Comparative Effectiveness of Care Systems 8 Established 8 Emerging Modalities

护理系统的比较有效性 8 已建立 8 新兴模式

• 批准号: 8555542
• 负责人: Anna N. A. Tosteson
• 金额: $ 2.67万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-27 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8555542
• 关键词: Address; Age; Breast; Breast Cancer Detection; Caring; Clinical Research; Clinical Trials; Data; Development; Diffusion; Digital Mammography; Documentation; Effectiveness; Emerging Technologies; Feedback; Imaging technology; Investments; Level of Evidence; Measurement; Methods; Modality; Modeling; New England; Outcome; Population; Population Study; Process; Randomized Clinical Trials; Registries; Relative (related person); Research Design; Risk; Screening procedure; Site; Subgroup; Technology; Time; Woman; advanced system; base; care systems; clinical practice; comparative effectiveness; data modeling; digital; effectiveness research; health information technology; imaging modality; improved; interest; routine practice; surveillance network; tool

The comparative effectiveness research (CER) that we propose conducting within the New England Collaborative Breast Surveillance Network, will use registry data and modeling to advance systems-based approaches to improving the processes of care for breast cancer screening with a focus on health information technology (IT). We propose three specific aims: Specific Aim 1: To develop a quantitative modeling framework that depicts screening processes across clinical practice network sites and incorporates findings from Project 1 (screening process measurement and feedback) to identity high-value targets for screening process improvement. Specific Aim 2: To use decision-analytic methods to estimate and compare the benefits and harms of alternative breast cancer screening strategies over various age horizons for use in the risk tools that will be developed and trialed within Project 2 (personalized modules for risk). Specific Aim 3: To compare breast cancer screening outcomes between study sites and across time to assess the impact that care processes involving health IT have as they are disseminated within the New England Collaborative Breast Surveillance Network. We hypothesize that a limited number of key attributes of care processes can be identified that are most associated with improved screening outcomes. To achieve this aim longitudinal data obtained by the Screening Process Documentation Unit on women undergoing digital mammography will be analyzed to compare process outcomes, benefits, and harms. Secondary analyses will address digital breast tomosynthesis, an emerging technology whose regulatory approval for use in clinical practice is imminent, in comparison with digital mammography. Comparing outcomes for an emerging technology relative to digital mammography will provide early evidence on the best uses of digital breast tomosynthesis.

我们建议在以下范围内进行比较有效性研究（CER）： 新英格兰协作乳房监测网络将使用注册数据和模型来推进 基于系统的方法来改善乳腺癌筛查的护理流程，重点是 健康信息技术（IT）。我们提出三个具体目标： 具体目标 1：制定 定量建模框架，描述跨临床实践网络站点的筛选过程和 结合项目 1（筛选过程测量和反馈）的发现来识别高价值 筛选过程改进的目标。具体目标 2：使用决策分析方法进行估计 并比较不同年龄的替代乳腺癌筛查策略的益处和危害 将在项目 2 中开发和试验的风险工具中使用的视野（个性化模块 风险）。具体目标 3：比较不同研究地点和不同时间段的乳腺癌筛查结果 评估涉及健康 IT 的护理流程在新医疗环境中传播时所产生的影响 英格兰协作乳房监测网络。我们假设有限数量的关键属性 可以确定与改善筛查结果最相关的护理流程。达到 这一目标是由筛查过程文件部门获得的关于接受手术的妇女的纵向数据 将分析数字乳房X线摄影以比较过程结果、益处和危害。中学 分析将涉及数字乳房断层合成，这是一项新兴技术，其监管部门批准 与数字乳房X线照相术相比，在临床实践中的使用迫在眉睫。比较结果 与数字乳房X线摄影相关的新兴技术将为数字乳房X线摄影的最佳用途提供早期证据。 乳房断层合成。