National Cancer Institute Research Agenda. New Opportunities in Health Services and Outcomes Research Steven B. Clauser, Ph.D. Nancy Breen, Ph.D. Applied Research Program http://appliedresearch.cancer.gov/ Academy Health Annual Meeting San Diego June 9, 2004. Session Outline. - PowerPoint PPT Presentation
1 National Cancer National Cancer Institute Institute Research Agenda Research Agenda New Opportunities in Health Services New Opportunities in Health Services and Outcomes Research and Outcomes Research Steven B. Clauser, Ph.D. Steven B. Clauser, Ph.D. Nancy Breen, Ph.D. Nancy Breen, Ph.D. Applied Research Program Applied Research Program http://appliedresearch.cancer.gov/ http://appliedresearch.cancer.gov/ Academy Health Annual Meeting Academy Health Annual Meeting San Diego June 9, 2004 San Diego June 9, 2004
Transcript
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National Cancer InstituteNational Cancer InstituteResearch AgendaResearch Agenda
New Opportunities in Health Services New Opportunities in Health Services and Outcomes Researchand Outcomes Research
Steven B. Clauser, Ph.D.Steven B. Clauser, Ph.D. Nancy Breen, Ph.D.Nancy Breen, Ph.D.
Applied Research ProgramApplied Research Programhttp://appliedresearch.cancer.gov/http://appliedresearch.cancer.gov/
Academy Health Annual MeetingAcademy Health Annual MeetingSan Diego June 9, 2004 San Diego June 9, 2004
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Session Outline Session Outline
Who We Are and What We Do Who We Are and What We Do
New Initiatives in Health Services ResearchNew Initiatives in Health Services Research Improving Quality of Cancer CareImproving Quality of Cancer Care Monitoring Cancer Services: Data and MethodsMonitoring Cancer Services: Data and Methods
Funding Opportunities for Junior and Mid-level Funding Opportunities for Junior and Mid-level Investigators Investigators
Office of the DirectorDr. Robert Croyle, Director
Dr. Jon F. Kerner, Deputy Director for Research Dissemination & Diffusion
Office of the DirectorDr. Robert Croyle, Director
Dr. Jon F. Kerner, Deputy Director for Research Dissemination & Diffusion
Office OfCancer Survivorship
Dr. Julia H. Rowland
Office OfCancer Survivorship
Dr. Julia H. Rowland
Applied CancerScreening Research
Dr. Helen Meissner
Applied CancerScreening Research
Dr. Helen Meissner
Basic BiobehavioralResearch
Dr. Michael Stefanek
Basic BiobehavioralResearch
Dr. Michael Stefanek
Health Communicationand
Informatics ResearchDr. Gary L. Kreps
Health Communicationand
Informatics ResearchDr. Gary L. Kreps
Health PromotionResearch
Dr. Linda Nebeling
Health PromotionResearch
Dr. Linda Nebeling
Tobacco ControlResearch
Dr. Scott Leischow
Tobacco ControlResearch
Dr. Scott Leischow
Health Services andEconomics
Dr. Martin Brown
Health Services andEconomics
Dr. Martin Brown
OutcomesResearch
Dr. Joseph Lipscomb
OutcomesResearch
Dr. Joseph Lipscomb
Risk Factor Monitoringand Methods
Dr. Susan Krebs-Smith
Risk Factor Monitoringand Methods
Dr. Susan Krebs-Smith
Surveillance ResearchProgram
Dr. Brenda K. Edwards
Surveillance ResearchProgram
Dr. Brenda K. Edwards
Cancer StatisticsDr. Benjamin Hankey
Cancer StatisticsDr. Benjamin Hankey
Statistical Researchand Applications
Dr. Eric Feuer
Statistical Researchand Applications
Dr. Eric Feuer
Epidemiology andGenetics Research
ProgramDr. Edward Trapido
Epidemiology andGenetics Research
ProgramDr. Edward Trapido
Analytic EpidemiologyResearch
Dr. Sandra Melnick
Analytic EpidemiologyResearch
Dr. Sandra Melnick
Clinical and GeneticEpidemiology Research
Dr. Deborah M. Winn
Clinical and GeneticEpidemiology Research
Dr. Deborah M. Winn
Behavioral ResearchProgram
Dr. Scott Leischow, Acting
Behavioral ResearchProgram
Dr. Scott Leischow, Acting
Applied ResearchProgram
Dr. Rachel Ballard-Barbash
Applied ResearchProgram
Dr. Rachel Ballard-Barbash
Division of Cancer Control and Population SciencesDivision of Cancer Control and Population Sciences
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NCI’s Role in Cancer ResearchNCI’s Role in Cancer Research
Discovery
Development
Delivery
Partnerships &Collaborations
Interdisciplinary Science
Ensure
Translational Research
Accelerate
Application in the Clinic & Public Health Programs
Integrate
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Health Services Research is Relevant Health Services Research is Relevant Across the Cancer ContinuumAcross the Cancer Continuum
Cross Cutting Topics• Barriers to Care • Health Disparities • Continuity of Care• Quality of Care
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**
A New NCI Priority to AddressA New NCI Priority to Address
a Major Public Health Concerna Major Public Health Concern
Improving the QualityImproving the Qualityof Cancer Careof Cancer Care
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Emerging Consensus from Cancer Emerging Consensus from Cancer Research and Policy Communities:Research and Policy Communities:
Far too many of the over 9 million cancer patients and Far too many of the over 9 million cancer patients and survivors in the U.S. do not receive high-quality care.survivors in the U.S. do not receive high-quality care.
