Columbia-GHI Consortium for Claims-Based Cancer Studies

描述（由申请人提供）：在这个探索性/发展性申请中，我们提议建立一个由哥伦比亚大学梅尔曼公共卫生学院和集团健康公司（GHI）组成的基于索赔的癌症研究中心。总部位于纽约市的GHI是全州最大的非营利性医疗保险提供商。近300万GHI用户的不同种族和民族构成是纽约市的一个反映——大约25%的非洲裔美国人，28%的拉丁裔美国人，10%的亚洲人——使其成为研究癌症差异的宝贵资源。广泛的受抚养人覆盖范围使我们能够研究配偶和子女。我们的长期目标是利用庞大的用户群作为核心资源，开展癌症筛查和干预、诊断、治疗和结果方面的研究。我们的直接目标是为中心创建基础设施，并通过实现三个具体目标来展示其实用性。目的1。确定研究中心的范围和结构。一个执行委员会将提供癌症流行病学、肿瘤学、监测、卫生服务研究和大型数据库技术方面的专门知识，指导选择相关和可行的研究问题，并制定合作和人类受试者保护指南。目标2。我们将为监测研究奠定基础（目标2a）：描述GHI用户群体的特征，描述流行病学和社会人口变量的分布，包括种族/民族、就业状况、年龄、性别和依赖关系（如配偶、子女），（目标2b）开发识别和评估癌症筛查和诊断程序的程序，以及索赔数据中的治疗方法。（目标2c）确定将GHI癌症索赔数据与外部数据源（如肿瘤登记处）联系起来所需的利益和努力。目标3。我们将通过开展三个试点项目来探讨GHI索赔数据库在癌症监测、健康服务和结果研究方面的有用性：试点A.对高（乳腺癌、结肠癌）和低（胰腺癌、食道癌）生存时间与医院容量、医院社会经济概况、医生特征和患者社会经济地位相关的癌症的初始治疗和后续化疗的变化进行研究。试点b：估计乳腺癌和结肠癌筛查检查的流行率与患者社会经济特征的关系。试点C.建立乳腺癌、结肠癌、前列腺癌和肺癌病例队列，作为研究资源，调查不同治疗方式的结果、合并症、出院后并发症和生存率，以及估计治疗费用。

DESCRIPTION (provided by applicant): In this exploratory/developmental application we propose to create a Center for Claims-Based Cancer Research as a consortium between the Mailman School of Public Health at Columbia University and Group Health Incorporated (GHI). New York City-based GHI is the largest statewide not-for-profit health insurance provider. The diverse racial and ethnic makeup of the nearly 3 million GHI subscribers is a reflection of New York City - about 25% African American, 28% Latino, and 10% Asian - making it a valuable resource for studies of cancer disparities. Extensive dependent coverage enables us to study spouses and children. Our long-term goal is to carry out research on cancer screening and interventions, diagnosis, treatment, and outcomes using the large subscriber base as a core resource. Our immediate goal is to create the infrastructure for the center and demonstrate its usefulness by accomplishing three specific aims. Aim 1. Define the scope and structure of the Research Center. An Executive Committee will provide expertise in cancer epidemiology, oncology, surveillance, health services research, and large database technology, guide selection of relevant and feasible research questions, and develop guidelines for collaboration and for human subject protection. Aim 2. We will lay the groundwork for surveillance studies by (Aim 2a): characterizing the GHI subscriber population, describing the distributions of epidemiological and socio-demographic variables including race/ethnicity, employment status, age, gender, and dependency (e.g., spouse, child), (Aim 2b) developing procedures for identifying and assessing cancer screening and diagnostic procedures, and treatments within claims data, and (Aim 2c) determining benefits and effort required for linkage of GHI cancer claims data with external data sources such as tumor registries. Aim 3. We will probe the usefulness for cancer surveillance, health services and outcomes research of the GHI claims database by carrying out three pilot projects: Pilot A. A study of the variation in initial treatment and subsequent chemotherapy for cancers with both high (breast, colon) and low (pancreatic, esophageal) survival times in relation to hospital volume, hospital socioeconomic profile, physician characteristics, and patient socioeconomic status. Pilot B. Estimation of the prevalence of screening examinations for the detection of breast and colon cancer in relation to patient socioeconomic characteristics. Pilot C. Creation of a cohort of incident cases of breast, colon, prostate, and lung cancer, as a research resource for investigating outcomes of different treatment modalities, comorbidity, post-discharge complications, and survival, as well as estimation of treatment costs.