UNDERSTANDING RACIAL DIFFERENCES--LUNG CANCER TREATMENT

了解种族差异——肺癌治疗

• 批准号: 6633950
• 负责人: PETER B. BACH
• 金额: $ 24.2万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2005-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6633950
• 关键词: African American; Medicare /Medicaid; cancer information system; caucasian American; health care service evaluation; health services research tag; human data; neoplasm /cancer diagnosis; neoplasm /cancer surgery; nonsmall cell lung cancer; outcomes research; physicians; racial /ethnic difference; statistics /biometry

Disparities in care among black and white patients have been documented for a number of chronic medical conditions. Dr. Bach proposes a project designed to evaluate several potential mechanisms underlying this observed phenomenon. Black patients with Stage I/II (early stage) non-small cell lung cancer (NSCLC) are less likely than white patients to undergo curative surgical resection. This disparity in treatment accounts for the majority of the survival gap that currently exists between these racial, ethnic groups, and is consistent with racial disparities observed for a number of other serious medical conditions. At present, the underlying causes for these disparities remain uncertain. The objective of this study is to use treatment of early stage NSCLC as a model for understanding the reasons why black patients undergo potentially curative treatment for serious medical conditions at lower rates than similar white patients. Identifying the underlying mechanisms of these disparities should facilitate the design of effective interventions. This hypothesis driven study addresses the supposition that black patients undergo surgery at lower rates for two reasons: one physician based, one patient based. First, physicians evaluate risk of surgery less aggressively in blacks and therefore recommend surgery less often. Second, a black patient is less likely to accept a physician's recommendation if that physician is not racially concordant with him. The study will use the SEER-Medicare linked database, augmented by provider specific information gleaned from the American Medical Association provider file and the National Claims History file. The database will be used to identify the paths of evaluation followed by black and white patients with early stage NSCLC. Once identified, differences in the evaluative process undergone by black and white patients will be assessed, and the association between provider and patient race on receipt of surgery will be tested.

黑人和白色患者之间的护理差异已经 记录了一些慢性疾病。 巴赫博士提出了一个 该项目旨在评估其背后的几种潜在机制 观察到的现象。 I/II期（早期）非小细胞肺癌黑人患者 （非小细胞肺癌）比白色患者更不可能接受根治性手术 切除术 这种待遇上的差异占了大多数。 目前存在于这些种族和族裔群体之间的生存差距， 与其他一些严重的种族歧视现象相一致， 医疗条件。 目前，造成这些差距的根本原因 仍然不确定。 本研究的目的是使用治疗早期 作为一个模型，了解黑人患者 接受可能治愈的治疗，以治疗较低的严重疾病 比相似的白色患者的发病率高。 确定潜在的机制 这些差异应有助于制定有效的干预措施。 这项假设驱动的研究解决了黑人患者 接受手术率较低的原因有两个：一个是基于医生，一个是 患者为基础。 首先，医生不那么积极地评估手术风险 因此建议手术次数较少。 第二，一个黑人病人 不太可能接受医生建议 与他的种族一致。 该研究将使用SEER-Medicare链接 数据库，由从美国收集的提供商特定信息增强 医学协会提供者文件和国家索赔历史文件。 的 数据库将被用来确定黑色的评价路径 和患有早期NSCLC的白色患者。 一旦确定， 将评估黑人和白色患者经历的评价过程， 以及提供者和患者种族之间的关联 会得到考验

项目成果

Estimating the empirical Lorenz curve and Gini coefficient in the presence of error with nested data.

• DOI: 10.1002/sim.3151
• 发表时间: 2008-07-20
• 期刊: STATISTICS IN MEDICINE
• 影响因子: 2
• 作者: Moskowitz, Chaya S.;Seshan, Venkatraman E.;Riedel, Elyn R.;Begg, Colin B.
• 通讯作者: Begg, Colin B.