In many instances, no consensus on what constitutes In many instances, no consensus on what constitutes “quality care” -- especially from the patient’s perspective.“quality care” -- especially from the patient’s perspective.
Even where consensus appears to exist, wide variations Even where consensus appears to exist, wide variations in practice patterns indicate significant populations in practice patterns indicate significant populations disparities in receipt of quality care. disparities in receipt of quality care.
President’s Cancer Panel will focus on “Translating President’s Cancer Panel will focus on “Translating Research into Clinical Practice” in 2004-5 meetings. Research into Clinical Practice” in 2004-5 meetings.
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NCI’s Response…..NCI’s Response…..
Designate “Improving the Quality of Cancer Care” as a priority area in Designate “Improving the Quality of Cancer Care” as a priority area in the 2002, 2003, 2004, and 2005 “Bypass Budget”: the 2002, 2003, 2004, and 2005 “Bypass Budget”:
The Nation’s Investment in Cancer Research (The Nation’s Investment in Cancer Research (http://plan.cancer.http://plan.cancer.govgov))
GoalGoal: : Improve the quality of cancer care by strengthening the scientific basis for Improve the quality of cancer care by strengthening the scientific basis for public and private decision making on care delivery, coverage, purchasing, public and private decision making on care delivery, coverage, purchasing, regulation, and standards setting.regulation, and standards setting.
Defining “Quality” Cancer CareDefining “Quality” Cancer Care
Quality of Care Quality of Care is the degree to which health is the degree to which health services for individuals and populations increase services for individuals and populations increase the likelihood of desired health outcomes and are the likelihood of desired health outcomes and are consistent with current professional knowledge. consistent with current professional knowledge. (Institute of Medicine, 1990)(Institute of Medicine, 1990)
In the NCI Initiative, this meansIn the NCI Initiative, this means provision of evidence-based care across the cancer provision of evidence-based care across the cancer
continuumcontinuum in a timely and technically competent mannerin a timely and technically competent manner with good communicationwith good communication shared decision makingshared decision making cultural sensitivitycultural sensitivity
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Cancer Care Quality Improvement CycleCancer Care Quality Improvement Cycle
Measuring Outcomesthat Matter
Monitoring Progress and Identifying New Targets
Impacting the Delivery of Care
Identifying Interventions thatImprove Outcomes
Strengthening Science Base for Quality of Care
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Cancer Care Quality Improvement CycleCancer Care Quality Improvement Cycle
Monitoring Progress and Identifying New Targets
Impacting the Delivery of Care
Identifying Interventions thatImprove Outcomes
Strengthening Science Base for Quality of Care
Measuring Outcomesthat Matter
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To Evaluate the State of the Science in To Evaluate the State of the Science in Measuring Outcomes that Matter, Measuring Outcomes that Matter,
NCI established the NCI established theCCancer ancer OOutcomes utcomes MMeasurement easurement WWorking orking GGrouproup
35 internationally recognized experts, convened in 2001, drawn from academia, government, and industry35 internationally recognized experts, convened in 2001, drawn from academia, government, and industry Not a consensus panel or advisory committeeNot a consensus panel or advisory committee Rather, members analyzed literature, interacted, and made recommendations, individually, to NCIRather, members analyzed literature, interacted, and made recommendations, individually, to NCI Focused on patient-reported outcomesFocused on patient-reported outcomes Findings forthcoming in Findings forthcoming in Outcomes Assessment in CancerOutcomes Assessment in Cancer (Cambridge University Press, 2004)(Cambridge University Press, 2004)
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Cancer Outcomes Measurement Working Group Cancer Outcomes Measurement Working Group Focus on Patient-Reported OutcomesFocus on Patient-Reported Outcomes
BreastProstateLungColorectal
PreventionScreeningTreatmentSurvivorshipEnd of Life
HRQOLSatisfaction/NeedsEconomic Burden
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Next Steps Post-COMWGNext Steps Post-COMWG
Key Research GapsKey Research Gaps Value-added of patient-reported outcomes (like Value-added of patient-reported outcomes (like
HRQOL) beyond traditional biomedical endpoints?HRQOL) beyond traditional biomedical endpoints?
