Center of Excellence in Eliminating Disparities

描述（由申请人提供）：此竞争性修订申请支持消除差异的比较有效性研究（CERED）的发展，其中包括四个CERED核心：研究，培训，数据基础设施和传播。该研究项目的目标是评估在医疗服务不足地区（MUAs）的乳房x光检查中心实施的以医院为基础的患者导航干预策略对芝加哥医疗服务不足妇女乳腺癌护理诊断和治疗服务充分性的有效性。我们的主要研究结果将是根据国家综合癌症网络（NCCN）临床实践指南的定义，对乳房x光检查异常妇女的治疗充分性和随访护理的依从性。这项工作将扩展正在进行的比较有效性研究，在一项随机临床试验中评估乳腺癌护理中的患者导航，其中主要结果是诊断解决和治疗的时间（Warnecke/Calhoun, P50CA106743-05；项目1，PI: Calhoun；结束日期：6/15/15）。结合现有的患者导航研究项目，拟议的研究工作将检验患者导航干预对乳房x光检查异常妇女（有或没有乳腺癌）的两个主要结果的比较有效性：1)随访护理的充分性和质量；2)患者对后续护理治疗的依从性。两个主要假设是：1)与通常的标准护理相比，筛查结果异常的导航患者更有可能接受充分的诊断评估和治疗。2)与通常的标准护理相比，导航诊断为乳腺癌的患者更有可能完成适当的后续护理和治疗。在开展研究项目时，培训、数据和传播的核心活动旨在提高科学水平

DESCRIPTION (provided by applicant): This competitive revision application supports the development of Comparative Effectiveness Research for Eliminating Disparities (CERED), which includes four CERED cores: Research, Training, Data Infrastructure, and Dissemination. The research project objective is to evaluate the effectiveness of a hospital-based patient navigation intervention strategy in mammography centers located in Medically Underserved areas (MUAs) on the adequacy of diagnostic and treatment services for breast cancer care among underserved women in Chicago. Our primary research outcome will be treatment adequacy and adherence to follow-up care in women with abnormal mammograms, as defined by The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines. This work will extend that of the ongoing comparative effectiveness research evaluating patient navigation in breast cancer care in a randomized clinical trial, in which the primary outcome is time to diagnostic resolution and treatment (Warnecke/Calhoun, P50CA106743-05; Project #1, PI: Calhoun; end date: 6/15/15). In conjunction with the existing patient navigation research project, the proposed research effort will examine comparative effectiveness of patient navigation intervention on two primary outcomes among women with abnormal mammograms (with and without breast cancer): 1) adequacy and quality of follow-up care; and 2) patient's adherence to follow-up care and treatment. The two primary hypotheses are: H 1) Navigated patients with abnormal screening results will be more likely to receive adequate diagnostic evaluations and treatment as compared to usual standard of care. H 2) Navigated patients diagnosed with breast cancer will be more likely to complete appropriate follow-up care and treatment as compared to usual standard of care. In carrying out the research project, training, data, and dissemination core activities aim to enhance scientific capital, data infrastructure, and dissemination of research findings to eliminate breast disparities.