Risk of Cancer in Incidental Findings Identified on Ultrasound Imaging

超声成像偶然发现的癌症风险

基本信息

批准号：
8519346
负责人：
REBECCA SMITH-BINDMAN
金额：
$ 12.18万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-19 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8519346
关键词：
Abdomen Accounting Address Age Anatomy Anxiety Award Benign Biometry Breast California Characteristics Clinical Clinical Data Cohort Analysis Cohort Studies Collection Comorbidity Data Databases Detection Development Diagnosis Diagnostic Diagnostic Imaging Diagnostic tests Discipline of obstetrics Disease Early Diagnosis Early identification Early treatment Educational process of instructing Endometrial Enrollment Epidemiology Evaluation Financial cost Fred Hutchinson Cancer Research Center Frequencies Funding Goals Graves&apos Disease Guidelines Gynecology Health Health Maintenance Organizations Healthcare Systems Hemorrhage Hepatic Mass Image Imaging technology Incidence Incidental Findings Individual Laboratories Lead Lesion Link Magnetic Resonance Imaging Malignant Neoplasms Mammography Medical Medical Records Medical Surveillance Mentors Methodology Minority Modeling Nature Neck Outcome Outcome Assessment Outcomes Research Pain Paper Pathology Patients Pattern Pelvis Physicians Prevalence Prevention Research Radiation Radiology Specialty Reaction Records Renal Mass Reporting Reproductive Medicine Research Research Personnel Resolution Risk Sample Size San Francisco Selection Bias Symptoms System Testing Thyroid Function Tests Thyroid Nodule Time Ultrasonography Uncertainty Universities Visit Washington X-Ray Computed Tomography base cancer complication cancer diagnosis cancer prevention cancer risk career clinically significant cohort cost design driving force evidence base evidence based guidelines follow-up member patient oriented research population based professor programs radiologist screening trend tumor registry

项目摘要

DESCRIPTION (provided by applicant): Rebecca Smith-Bindman is an Associate Professor of Radiology, Epidemiology and Biostatistics, Obstetrics, Gynecology and Reproductive Medicine at the University of California, San Francisco (UCSF) and director of the Universities' Radiology Outcomes Research Lab. Her research focuses on evaluating the clinical impact of commonly used screening and diagnostic tests. She is applying for a Mid Career Investigator Award in Patient Oriented Research to evaluate the risk of cancer associated with incidental findings identified on ultrasound imaging, and to increase the time she devotes to teaching and mentoring radiology residents and fellows in patient oriented research through creation of a research program for these trainees. If funded, Dr. Smith-Bindman will complete the proposed research, develop a program to encourage radiology trainees to embark on careers in clinical cancer prevention research including one-on-one mentoring of 6-8 trainees annually. This award provides an ideal opportunity to advance her own research agenda and advance her career by developing a program to mentor junior investigators. Over the last 10 years, advances in imaging technology and dramatic increases in the use of imaging have allowed the detection of increasingly smaller and questionable anatomic lesions. The positive impact on patient health from the earlier diagnosis of cancer cannot be overstated. However, one consequence of the increased imaging utilization and resolution is the diagnosis of increasing numbers of incidental and indeterminate findings. Although the pathology risks associated with theses findings is considered very low (the are almost entirely false positive diagnoses), uncertainty regarding their importance and clinical significance, and lack of management guidelines, often generated extensive further testing and surveillance to exclude occult malignancy. The aims of the proposed study are to determine: 1) the frequency that different indications lead to ultrasound imaging of the neck, breast and pelvis 2) the prevalence of incidental/indeterminate findings associated with these examinations and the risk of cancer associated with these incidental/indeterminate findings and 3) to assess surveillance patterns of these lesions. To complete these aims, Dr. Smith-Bindman will conduct a retrospective cohort study of patients enrolled between 1997-2004 in Group Health, a large Not-for-Profit health maintenance organization in Seattle Washington. Group Health has over 500,000 members who obtained over 200,000 ultrasound imaging tests over the years of the study. We will link Group Health's detailed automated clinical data, including indication and result of all radiology testing, with regional Surveillance Epidemiology and End Results tumor registry to determine cancer incidence among all enrollees and associated with the imaging findings. We will use the results of these analyses to develop evidence-based practice guidelines for the management of incidental findings identified on ultrasound imaging.