Defining the concept of a “clinically meaningful Defining the concept of a “clinically meaningful difference”difference”
Successfully negotiating balance between adequate Successfully negotiating balance between adequate responsivenessresponsiveness for the outcome under study while for the outcome under study while promoting promoting comparabilitycomparability across studies across studies
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Cancer Care Quality Improvement CycleCancer Care Quality Improvement Cycle
Measuring Outcomesthat Matter
Monitoring Progress and Identifying New Targets
Impacting the Delivery of Care
Identifying Interventions thatImprove Outcomes
Strengthening Science Base for Quality of Care
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CanCORSCanCORS
study the impact of targeted interventions on study the impact of targeted interventions on patient-centered outcomespatient-centered outcomes
investigate dissemination of state-of-the-art investigate dissemination of state-of-the-art therapies in the community therapies in the community
examine gaps between best, evidence-based examine gaps between best, evidence-based clinical practice and actual care in community clinical practice and actual care in community
analyze disparities in quality cancer careanalyze disparities in quality cancer care
CanCancer cer CCare are OOutcomes utcomes RResearch and esearch and SSurveillance Consortium:urveillance Consortium: A 5-year, $34M A 5-year, $34M RFA-supported cooperative agreement to:RFA-supported cooperative agreement to:
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CanCORS Study DesignCanCORS Study Design
Established in 2001 & co-funded by NCI and VAEstablished in 2001 & co-funded by NCI and VA
Large observational cohort study of newly Large observational cohort study of newly identified lung and colorectal cancer patientsidentified lung and colorectal cancer patients For lung: 5 research teams with N = 4,700For lung: 5 research teams with N = 4,700 For colorectal: 6 research teams with N = 5,300For colorectal: 6 research teams with N = 5,300
Socio-economically,geographically, and Socio-economically,geographically, and race/ethnically diverse samplesrace/ethnically diverse samples
Public-private provider mix: large HMOs, fee-for-Public-private provider mix: large HMOs, fee-for-service, VA medical centersservice, VA medical centers
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CanCORS Study Design (cont)CanCORS Study Design (cont)
Rapid case ascertainment : < 3 months after Rapid case ascertainment : < 3 months after diagnosisdiagnosis
Follow-up patients 12 months after diagnosisFollow-up patients 12 months after diagnosis
For each patient, creates a longitudinal profile of For each patient, creates a longitudinal profile of cancer care by utilization multiple data sourcescancer care by utilization multiple data sources
Investigate structure - process - outcome links at Investigate structure - process - outcome links at the patient, provider, and organizational levelthe patient, provider, and organizational level
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CanCORS Specific AimsCanCORS Specific Aims
To determine how the characteristics & beliefs of To determine how the characteristics & beliefs of cancer patients and providers and the cancer patients and providers and the characteristics of health-care organizations characteristics of health-care organizations influence treatments and outcomes, influence treatments and outcomes, spanning spanning continuum of cancer care from diagnosis to continuum of cancer care from diagnosis to recovery or deathrecovery or death
TTo evaluate effects of select processes of care o evaluate effects of select processes of care on patients’ survival, health-related quality of life, on patients’ survival, health-related quality of life, and satisfaction with careand satisfaction with care
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Some CanCORS High-Priority QuestionsSome CanCORS High-Priority Questions
How and why do processes and outcomes of How and why do processes and outcomes of care vary by patient age, race, ethnicity, SES? care vary by patient age, race, ethnicity, SES?
