OUTCOMES OF SCREENING MAMMOGRAPHY IN ELDERLY WOMEN

Smith-Bindman博士是放射学助理教授，最近完成了为期两年的流行病学、生物统计学和研究设计奖学金，该奖学金由加州大学旧金山分校弗朗西斯科流行病学和生物统计学系以及普通内科共同赞助。 她广泛的研究兴趣是在针对妇女健康的领域进行诊断成像测试的结果评估。 具体而言，她的研究兴趣是评估老年妇女进行乳房X线检查的结果。 更深入地了解筛查性乳房X线摄影、乳腺癌检测和治疗以及乳腺癌死亡率之间的关系，对于规划关于谁应该接受乳房X线摄影筛查的公共政策至关重要。这项拟议的研究涉及加州医疗保健融资管理局医疗保险账单索赔的数据分析的设计和实施，这些索赔与来自加州癌症登记处的乳腺癌分期和治疗的肿瘤登记数据有关。 这些数据将在医疗保险质量改进组织加州医学评论公司进行分析。 该研究者先前已成功分析了类似数据。 具体目标将侧重于对65岁以上妇女进行筛查性乳房X光检查的结果。 该提案将评估以下内容：1）乳腺癌死亡率的差异，2）乳腺癌治疗率的差异，包括乳房切除术，肿块切除术和放射治疗，以及3）乳腺癌肿瘤属性的差异，包括先前接受过乳房X光检查的女性和未接受过乳房X光检查的女性之间的大小和分期。 她还将评估患有合并症的女性是否与没有合并症的女性进行筛查有不同的结果。 对于该奖项的培训部分，她将参加生物统计方法的额外课程，以发展调整混杂因素的专业知识，她将定期与赞助商会面。Smith-Bindman博士组建了一个由国家认可的临床研究人员组成的多学科团队。 他们对她的研究计划充满热情，并致力于帮助她发展出色的研究技能，并成功完成计划中的研究。 职业发展奖将提供五年的监督经验，使史密斯-宾德曼博士成为老年妇女乳房X光检查领域的独立调查员。

Dr. Smith-Bindman is an Assistant Professor in Radiology, and recently completed a two year fellowship in epidemiology, biostatistics, and research design sponsored jointly by the Departments of Epidemiology and Biostatistics and the General Internal Medicine Section, University of California, San Francisco. Her broad research interest is in performing outcome assessment of diagnostic imaging tests in areas targeted to women's health. Specifically her research interest is in evaluating the outcomes of performing mammographic screening in elderly women. A more thorough understanding of the relationship between screening mammography, breast cancer detection and treatment, and breast cancer mortality is critical to the planning of public policy regarding who should undergo mammographic screening. The proposed study involves the design and implementation of a data analysis of California Health Care Financing Administration Medicare billing claims that have been linked with tumor registry data from the California Cancer Registry on breast cancer stage and treatment. The data will be analyzed at the California Medical Review Incorporated, a Medicare quality improvement organization. Similar data has been successfully analyzed by this investigator previously. The specific aims will focus on the outcome of performing screening mammography in women older than age 65 years. The proposal will evaluate the following: 1) differences in breast cancer mortality, 2) differences in breast cancer treatment rates including mastectomy, lumpectomy and radiation and 3) difference in breast cancer tumor attributes including size and stage between women who were previously screened with mammography and women who were not. She will also evaluate if women with co-morbidities have different outcomes from undergoing screening as women without co-morbidities. For the training component of the award, she will take additional course work in biostatistical methods to develop expertise in adjustment for confounding, and she will meet regularly with her sponsors. Dr. Smith-Bindman has assembled a multidisciplinary team of nationally recognized clinical researchers. They are enthusiastic about her research plan and are dedicated to assisting her in developing outstanding research skills and successfully completing the planned research. The Career Development Award will provide five years of supervised experience to enable Dr. Smith-Bindman to become an independent investigator in the area of mammographic screening in elderly women.