描述（由申请人提供）：丽贝卡·史密斯·辛德曼（Rebecca Smith-Bindman）是加利福尼亚大学，旧金山大学（UCSF）的放射学，流行病学和生物统计学，妇产科和生殖医学的副教授，妇产科和繁殖医学副教授和大学放射学结合研究实验室。她的研究重点是评估常用筛查和诊断测试的临床影响。她正在申请以患者为导向研究的职业生涯中期调查员奖，以评估与超声成像中确定的偶然发现相关的癌症风险，并通过为这些受训者创建一项研究计划，从而增加了她致力于教学和指导放射学居民和研究员的时间。史密斯·辛德曼（Smith-Bindman）博士将完成拟议的研究，制定一项计划，以鼓励放射学学员开始从事临床癌症预防研究的职业，包括每年一次的6-8名学员的一对一指导。该奖项提供了一个理想的机会，可以通过制定一个指导初级调查员的计划来推进自己的研究议程并提高职业生涯。在过去的十年中，成像技术的进步和成像使用的急剧增长允许检测越来越小且可疑的解剖病变。癌症早期诊断对患者健康的积极影响不能被夸大。但是，成像利用率增加和分辨率增加的结果是诊断出偶然和不确定的发现数量增加。尽管与这些发现相关的病理风险被认为是非常低的（几乎完全是假阳性的诊断），对其重要性和临床意义的不确定性以及缺乏管理指南，但通常会产生广泛的进一步测试和监视，以排除神秘性恶性肿瘤。拟议研究的目的是确定：1）不同指示导致颈部，乳房和骨盆超声成像的频率2）与这些检查有关的偶然/不确定发现的流行率以及与这些偶然/不确定的发现相关的癌症风险，以及3）评估这些率的监视模式。为了完成这些目标，Smith-Bindman博士将对1997 - 2004年间招募的患者进行回顾性队列研究，该组织是团体健康，这是西雅图华盛顿的一个大型非营利性健康维护组织。集团健康有超过500,000名成员在研究的多年中获得了200,000多个超声检查测试。我们将把组健康的详细自动临床数据（包括所有放射学测试的指示和结果）与区域监视流行病学和最终结果肿瘤注册中心联系起来，以确定所有参与者之间的癌症发生率，并与成像结果相关。我们将使用这些分析的结果来制定基于证据的实践指南，以管理超声成像中确定的偶然发现。

项目成果

期刊论文数量（14）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Airport full-body screening: what is the risk?

DOI：
10.1001/archinternmed.2011.105
发表时间：
2011-06-27
期刊：
ARCHIVES OF INTERNAL MEDICINE
影响因子：
0
作者：
Mehta, Pratik;Smith-Bindman, Rebecca
通讯作者：
Smith-Bindman, Rebecca

Rising use of diagnostic medical imaging in a large integrated health system.

DOI：
10.1377/hlthaff.27.6.1491
发表时间：
2008-11
期刊：
Health affairs (Project Hope)
影响因子：
0
作者：
Smith-Bindman R;Miglioretti DL;Larson EB
通讯作者：
Larson EB

Radiation dose metrics in CT: assessing dose using the National Quality Forum CT patient safety measure.

DOI：
10.1016/j.jacr.2013.10.009
发表时间：
2014-03
期刊：
Journal of the American College of Radiology : JACR
影响因子：
0
作者：
J. Keegan;D. Miglioretti;R. Gould;L. Donnelly;Nicole Wilson;R. Smith-Bindman
通讯作者：
J. Keegan;D. Miglioretti;R. Gould;L. Donnelly;Nicole Wilson;R. Smith-Bindman

Virtual meetings: improving impact and accessibility of CME.

虚拟会议：提高 CME 的影响力和可及性。