Why do high-volume hospitals tend to have Why do high-volume hospitals tend to have lower surgical mortality rates?lower surgical mortality rates?
How do patients and physicians go about How do patients and physicians go about making treatment decisions for metastatic making treatment decisions for metastatic cancer?cancer?
Are symptoms (especially pain and depression) Are symptoms (especially pain and depression) treated effectively?treated effectively?
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Cancer Care Quality Improvement CycleCancer Care Quality Improvement Cycle
Measuring Outcomesthat Matter
Monitoring Progress and Identifying New Targets
Impacting the Delivery of Care
Identifying Interventions thatImprove Outcomes
Strengthening Science Base for Quality of Care
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The Cancer Care Quality Measures The Cancer Care Quality Measures Project (CanQual) Project (CanQual)
In 2002, NCI spearheaded the creation of a public-In 2002, NCI spearheaded the creation of a public-private effort: private effort: Convened by the non-profit National Quality Forum (NQF)Convened by the non-profit National Quality Forum (NQF)
Driving Questions: Driving Questions: Where are the most critical quality “gaps”?Where are the most critical quality “gaps”? How can we measure and close those gaps? How can we measure and close those gaps? How do we make these measures suitable to support QOC How do we make these measures suitable to support QOC
improvement strategies? improvement strategies?
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The Cancer Care Quality Measures The Cancer Care Quality Measures Project (CanQual) Project (CanQual)
Guided by a Steering Committee whose members Guided by a Steering Committee whose members (voting and liaison) are drawn from across the spectrum (voting and liaison) are drawn from across the spectrum of organizations concerned with the quality of cancer of organizations concerned with the quality of cancer care and performance measurement, including:care and performance measurement, including:
ASCO
ACS
NCI
ACoS
ACR
NCCS NCPB VA
OPM
CMS
NCQAJCAHO ONSNCCN
NQF
CDC
AHRQ
AAHP-HIAA
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Focus Areas Identified by Steering Focus Areas Identified by Steering Committee at Sept 2002 Meeting Committee at Sept 2002 Meeting
(Phase I completed)(Phase I completed) Tumor-site specific measures: Tumor-site specific measures:
Breast cancer diagnosis and treatmentBreast cancer diagnosis and treatment Colorectal cancer diagnosis and treatmentColorectal cancer diagnosis and treatment Prostate cancer diagnosis and treatmentProstate cancer diagnosis and treatment
Cross-cutting measures: Cross-cutting measures: Access to care, including clinical trialsAccess to care, including clinical trials Communications and coordination of care (including Communications and coordination of care (including
IT uses)IT uses) Prevention/Screening (including quality of screening, Prevention/Screening (including quality of screening,
risk assessment, and prevention activities under risk assessment, and prevention activities under purview of health systems)purview of health systems)
Symptom management and end-of-life careSymptom management and end-of-life care
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CanQual Project Plan for Phase IICanQual Project Plan for Phase II (2004-2006) (2004-2006)
Contract Start date Contract Start date May 3, 2004
Steering Committee selects topics July 2004
Data and Methods Panel selected and convened August 2004
3 Technical Panels selected and convened Sept. - Oct. 2004
Technical Panels’ deliver recommendations on core June 2005 - measures and future research priorities to SC Nov. 2005
Steering Committee deliver recommendations to Sept. 2005 - NQF “Consensus Development Process” Feb. 2006
NQF 4 Member Councils, membership and Board Sept. 2005 - of Directors review and vote on measures July 2006
NQF publishes core measures of cancer care Sept. 2006quality as “voluntary consensus standards”
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Phase III and Beyond…...Phase III and Beyond…...
