VA ASSIST Project

VA 协助项目

基本信息

  • 批准号:
    8182131
  • 负责人:
  • 金额:
    --
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2010
  • 资助国家:
    美国
  • 起止时间:
    2010-02-01 至 2013-01-31
  • 项目状态:
    已结题

项目摘要

Objectives: Using a national random sample of veterans diagnosed with colorectal and nonsmall cell lung cancer drawn from the VA national cancer registry, we will use the Cancer Quality-ASSIST indicator set to evaluate the overall quality of veterans' supportive cancer care, as well as: 1. Patient-level factors and facility factors that may be associated with overall quality, and 2. Whether palliative care services use is associated with higher quality supportive care. Research Plan: We will use the VA national cancer registry and link it to Austin data in order to identify approximately 750 veterans with advanced lung and colorectal cancer. We will conduct remote chart abstraction using the VA electronic medical record and an Access graphical user data entry tool. Methodology: A cohort of veterans with advanced cancer will be developed by obtaining data about incident cases in 2008 with metastatic disease. We will also obtain data about earlier stage incident cases for the previous 2 years. We will link these files with Austin data (patient treatment files) to determine preliminary eligibility (based on inpatient, outpatient usage and disease status). PTF files will provide patient data to supplement patient characteristics obtained from chart review. We will link patient data to KLFMenu files to characterize facilities. Following revision of the Cancer Quality ASSIST guidelines and quality indicator abstraction tool,oncology and other experienced nurses with a background in chart abstraction will train using the ASSIST guidelines and protocol to achieve an initial kappa for key variables of 0.8 or higher. Nurses will follow an abstraction protocol of approximately 2.75 hours / case to evaluate the quality of symptoms related to cancer and its complications, treatment-related toxicities, and information and care planning needs. Palliative care service use and descriptions will be obtained from chart review. Analyses will evaluate the overall quality of supportive cancer care, and control for age, gender, type of cancer, stage, co-morbidity, as well as the analytic variables of race / ethnicity, serious mental illnesses, and palliative care service use. Complete models will control for patient and facility factors. Given likely selection effects, we will explore the use of treatment selection models including propensity matching and instrumental variable analysis to evaluate the effect of service use. We will attempt multivariable linear regression and explore count data models for main models and consider evaluating facility effects with fixed effects and multi-level approaches. Results: This is a new project and results have not yet been obtained. Significance: Information on the quality of supportive care management, veterans who are particularly vulnerable and may receive lower quality supportive care, and the effectiveness of palliative care services in addressing these issues is urgently needed to information programmatic development, and other research and clinical priorities.
目的:采用全国随机抽样诊断为结直肠和非小细胞肺的退伍军人

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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Karl Lorenz其他文献

Karl Lorenz的其他文献

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{{ truncateString('Karl Lorenz', 18)}}的其他基金

Improving Palliative Measurement Application with Computer-Assisted-Abstraction Study
通过计算机辅助抽象研究改进姑息测量应用
  • 批准号:
    10305693
  • 财政年份:
    2018
  • 资助金额:
    --
  • 项目类别:
Improving Palliative Measurement Application with Computer-Assisted-Abstraction Study
通过计算机辅助抽象研究改进姑息测量应用
  • 批准号:
    10216351
  • 财政年份:
    2018
  • 资助金额:
    --
  • 项目类别:
Effective Screening for Pain Study
疼痛研究的有效筛查
  • 批准号:
    8397641
  • 财政年份:
    2013
  • 资助金额:
    --
  • 项目类别:
Trajectories and Palliation Study (TAPS)
轨迹和姑息治疗研究 (TAPS)
  • 批准号:
    8339365
  • 财政年份:
    2011
  • 资助金额:
    --
  • 项目类别:
Trajectories and Palliation Study (TAPS)
轨迹和姑息治疗研究 (TAPS)
  • 批准号:
    8258184
  • 财政年份:
    2011
  • 资助金额:
    --
  • 项目类别:
Trajectories and Palliation Study (TAPS)
轨迹和姑息治疗研究 (TAPS)
  • 批准号:
    8735667
  • 财政年份:
    2011
  • 资助金额:
    --
  • 项目类别:
Trajectories and Palliation Study (TAPS)
轨迹和姑息治疗研究 (TAPS)
  • 批准号:
    8538264
  • 财政年份:
    2011
  • 资助金额:
    --
  • 项目类别:
VA ASSIST Project
VA 协助项目
  • 批准号:
    7867852
  • 财政年份:
    2010
  • 资助金额:
    --
  • 项目类别:

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