. IMPLICATIONS FOR PRACTICE: Considerable differences exist in expenditures across phases of cancer care. There are further differences by varying patient characteristics. Understanding the drivers of such payment variations across patient and tumor characteristics can inform efforts to decrease costs and increase quality, thereby reducing the burden of cancer care.
Authors
Kaye, DR; Min, HS; Herrel, LA; Dupree, JM; Ellimoottil, C; Miller, DC
MLA Citation
Kaye, Deborah R., et al. “Costs of Cancer Care Across the Disease Continuum.Oncologist, vol. 23, no. 7, July 2018, pp. 798–805. Pubmed, doi:10.1634/theoncologist.2017-0481.
URI
https://scholars.duke.edu/individual/pub1426599
PMID
29567821
Source
pubmed
Published In
Oncologist
Volume
23
Published Date
Start Page
798
End Page
805
DOI
10.1634/theoncologist.2017-0481

Treatment of infective endocarditis due to viridans streptococci, This statement was prepared by the ad hoc subcommittee on Treatment of Bacterial endocarditis of the American Heart Association Council on Cardiovascular Disease in the Young.

Authors
Bisno, AL; Dismukes, WE; Durack, DT; Kaplan, EL; Karchmer, AW; Kaye, D; Sande, MA; Sanford, JP; Wilson, WR
URI
https://scholars.duke.edu/individual/pub1228682
PMID
7460258
Source
pubmed
Published In
Circulation
Volume
63
Published Date
Start Page
730A
End Page
733A

Association of Delivery System Integration and Outcomes for Major Cancer Surgery.

BACKGROUND: Integrated delivery systems (IDSs) are postulated to reduce spending and improve outcomes through successful coordination of care across multiple providers. Nonetheless, the actual impact of IDSs on outcomes for complex multidisciplinary care such as major cancer surgery is largely unknown. METHODS: Using 2011-2013 Medicare data, this study identified patients who underwent surgical resection for prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, or ovarian cancer. Rates of readmission, 30-day mortality, surgical complications, failure to rescue, and prolonged hospital stay for cancer surgery were compared between patients receiving care at IDS hospitals and those receiving care at non-IDS hospitals. Generalized estimating equations were used to adjust results by cancer type and patient- and hospital-level characteristics while accounting for clustering of patients within hospitals. RESULTS: The study identified 380,053 patients who underwent major resection of cancer, with 38% receiving care at an IDS. Outcomes did not differ between IDS and non-IDS hospitals regarding readmission and surgical complication rates, whereas only minor differences were observed for 30-day mortality (3.5% vs 3.2% for IDS; p < 0.001) and prolonged hospital stay (9.9% vs 9.2% for IDS; p < 0.001). However, after adjustment for patient and hospital characteristics, the frequencies of adverse perioperative outcomes were not significantly associated with IDS status. CONCLUSIONS: The collective findings suggest that local delivery system integration alone does not necessarily have an impact on perioperative outcomes in surgical oncology. Moving forward, stakeholders may need to focus on surgical and oncology-specific methods of care coordination and quality improvement initiatives to improve outcomes for patients undergoing cancer surgery.
Authors
Li, J; Ye, Z; Dupree, JM; Hollenbeck, BK; Min, HS; Kaye, D; Herrel, LA; Miller, DC; Ellimoottil, C
MLA Citation
Li, Jonathan, et al. “Association of Delivery System Integration and Outcomes for Major Cancer Surgery.Ann Surg Oncol, vol. 25, no. 4, Apr. 2018, pp. 856–63. Pubmed, doi:10.1245/s10434-017-6312-6.
URI
https://scholars.duke.edu/individual/pub1426603
PMID
29285642
Source
pubmed
Published In
Annals of Surgical Oncology
Volume
25
Published Date
Start Page
856
End Page
863
DOI
10.1245/s10434-017-6312-6