Continue to build the evidence-base for cancer quality Continue to build the evidence-base for cancer quality of care measurementof care measurement Pilot test endorsed QOC measuresPilot test endorsed QOC measures Develop new measures with public & private partnersDevelop new measures with public & private partners
Work with partners to adopt QOC measures and Work with partners to adopt QOC measures and evaluate their dissemination and useevaluate their dissemination and use
Work with provider and quality improvement Work with provider and quality improvement organizations to implement QOC-enhancing organizations to implement QOC-enhancing interventionsinterventions
Track improvements in QOC -- and feed back findings Track improvements in QOC -- and feed back findings to policy makers at all levelsto policy makers at all levels
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Cancer Care Quality Improvement CycleCancer Care Quality Improvement Cycle
Measuring Outcomesthat Matter
Monitoring Progress and Identifying New Targets
Impacting the Delivery of Care
Identifying Interventions thatImprove Outcomes
Strengthening Science Base for Quality of Care
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Building a National Cancer Data Building a National Cancer Data SystemSystem
**Overall strategy for developing a national Overall strategy for developing a national system to track quality, access and costs of system to track quality, access and costs of
cancer care servicescancer care services**
Data NetworksData Networks* *
Data ResourcesData Resources
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Key Steps Toward Building CapacityKey Steps Toward Building Capacity
Encourage innovative use of existing data sourcesEncourage innovative use of existing data sources Registries (e.g., SEER, NPCR, NCDB)Registries (e.g., SEER, NPCR, NCDB) Medical records Medical records Administrative files (e.g., Medicare, Medicaid, private Administrative files (e.g., Medicare, Medicaid, private
Accelerate development and linkage of multiple Accelerate development and linkage of multiple data sources to data sources to Enhance timeliness, scope, and level of detail in Enhance timeliness, scope, and level of detail in
monitoring population monitoring population Capture complexity of cancer care to facilitate advanced Capture complexity of cancer care to facilitate advanced
statistical modeling of structure-process-outcome statistical modeling of structure-process-outcome relationships relationships
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Health Services Research NetworksHealth Services Research Networks
National, multi-site research networks thatNational, multi-site research networks that Can enroll large cohorts of individualsCan enroll large cohorts of individuals Track receipt of cancer control services longitudinally Track receipt of cancer control services longitudinally
at the patient, provider, and health system levels at the patient, provider, and health system levels Investigate impact of interventions on patient-Investigate impact of interventions on patient-
centered outcomescentered outcomes
Current ExamplesCurrent Examples Breast Cancer Surveillance Consortium (BCSC)Breast Cancer Surveillance Consortium (BCSC) Cancer Care Outcomes Research and Surveillance Cancer Care Outcomes Research and Surveillance
Consortium (CanCORS)Consortium (CanCORS) Cancer Research Network (CRN)Cancer Research Network (CRN)
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Cancer Research Network Cancer Research Network
Initiated in 1999 to create a population research Initiated in 1999 to create a population research laboratory in the context of health care delivery laboratory in the context of health care delivery systemssystems
Research on cancer prevention, early detection, Research on cancer prevention, early detection, treatment, and post treatment surveillancetreatment, and post treatment surveillance
Collaborative cancer research among health care Collaborative cancer research among health care provider organizations oriented to community careprovider organizations oriented to community care
Access to large, stable and diverse populationsAccess to large, stable and diverse populations
Existing integrated data-bases that can provide Existing integrated data-bases that can provide patient level informationpatient level information
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GHC Ctr for Health GHC Ctr for Health Studies - Lead SiteStudies - Lead Site
KPH Ctr for Health Research, HonoluluKPH Ctr for Health Research, Honolulu
HealthPartners Research FoundationHealthPartners Research Foundation
Breast and Cervical Cancer Screening – Project Breast and Cervical Cancer Screening – Project DETECTDETECT ((DDiagnosing iagnosing EEarly arly TTumors umors EEases ases CCancer ancer TTreatment)reatment)
Outcomes of Prophylactic Mastectomy and Early Screening Outcomes of Prophylactic Mastectomy and Early Screening in High Risk Women – Project in High Risk Women – Project PROTECTSPROTECTS((ProProgram gram TTesting esting EEarly arly CCancer ancer TTreatment and reatment and SScreening)creening)
Others CanCORS, IMPACT, Others CanCORS, IMPACT, Pilot Study of Pilot Study of Disenrollment among HMO Patients with CancerDisenrollment among HMO Patients with Cancer
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Health Services Research at NCI:Health Services Research at NCI:Research ResourcesResearch Resources
National SurveysNational Surveys National Health Interview Survey – Cancer Control National Health Interview Survey – Cancer Control
Topical Module, 1987, 1992, 2000Topical Module, 1987, 1992, 2000 California Health Interview Survey, 2000California Health Interview Survey, 2000 National Survey of Mammography Facilities, 1992National Survey of Mammography Facilities, 1992 National Survey of Colorectal Screening in Healthcare National Survey of Colorectal Screening in Healthcare
Organizations, 2000Organizations, 2000 National Survey of Cancer Genetic Screening, 2000National Survey of Cancer Genetic Screening, 2000
Database ResourcesDatabase Resources SEER – Medicare Linked DatabaseSEER – Medicare Linked Database Cancer Research NetworkCancer Research Network
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Percentages are standardized to the 2000 Projected U.S. Population by 5-year age groups.
