Comparing GIS-based measures in access to mammography and their validity in predicting neighborhood risk of late-stage breast cancer.
Comparing GIS-based measures in access to mammography and their validity in predicting neighborhood risk of late-stage breast cancer.
复制标题
比较基于 GIS 的乳房 X 光检查方法及其在预测邻近晚期乳腺癌风险方面的有效性。
DOI：
10.1371/journal.pone.0043000
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Schootman M
中科院分区：
文献类型：
--
作者：
Lian M;Struthers J;Schootman M
在调查其对乳腺癌相关结果的背景影响时，评估获得乳房X光检查的邻里环境仍然是一个挑战。使用不同的基于地理信息系统 (GIS) 的测量方法进行的研究报告了不一致的结果。我们根据 Spearman 相关性、一致性 (Kappa) 和空间模式，比较了基于 GIS 的措施（旅行时间、服务密度和两步浮动集水区方法 [2SFCA]）获得 FDA 认可的乳房 X 光检查设施的情况。作为预测有效性的指标，我们使用癌症登记数据检查了它们与晚期乳腺癌几率的关联。可达性测量表明相关性、Kappa 和空间格局存在相当大的变化。使用最短出行时间（或平均值）和服务密度的测量显示相关性较低、不一致且空间模式不同。两种类型的衡量指标均表现出较低的相关性，且与 2SFCA 衡量指标的一致性较差。在所有测量中，只有使用 6 时区加权 2SFCA 方法的两项测量与晚期乳腺癌的几率增加相关（快速距离衰减：优势比 [OR] = 1.15，95% 置信区间 [CI] = 1.01–1.32；慢距离衰减：OR = 1.19，95% CI = 1.03–1.37）在控制人口统计和邻里社会经济剥夺后。现有各种基于 GIS 的乳腺 X 光检查设施使用情况测量方法，但原则上并不相同，而且它们与晚期乳腺癌风险的关联也各不相同。只有使用 2SFCA 方法和 6 时区加权的两项测量与晚期乳腺癌的几率增加相关。这些措施包括旅行障碍和服务竞争。根据所使用的可访问性衡量标准，研究可能会观察到不同的结果。
Assessing neighborhood environment in access to mammography remains a challenge when investigating its contextual effect on breast cancer-related outcomes. Studies using different Geographic Information Systems (GIS)-based measures reported inconsistent findings. We compared GIS-based measures (travel time, service density, and a two-Step Floating Catchment Area method [2SFCA]) of access to FDA-accredited mammography facilities in terms of their Spearman correlation, agreement (Kappa) and spatial patterns. As an indicator of predictive validity, we examined their association with the odds of late-stage breast cancer using cancer registry data. The accessibility measures indicated considerable variation in correlation, Kappa and spatial pattern. Measures using shortest travel time (or average) and service density showed low correlations, no agreement, and different spatial patterns. Both types of measures showed low correlations and little agreement with the 2SFCA measures. Of all measures, only the two measures using 6-timezone-weighted 2SFCA method were associated with increased odds of late-stage breast cancer (quick-distance-decay: odds ratio [OR] = 1.15, 95% confidence interval [CI] = 1.01–1.32; slow-distance-decay: OR = 1.19, 95% CI = 1.03–1.37) after controlling for demographics and neighborhood socioeconomic deprivation. Various GIS-based measures of access to mammography facilities exist and are not identical in principle and their association with late-stage breast cancer risk. Only the two measures using the 2SFCA method with 6-timezone weighting were associated with increased odds of late-stage breast cancer. These measures incorporate both travel barriers and service competition. Studies may observe different results depending on the measure of accessibility used.
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影响因子：
3
作者：
Elkin EB;Ishill NM;Snow JG;Panageas KS;Bach PB;Liberman L;Wang F;Schrag D
通讯作者：
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