Examine the Effectiveness of Cancer Screening Among Patients with Alzheimer’s Disease and Related Dementias Using Real-World Data
Examine the Effectiveness of Cancer Screening Among Patients with Alzheimer’s Disease and Related Dementias Using Real-World Data
批准号:
10284993
负责人:
Jiang Bian
金额:
$38.13万
依托单位:
依托单位国家:
美国
项目类别:
财政年份:
2020
资助国家:
美国
项目状态:
已结题
起止时间:
2020-01-01 至 2023-12-31
关键词:
Administrative SupplementAdoptionAdvisory CommitteesAlzheimer disease screeningAlzheimer&aposs DiseaseAlzheimer&aposs disease related dementiaAmerican Cancer SocietyAwardCancer BurdenCancer PatientCaregiversCause of DeathCessation of lifeClinical DataClinical ResearchColorectal CancerCosts and BenefitsCox ModelsDataDiagnosisEarly DiagnosisEffectivenessEffectiveness of InterventionsElderlyElectronic Health RecordEligibility DeterminationEthicsEventFamilyFinancial HardshipFrequenciesFundingGuidelinesHealthcare SystemsIncidenceIndividualLeadLife ExpectancyLinkLogistic ModelsLogisticsMalignant NeoplasmsMalignant neoplasm of lungMedicaidMedicalMedicare claimModelingParentsPatientsPatternPopulationPopulations at RiskPreventive serviceProfessional OrganizationsRandomized Clinical TrialsRecommendationResearchRetrospective cohortRiskSafetySample SizeScreening for cancerSourceStructureSymptomsSystemTechniquesTestingTimeTreatment EffectivenessVital Statisticsbasecancer clinical trialcancer diagnosiscancer survivalcancer therapycancer typeclinical research sitecognitive abilitycohortcolorectal cancer screeningcomorbiditycomparative effectiveness studycomputable phenotypescost effectivenessdesignevidence basefamily burdenfollow-upfunctional statuslung cancer screeningmalignant breast neoplasmmortalityneoplasm registrynonalzheimer dementiascreeningscreening guidelines
中文摘要
摘要
英文摘要
ABSTRACT
Detecting cancer early through screening substantially increases the chance of successful treatment, and thus
provides the best opportunity for reducing cancer mortality and alleviating cancer burden in the population.
National professional associations such as the US Preventive Services Task Force (USPSTF) and the
American Cancer Society have developed screening guidelines for various types of cancers based on
extensive reviews of scientific evidence. These guidelines identify cancer screening-eligible populations and
provide recommendations on the type and frequency of screening tests. However, even with the evidence-
based screening guidelines, a decision to undergo cancer screening is not always straightforward, especially
for patients with Alzheimer's disease and related dementias (ADRD). ADRD patients suffer from poor
functional status, comorbid illnesses, and shortened life expectancy. Screening ADRD patients for cancer may
lead to over-diagnosis and treatment of cancers that otherwise would not have caused symptoms during a
patient’s lifetime. On the other hand, the key evidence on the effectiveness of a cancer screening test is the
reduction in late-stage cancer incidence and mortality, which is often obtained in randomized clinical trials
(RCTs). However, RCTs of cancer screening require a long follow-up. Conducting these RCTs in ADRD
patients, a population of compromised physical and cognitive abilities, can be logistically, financially, and
ethically challenging. To date, it remains unclear whether cancer screening can actually reduce mortality in
this population. In our parent award R01 CA246418, we have developed research-grade computable
phenotypes (CP) for identifying individuals who are eligible or ineligible for lung cancer screening (LCS) using
both structured and unstructured EHR data in the OneFlorida network. We will soon begin to examine the
utilization patterns and predictors of appropriate and inappropriate LCS, and estimate the benefits and cost-
effectiveness of LCS. OneFlorida is one of the 9 PCORI-funded research networks contributing to the national
PCORnet. It contains ~15 million patient EHRs linked with data from various other sources, including Medicaid
and Medicare claims, cancer registries, and vital statistics. In this administrative supplement, we propose to
identify a retrospective cohort of ADRD patients in OneFlorida to: (1) examine the utilization patterns and
predictors of lung, breast, and colorectal cancer screening among ADRD patients and (2) test whether cancer
screening reduces late-stage cancer incidence and mortality among ADRD patients. This study will be the first
to examine the effectiveness of cancer screening in reducing late-stage cancer diagnosis and mortality in
ADRD patients. Given the infeasibility of RCTs, our study will provide critical evidence that can help clinicians,
caregivers, and families understand the effectiveness of cancer screening in quantitative terms and decide
whether cancer screening is useful in ADRD patients.
期刊论文(0)
专著(0)
科研奖励(0)
会议论文
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Optimizing the Population Representativeness of Older Adults in Cancer Trials
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依托单位:
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海外基金