1 National Health Interview Survey2 http://healthservices.cancer.gov/seermedicare/considerations/testing.html3 U.S. Preventive Services Task Force. Guide to clinical preventive services: an assessment of the effectiveness of 169 interventions. Baltimore: Williams & Wilkins, 1989 for mammography and Pap test recommendations. U.S. Preventive Services Task Force. Guide to clinical preventive services, 2nd ed. Washington, DC: Office of Disease Prevention and Health Promotion, U.S. Government Printing Office, 1996 for FOBT and CRE.
PAP smear: Within the last 3 years, age 25+
Mammogram: Within the last 2 years, age 40+ FOBT: Fecal Occult Blood Test within
the last year, age 50+
CRE: Colorectal endoscopy within the last 3 years, age 50+
PSA: Prostate Specific Antigen test within the past year, age 50+
Women
0
10
20
30
40
50
60
70
80
90
1987 1989 1991 1993 1995 1997 1999
Year
Pe
rce
nt
Men
0
10
20
30
40
50
60
70
80
90
1987 1989 1991 1993 1995 1997 1999
Year
Pe
rce
nt
Recent Use of Cancer Screening Tests¹, Initiation of Medicare Coverage², and USPSTF guidelines³: 1987, 1992, 1998, 2000
USPSTF guidelines
Initiation of Medicare coverage
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CHIS 2001 NHIS 2000
Latino 11,840 5,147White 34,383 21,347Other race 182 290*Asian 3,809 865African American 2,497 4,492Two or more races 2,104 33American Indian/Alaska Natives 424 200Native Hawaiian & Other Pacific Islander (NHOPI)
189 *
55,428 32,374*Other race in the NHIS includes NHOPI
CHIS and National Health Interview Survey CHIS and National Health Interview Survey (NHIS): Size of Samples(NHIS): Size of Samples
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California Health Interview Survey (CHIS): California Health Interview Survey (CHIS): Designed to Inform Local Health ActionsDesigned to Inform Local Health Actions
Sollicited data and health needs from communities, tribes, and health departments
Adult Interview Topic Areas(ages 18 and above)
Age, gender, race, ethnicityPhysical activityHealth statusHealth use and accessHealth conditionsCancer screeningHealth insuranceHealth behaviorsEmploymentDietIncome
Department of Health Services Public Health Institute California Endowment
NCI CDC IHS
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Content of Cancer Module (2000)Content of Cancer Module (2000)
ScreeningScreeningUse and follow upUse and follow up
Vitamin supplementsVitamin supplements Fruit & vegetable consumptionFruit & vegetable consumption
Physical ActivityPhysical ActivitySmokingSmoking
Family History of CancerFamily History of CancerGenetic screeningGenetic screening
NHIS CHISXXXXXXXXXX
XXX
XXXX
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What are the SEER - Medicare data?What are the SEER - Medicare data?
The SEER-Medicare data are the result of the linkage of two large The SEER-Medicare data are the result of the linkage of two large population-based sources of data: SEER cancer registry data and population-based sources of data: SEER cancer registry data and Medicare claims from CMSMedicare claims from CMS
Medicare data are Medicare data are longitudinallongitudinal, with claims for all covered health , with claims for all covered health services from the time of eligibility to death. Claims come from all services from the time of eligibility to death. Claims come from all types of providers, e.g. hospitals, physicians, outpatient clinics, types of providers, e.g. hospitals, physicians, outpatient clinics, hospice, etc.hospice, etc.
