COMPREHENSIVE OUTCOME OF NONMELANOMA SKIN CANCER

申请人的长期职业目标是提高慢性皮肤病的护理质量。在过去的五年里，在临床研究者（K08）奖的指导下，她开发了一种皮肤病的生活质量结果测量方法，称为Skindex。她的近期职业目标是比较非黑色素瘤皮肤癌（NMSC）治疗的结果。她的研究生涯发展计划以NMSC患者的纵向队列研究为中心。在建议的支持下，她将通过专注于本研究样本中的新研究问题来获得增强的技能。环境。该提案将在加州大学旧金山分校（UCSF）及其附属机构旧金山退伍军人事务医疗中心（VAMC）进行。这项研究将在VAMC调查研究单位进行，这是一个调查研究、图表审查和数据管理的实验室。为了解决增量研究问题，申请人将与加州大学旧金山分校健康与老龄化研究所以及医学、流行病学和生物统计学部门的教师合作。研究项目。本研究的重点是对在私人诊所和VAMC皮肤科诊所新诊断为NMSC的患者进行前瞻性纵向观察研究。目的是比较不同治疗方式患者的治疗结果。数据的主要来源是病人调查和病历审查。主要结果是皮肤相关的生活质量，由skinindex测量；另外的分析将比较治疗组之间的肿瘤复发率、患者满意度和资源利用率。申请人还将学习额外的分析技术来测量生活质量随时间变化的模式，并将解决一个新的研究问题，即患者对护理的先验期望如何与护理的过程和结果相关。由于NMSC的普遍性和确定其最佳治疗方法的重要性，该建议具有重要意义。此外，该提案将为申请人提供一个密集的新颖的研究重点。这个机会将扩大她的能力，通过确定患者对护理的期望如何与他们的护理过程和结果相关，从而扩大医疗保健质量的传统概念，从而为医疗保健质量改进科学做出重大贡献。

The applicant's long-term career goal is to improve the quality of care for chronic skin conditions. In the last five years, supported by a mentored Clinical Investigator (K08) Award, she has developed a quality-of-life outcomes measure for skin diseases, called Skindex. Her immediate career goal is to compare outcomes of treatments for nonmelanoma skin cancer (NMSC). Her research career development plan centers on a longitudinal cohort study of patients with NMSC. With the proposed support she will acquire enhanced skills by focusing on new research questions in this study sample. ENVIRONMENT. This proposal will be conducted at University of California at San Francisco (UCSF) and its affiliate, the San Francisco Veterans Affairs Medical Center (VAMC). The research will be conducted in the VAMC Survey Research Unit, a laboratory for survey research, chart review, and data management. To address incremental research questions, the applicant will collaborate with UCSF faculty in the Institute for Health and Aging and the Departments of Medicine and Epidemiology and Biostatistics. RESEARCH PROJECT. This proposal focuses on a prospective longitudinal observational study of a cohort of patients newly-diagnosed with NMSC at a private practice and a VAMC dermatology clinic. The goal is to compare treatment outcomes among patients treated in different ways. Principal sources of data are patient survey and medical record review. The primary outcome is skin-related quality of life measured by Skindex; additional analyses will compare tumor recurrence, patient satisfaction, and resource utilization among the treatment groups. The applicant will also learn additional analytic techniques to measure patterns of change in quality of life over time, and will address a new research question about how patients' a priori expectations for care relate to process and outcomes of that care. The proposal is significant because of the prevalence of NMSC and the importance of determining its optimal therapy. In addition, this proposal will provide an intensive novel research focus for the applicant. This opportunity will expand her ability to make a significant contribution to the science of health care quality improvement by determining how patients' expectations for care relate to the process and outcomes of their care, thus broadening conventional conceptualizations of health care quality.