Improving Accuracy & Outcomes of Breast Cancer Screening

描述（由申请人提供）：本申请是根据K05机制为埃尔默博士提供的工资支持。 这种支持将减轻她的临床和行政职责，使她能够扩大她的临床研究计划，并增加花在指导新的临床研究者的时间。 此K05应用程序得到了部门的支持。 医学和奖学金计划在华盛顿大学。 这些研究项目旨在衡量和提高乳腺癌筛查的准确性和结果。 现有的主要赠款和新的K05具体目标的具体目标是： 项目1：乳腺X线摄影 主要补助金：使用分层建模技术，探索放射科医生和设施的财政、法律的、临床和个人特征可以变化的程度，以降低基于社区的乳腺X射线摄影的召回率，同时保持高水平的准确性。 AIM 1. 探讨患者水平特征与乳腺摄影准确性之间的关系。 具体而言，研究体重指数对筛查性乳腺X线摄影准确性的影响。 项目2：乳房自我检查初级补助金：研究在特定人群中的乳腺癌筛查计划。 AIM 2. 描述自我报告的乳房自我检查行为和相关结局。 项目3：临床乳腺检查主要补助金：在一项多中心病例对照研究中，评估乳腺癌筛查在两个不同乳腺癌风险水平的两个年龄组女性中的疗效。 AIM 3. 在病例对照研究的受试者中评估临床乳腺检查的性能特征。 研究项目的独特广度，其中包括乳房X光检查，乳房检查和自我检查，反映了申请人作为初级保健临床医生的广阔视野。 所有这三个项目都使用为正在进行的资助项目收集的数据。 乳腺癌筛查的准确性和结果存在临床显著差异。 我们所概述的项目是改善这一领域的关键一步。

DESCRIPTION (provided by applicant): This application is for salary support for Dr. Elmore under the K05 mechanism. This support will relieve her from clinical and administrative duties, allowing her to expand her clinical research program and increase the time spent mentoring new clinical investigators. This K05 application has the support of the Dept. of Medicine and fellowship programs at the Univ. of Washington. The research projects are designed to measure and improve the accuracy and outcomes of breast cancer screening. Specific aims of existing primary grants and new K05 specific aims are: PROJECT 1: Mammography Primary Grant: To explore, using hierarchical modeling techniques, the extent to which fiscal, legal, clinical and personal characteristics of radiologists and facilities could be varied to lower the recall rates for community-based mammography while maintaining high levels of accuracy. AIM 1. To explore the relationship between patient level characteristics and mammographic accuracy. Specifically, to study the influence of body mass index on the accuracy of screening mammography. PROJECT 2: Breast Self Examination Primary Grant: To study a breast cancer screening program in a defined population. AIM 2. To describe self-reported breast self-examination behavior and associated outcomes. PROJECT 3: Clinical Breast Examination Primary Grant: To assess the efficacy of breast cancer screening among women in two age cohorts at two different breast cancer risk levels in a multi-center case-control study. AIM 3. To assess performance characteristics of clinical breast examination in subjects of a case-control study. The unique breadth of the research projects, which include mammography, breast examination and self examination reflect the applicant's broad perspective as a primary care clinician. All three projects use data collected for ongoing funded projects. Clinically significant variability exists in the accuracy and outcomes of breast cancer screening. Projects such as we have outlined are a critical step in improving this field.