Medicare data are also available for a 5% random sample of Medicare data are also available for a 5% random sample of persons residing in the SEER areas who have not been diagnosed persons residing in the SEER areas who have not been diagnosed with cancer. These files can be used to create comparison groups with cancer. These files can be used to create comparison groups as well as population-based rates of testing and treatment.as well as population-based rates of testing and treatment.
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$$$$$$$$$$$$$$$$$$$$$$
HSR Funding HSR Funding Opportunities at NClOpportunities at NCl
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NCI Funding Mechanisms for NCI Funding Mechanisms for Junior and Mid-level InvestigatorsJunior and Mid-level Investigators
K-Awards NCI – Training Awards K-Awards NCI – Training Awards
R03 – Small Research GrantsR03 – Small Research Grants
In response to the concern that racial and ethnic minority In response to the concern that racial and ethnic minority researchers have been historically underrepresented among researchers have been historically underrepresented among NIH funded investigators, the NCI is sponsoring a workshop NIH funded investigators, the NCI is sponsoring a workshop to provide training to mid-career and/or transitioning to provide training to mid-career and/or transitioning investigators from underrepresented racial/ethnic groups to investigators from underrepresented racial/ethnic groups to enhance their ability to compete for NIH funding by providing enhance their ability to compete for NIH funding by providing information that will facilitate professional growth and information that will facilitate professional growth and development and increase technical skills. development and increase technical skills.
The workshop will be in Palm Desert, CA July 21-July 23, The workshop will be in Palm Desert, CA July 21-July 23, 2004. 2004.
Travel support will be provided to a limited number of Travel support will be provided to a limited number of participants.participants.
Contact: Vickie L. Shavers, PhDContact: Vickie L. Shavers, PhDemail: email: shaversvshaversv@[email protected]
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Support for Extramural Investigators Who Support for Extramural Investigators Who Want to Use the SEER-Medicare DataWant to Use the SEER-Medicare Data
NCI offers technical support for data users through:NCI offers technical support for data users through: Extensive SEER-Medicare WEB pageExtensive SEER-Medicare WEB page
http://healthservices.cancer.gov/seermedicare/http://healthservices.cancer.gov/seermedicare/ Data users conferencesData users conferences Medical CareMedical Care supplement supplement Special projects related to methods development Special projects related to methods development
There are 2 (PAs) that are support SEER-Medicare There are 2 (PAs) that are support SEER-Medicare projects:projects: Economic Studies In Cancer Prevention, Screening Economic Studies In Cancer Prevention, Screening
And Care (And Care (PA-02-006PA-02-006)) Cancer Surveillance Using Health Claims-Based Data Cancer Surveillance Using Health Claims-Based Data
System (System (PA-02-005PA-02-005))
Academy Health Annual Research Meeting, June 2004
PAR 04-036: Colorectal Cancer PAR 04-036: Colorectal Cancer Screening in Primary Care PracticeScreening in Primary Care Practice
Utilization of CRC screening in the general Utilization of CRC screening in the general population is low.population is low.
CRC screening delivery by primary care CRC screening delivery by primary care physicians is less than optimal.physicians is less than optimal.
Few U.S. health plans have systems in Few U.S. health plans have systems in place for CRC screening recruitment and/or place for CRC screening recruitment and/or results tracking.results tracking.
Types of Studies PAR 04-036 is Types of Studies PAR 04-036 is Intended to PromoteIntended to Promote
Delivery:Delivery: Novel ways of integrating CRC screening into primary care Novel ways of integrating CRC screening into primary care
practice.practice. Risk assessment; time to completion of tests; procedure Risk assessment; time to completion of tests; procedure
quality.quality.
Utilization:Utilization: Interventions, mechanisms, or systems to improve screening Interventions, mechanisms, or systems to improve screening
compliance.compliance. Measures, scales, or instruments to assess screening Measures, scales, or instruments to assess screening
adherence over time and with multiple modalities.adherence over time and with multiple modalities.
Outcomes:Outcomes: Test performance characteristics and factors influencing these Test performance characteristics and factors influencing these
in community practice.in community practice. Adverse events.Adverse events.
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For further information on anything For further information on anything presented today -- including most presented today -- including most appropriate NCI contacts, email….appropriate NCI contacts, email….
Steven Clauser Ph.D., Senior ScientistSteven Clauser Ph.D., Senior ScientistClausersClausers@[email protected]
