Center of Excellence in Eliminating Disparities

描述(由申请人提供)：本竞争性修订申请支持开发消除差异比较有效性研究(CERED)，其中包括CERED的四个核心：研究、培训、数据基础设施和传播。该研究项目的目标是评估位于医疗服务不足地区(MUA)的乳房X光摄影中心基于医院的患者导航干预策略对芝加哥服务不足的女性乳腺癌诊断和治疗服务的充分性的有效性。我们的主要研究成果将是根据国家全面癌症网络(NCCN)临床实践指南的定义，对患有异常乳房X光检查的女性进行治疗充分性和坚持后续护理。这项工作将扩展正在进行的比较有效性研究，在随机临床试验中评估患者在乳腺癌护理中的导航，其中主要结果是诊断解决和治疗的时间(沃内克/卡尔霍恩，P50CA106743-05；项目#1，PI：卡尔霍恩；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光检查异常的女性(患有和不患有乳腺癌)的两个主要结果的比较有效性：1)后续护理的充分性和质量；以及2)患者对后续护理和治疗的坚持程度。两个主要假设是：H1)与通常的护理标准相比，筛查结果异常的导航患者将更有可能得到足够的诊断评估和治疗。与通常的护理标准相比，被诊断为乳腺癌的导航患者将更有可能完成适当的后续护理和治疗。在开展研究项目、培训、数据和传播的核心活动中，旨在加强科学研究 资金、数据基础设施和研究成果的传播，以消除乳房差异。

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.