Evidence map›Paper›PMID 42410166›Full record

ArticleJournal of neuro-oncology2026

Divided care, diminished outcomes? The impact of care fragmentation on survival in glioblastoma.

Hazem S Ghaith, Saud K Zaidan, Matthew K McIntyre, Christina E Gerges Castro, Ahmed Abdou, Matthew C Henn, Julian Gendreau, Beck Shafie, Christian G Lopez Ramos, Joseph G Nugent and 6 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Hazem S Ghaith *Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Saud K Zaidan *Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Matthew K McIntyreDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Christina E Gerges CastroDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Ahmed AbdouSchool of Engineering Medicine, Texas A&M University, College Station, Texas, USA.
Matthew C HennDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Julian GendreauDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Beck ShafieDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Christian G Lopez RamosDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Joseph G NugentDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Erin A YamamotoDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Muhibullah ToraDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Stephen G BowdenDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Sushant PuriDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Olabisi R SanusiDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA.
Ahmed M RaslanDepartment of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA. raslana@ohsu.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe impact of fragmentation of care (FC) on glioblastoma (GBM), a malignancy requiring coordinated multimodal therapy, remains unknown. We aimed to identify factors associated with FC and evaluate effects on treatment delays and survival.

methodsPatients with GBM diagnosed between 2004 and 2022 were identified from the National Cancer Database. Multivariable logistic regression, Kaplan-Meier analysis, and Cox proportional hazards modeling were performed.

resultsOf 42,390 patients, 22,478 (53.0%) received FC. FC was associated with longer time to radiation (37 vs. 35 days; p < 0.001) and chemotherapy (36 vs. 34 days; p < 0.001), and higher rates of delayed adjuvant treatment, defined as adjuvant therapy > 42 days after surgery (19.6% vs. 14.4%; p < 0.001). The strongest predictors of FC were patient distance and non-academic facility type. Black race (OR 0.82, 95% CI 0.75-0.91; p < 0.001) and low socioeconomic status (OR 0.88, 95% CI 0.82-0.94; p < 0.001) were independently associated with decreased odds of FC. Median overall survival was shorter in FC patients (14.6 vs. 15.2 months; p = 0.0005), and FC was independently associated with worse survival (aHR 1.02, 95% CI 1.00-1.05; p = 0.038). Subgroup analysis revealed worse survival with FC at academic and integrated network facilities, but improved survival at community and comprehensive community programs.

conclusionsFC is prevalent in GBM and independently associated with treatment delays and worse survival, though the prognostic impact varies by facility type. FC was associated with improved survival at community programs, suggesting fragmentation may reflect purposeful referrals to specialized centers. Improved care coordination, particularly at academic centers, is needed.

Indexed as

Brain NeoplasmsGlioblastomaAgedCombined Modality TherapyFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateTreatment DelayCare fragmentationGlioblastomaHealth disparitiesNational Cancer Database

Identifiers

PMID42410166

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.