Coordinating Center for Population-based Research to Optimize Cancer Screening (PROSPR) (U24)

项目概要 癌症筛查是一个复杂的多步骤过程，完成每个步骤后效益就会最大化 成功，但由于随时可能发生故障而导致次优结果的情况经常发生 这个过程中的点。筛查还受到个体患者以外的因素的影响，包括因素 在提供者、实践和健康计划/机构层面，这些所谓的系统层面因素可以 影响高质量癌症筛查服务的适当提供。 PROSPR 的成立是为了解决 与美国癌症筛查相关的一些关键问题，以及我们的 PROSPR I 统计协调中心对该举措的许多成功至关重要，其中包括：1) 开发癌症筛查过程的跨器官概念模型，2) 创建通用数据 要素和筛选绩效指标，3）评估影响的个人和系统级因素 筛选表现，4) 21 篇跨网络发表论文的作者身份和统计支持，其中 2 篇为 审核中，17个正在准备中； 5) 建立 PROSPR 数据存储库并创建基础设施 公开共享 PROSPR 数据。我们的 PCC 团队在领导大型企业方面拥有丰富的专业知识 协调中心以及与 PROSPR 相关的每个科学领域，包括卫生服务/健康 护理服务、实施科学、癌症流行病学、健康差异研究、生物统计学、 生物信息学/健康信息技术，以及结直肠癌、宫颈癌和肺癌的筛查。因此， 我们拥有独特的优势，能够成功执行该协调中心的所有组成部分。具体的 我们 PCC 的目标是： 1) 为 PROSPR 网络提供行政协调并提供指导 制定 PROSPR 的治理、组织和政策/程序； 2）引领发展 共同概念化和措施： A. 评估影响系统级因素的作用 筛选过程。 B. 评估筛选质量； 3) 促进反式 PROSPR 研究比较 至少 2 个器官部位的筛查过程； 4) 制定并实施流程和程序 与 PROSPR 网络之外的合格研究人员共享 PROSPR 数据。相关性：改进 宫颈癌、结直肠癌和肺癌的筛查过程和筛查质量都将减少 美国与这些癌症相关的死亡率、发病率和医疗保健费用。

Project Summary Cancer screening is a complex, multi-step process where benefits are maximized when each step is completed successfully, but where sub-optimal outcomes are frequent as a result of breakdowns that can happen at any point in this process. Screening is also impacted by factors beyond simply individual patients—including factors at the provider-, practice-, and health plan/institution-level—and these so-called systems level factors can impact the appropriate delivery of high quality cancer screening services. PROSPR was established to address a number of critical questions related to the delivery of cancer screening in the United States, and our PROSPR I Statistical Coordinating Center was central to many of the successes of this initiative including: 1) Developing a trans-organ conceptual model of cancer screening processes, 2) Creating common data elements and screening performance metrics, 3) Evaluating individual and systems-level factors impacting screening performance, 4) Authorship and statistical support on 21 trans-network published papers, 2 under review, and 17 in preparation; and 5) Establishing PROSPR data repositories and creating an infrastructure for publicly sharing PROSPR data. Our PCC team has considerable expertise both in the leadership of large coordinating centers and in each of the scientific fields relevant to PROSPR including health services/health care delivery, implementation science, cancer epidemiology, health disparities research, biostatistics, bioinformatics/health information technology, and the screening of colorectal, cervical, and lung cancers. Thus, we are uniquely positioned to successfully execute all components of this coordinating center. The specific aims of our PCC are to: 1) Provide administrative coordination for the PROSPR network and guidance in the development of PROSPR’s governance, organization, and policies/procedures; 2) Lead the development of common conceptualization and measures for: A. Assessing the role of systems-level factors that impact the screening process. B. Assessing screening quality; 3) Facilitate trans-PROSPR research comparing the screening process across at least 2 organ sites; and 4) Develop and implement processes and procedures to share PROSPR data with qualified investigators outside of the PROSPR network. RELEVANCE: Improving both the screening process and screening quality for cervical, colorectal, and lung cancers will reduce mortality, morbidity, and health care costs associated with these cancers in the United States.