EVALUATING MAMMOGRAPHY CLAIMS DATA

评估乳房X光检查索赔数据

• 批准号: 6173321
• 负责人: Jean L Freeman
• 金额: $ 17.59万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-06-01 至 2002-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6173321
• 关键词: bioimaging /biomedical imaging; breast neoplasm /cancer diagnosis; clinical research; diagnosis design /evaluation; female; health care cost /financing; health care service evaluation; human data; longitudinal human study; mammography; mass screening; outcomes research; statistics /biometry

Despite its proven efficacy in reducing breast cancer mortality, little is known about the effectiveness of screening mammography in community practice. Of particular concern is its specificity outside academic medical settings and the implications of false positives on patient outcomes and costs of care. These are major issues for older women since surveys of mammography use have documented large increases in the rate of routine screening, especially for women over age 65. Monitoring trends in the use of screening mammography, assessing the accuracy of mammography in community practice and studying outcomes of routine screening in terms of follow-up procedures have been targeted by the Institute of Medicine as important topics for effectiveness research in breast cancer that might be initially addressed with Medicare claims data. Our current research is aimed at identifying potential uses and limitations of the claims data for mammography effectiveness research. Our goals for the competing renewal are to: 1) continue the validation studies by assessing the completeness of mammography in the claims; 2) examine correlates of the use and outcomes of screening mammograms; 3) describe changes in screening mammography outcomes over time (1993-1996) and 4) assess the effectiveness of mammography screening in community practice. Of particular interest is the comparison of completeness, use, outcomes and effectiveness for women age 65-74 versus women age 75 and older. Potential sources of missing mammograms in the claims will be examined by trying to link the radiology reports of Medicare beneficiaries who received mammograms in selected facilities to the Medicare claims data. The evaluation of use, outcomes and effectiveness will be conducted with the SEER-Medicare linked database and the sample of non-cancer controls. Measures of use and outcomes will be derived from these data and compared across the two age groups, the nine SEER areas and the four years from 1993 through 1996. The effect of screening mammography on breast cancer survival will be estimated for the two age groups by examining the screening practices from 1991-1994 for a cohort of SEER breast cancer cases diagnosed in 1995. Analyses will compare the size of tumor, stage and survival for women with different screening practices.

尽管它在降低乳腺癌死亡率方面有效，但对筛查乳房X线摄影在社区实践中的有效性知之甚少。特别关心的是其在学术医疗环境之外的特异性以及假阳性对患者预后和护理成本的影响。 这些是老年妇女的主要问题，因为使用乳房X线摄影的调查已经证明了日常筛查率的大幅度提高，尤其是对于65岁以上的女性。监测乳房X线摄影的使用的趋势，评估乳房X线X摄影术在社区实践中的准确性并研究了在医学研究所中，对医学研究所进行了有效研究，以使其针对性地癌症研究，以至于有效地掌握了术中的一项癌症，以至于有效地对医学进行了研究，以至于有效地研究了有效性的研究。我们当前的研究旨在确定乳房X线摄影有效性研究的索赔数据的潜在用途和局限性。我们的竞争更新目标是：1）通过评估索赔中乳房X线摄影的完整性继续进行验证研究； 2）检查筛查乳房X线照片的使用和结果的相关性； 3）描述随着时间的推移（1993-1996）和4）评估乳房X线摄影筛查在社区实践中的有效性。特别有趣的是比较65-74岁的女性的完整性，使用，结果和有效性与75岁及75岁以上的女性。索赔中缺少乳房X光检查的潜在来源将通过尝试将在选定设施中收到乳房X线照片的医疗保险受益人的放射学报告与Medicare索赔数据联系起来。使用Seer-Medicare链接数据库和非癌症对照样本的使用，结果和有效性的评估将进行。使用和结果的度量将从这些数据中得出，并在两个年龄组中进行比较，从1993年到1996年，将从1993年到1996年的四年来进行比较。筛查乳房X线摄影对乳腺癌存活的影响将估算两个年龄段的筛查群体，通过检查1991 - 1994年间筛查的筛查实践的筛查习惯，以与1995年诊断的阶段相比，将与1995年诊断的阶段及其相比。实践。