DATA SOURCES AND PATTERNS OF CARE FOR BREAST CANCER

乳腺癌的数据来源和护理模式

基本信息

批准号：
2896178
负责人：
EDWARD GUADAGNOLI
金额：
$ 27.87万
依托单位：
HARVARD MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
1998
资助国家：
美国
起止时间：
1998-06-01 至 2002-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/2896178
关键词：
breast neoplasms clinical research female health services research tag human data human therapy evaluation mathematical model model design /development neoplasm /cancer therapy patient care management

项目摘要

This application is a revision of one (CA/HS75545) submitted October 1, 1996 to the National Cancer Institute in response to their Program Announcement PA-95-069, Cancer Surveillance Using Health Claim-Based Data Systems. Researches have used administrative data sets, hospital discharge data, and/or cancer registry data to study geographic variation in patterns of care for breast cancer as well as to study the association of patient and hospital characteristics with patterns of care and mortality. Among their findings, they reported that rates of breast-conserving surgery varied across the country and were lower than expected. They also reported that some women (for example, older women and women who lived in rural areas) were less likely than others to receive standard treatments. Based on their findings, several authors suggested that the results of randomized clinical trials associated with breast cancer treatment and the dissemination of practice guidelines by national organizations such as the National Institutes of Health have not influenced breast cancer care in the United States. If their conclusions are not valid, however, any activities taken in response may be misguided. Resources would not only be wasted, but the results of these studies may cause unnecessary anxiety and confusion among women treated for breast cancer and among their providers. We have constructed two primary data sets comprised of data from medical records, patients, and physicians - one data set is from Massachusetts (N=1,497) and the other is from Minnesota (N-2,327). We propose to use these data to assess the accuracy of secondary data. The specific aims of this study are to 1) construct cohorts of patients with early-stage breast cancer using Medicare claims data, hospital discharge data, ad tumor registry data and compare the sample size, clinical characteristics, and demographic characteristics that result with those obtained from primary data; 2) determine the extent to which patterns of care reported from secondary data are consistent with patterns obtained from primary sources; 3) determine whether the degree of consistency between secondary data and primary data varies by the characteristics of patients or type of provider; and 4) develop an algorithm to adjust estimates derived from secondary data sets.

此申请是10月1日提交的一项（CA/HS75545）的修订版 1996年向国家癌症研究所致以他们的计划公告PA-95-069，使用基于健康索赔的癌症监测数据系统。研究使用了管理数据集，医院排放数据和/或癌症注册表数据研究地理乳腺癌护理模式的变化以及研究患者和医院特征与模式的关联关心和死亡率。在他们的发现中，他们报告说全国各种乳房的手术各不相同，低于预期的。他们还报告说有些妇女（例如，老年妇女和住在农村地区的妇女比其他人的可能性较小接受标准治疗。根据他们的发现，几位作者提出与乳腺癌治疗和传播实践指南国家卫生研究院等国家组织已有在美国不影响乳腺癌护理。如果他们结论是无效的，但是，任何响应的活动都可以被误导。资源不仅会浪费，而且会浪费这些研究可能会引起女性不必要的焦虑和困惑接受乳腺癌及其提供者的治疗。我们已经构建了两个主要数据集由病历，患者，患者，和医生 - 一个数据集来自马萨诸塞州（n = 1,497），其他来自明尼苏达州（N-2,327）。我们建议将这些数据用于评估辅助数据的准确性。这项研究的具体目的是1）构建早期乳腺癌患者队列使用Medicare索赔数据，医院出院数据，AD肿瘤注册表数据并比较样本量，临床特征和从主要的人口特征导致的人口特征数据; 2）确定报告的护理模式的程度辅助数据与从初级获得的模式一致来源； 3）确定是否之间的一致性是否二级数据和主要数据因特征而异患者或提供者的类型； 4）开发一种算法以调整从辅助数据集得出的估计。