Lung Cancer Care Outcomes/Surveillance Consortium--Iowa

肺癌护理结果/监测联盟——爱荷华州

• 批准号: 6413870
• 负责人: Robert Bruce Wallace
• 金额: $ 46.03万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-20 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6413870
• 关键词: belief; cancer rehabilitation /care; continuing education; cooperative study; data collection; decision making; human subject; human therapy evaluation; immunomodulators; medical records; neoplasm /cancer education; neoplasm /cancer immunotherapy; nonsmall cell lung cancer; outcomes research; patient care management; patient oriented research; preference; quality of life; social support network

We have assembled a team of multi-disciplinary investigators to study, on a population basis, the patterns of treatment initially and continuing for a representative sample of lung cancer patients in the state of Iowa. These patterns will be explored in terms of patient decision-making processes for short and long-term treatment, with follow-up for suitable outcomes including disease-free interval, quality-of-life measures, end of-life care and overall survivorship. Factors proposed for exploration include including patient demographic, economic and behavioral attributes, including traits such as the patient's cancer learning environment and fatalism, the influences of geographically-dispersed practitioners with varied clinical management approaches, practitioner continuing education and information sources, the application of treatments where optimal approaches are uncertain and the influence of spatial and fiscal access to care. Special features of this proposal include: a) a multi-disciplinary team of investigators including epidemiology, disease registration, biostatistics, health economics, behavioral science and thoracic oncology; b) proven ability to access approximately 2000 lung cancer patients per year and achieve long term follow-up rates of 98-99%, using the Iowa Cancer Registry (NCI SEER Program); c) the elaboration of an economics model to guide both theory and questionnaire design for patients and practitioners, and offered to understand patient decision-making and its relation to outcomes; and d) demonstrable high levels of community cooperation, from patients, cancer care practitioners and pathologists. The goal of the special study is to use Instrumental Variable (IV) techniques to assess whether patient survival rates can be increased by increasing adjuvant therapy treatment rates for early stage non-small cell lung cancer (ENSCLC) patients. If providers are accurately sorting patients by their expected treatment benefits, and only patients expected to benefit from adjuvant treatments actually receive them, we would expect that treatment benefits for patients on the extensive margin to be minimal. We hypothesize there will be little or no treatment survival benefits for patients on the ENSCLC patients provides the rationale for this study.

我们已经组建了一个多学科调查团队，以人口为基础，研究爱荷华州具有代表性的肺癌患者的初始和继续治疗模式。这些模式将在短期和长期治疗的患者决策过程方面进行探索，并对适当的结果进行后续跟踪，包括无病间隔、生活质量衡量、生命末期护理和总体存活率。建议探讨的因素包括患者的人口统计、经济和行为属性，包括患者的癌症学习环境和宿命论等特征，具有不同临床管理方法的地理分散的从业者的影响，从业者的继续教育和信息来源，在最佳方法不确定的情况下治疗的应用，以及空间和财政获得护理的影响。这一建议的特点包括：a)一个多学科的研究团队，包括流行病学、疾病登记、生物统计学、健康经济学、行为科学和胸部肿瘤学；b)利用爱荷华州癌症登记中心(NCI SEER计划)，证明有能力每年接触约2000名肺癌患者，并实现98-99%的长期随访率；c)建立经济学模型，指导患者和从业者的理论和问卷设计，并帮助他们了解患者的决策及其与结果的关系；以及d)显示患者、癌症护理从业者和病理学家之间高度合作的社区。这项专门研究的目标是使用工具变量(IV)技术来评估是否可以通过提高早期非小细胞肺癌(ENSCLC)患者的辅助治疗治疗率来提高患者存活率。如果提供者根据患者的预期治疗好处对患者进行准确的分类，并且只有预期从辅助治疗中受益的患者才能真正获得这些好处，我们预计对广泛范围内的患者的治疗好处是微乎其微的。我们假设对ENSCLC患者的治疗生存益处很少或没有，这为这项研究提供了理论基础。