OUTCOMES OF SCREENING MAMMOGRAPHY IN ELDERLY WOMEN

史密斯-宾德曼博士是放射学助理教授，最近完成了一项为期两年的流行病学、生物统计学和研究设计方面的奖学金，该奖学金由流行病学和生物统计学系和加州大学旧金山分校普通内科联合赞助。她的广泛研究兴趣是在针对女性健康的领域进行诊断成像测试的结果评估。具体地说，她的研究兴趣是评估老年妇女进行乳房X光检查的结果。更透彻地了解筛查乳房X光检查、乳腺癌检测和治疗以及乳腺癌死亡率之间的关系，对于规划关于谁应该接受乳房X光检查的公共政策至关重要。这项拟议的研究涉及设计和实施加州医疗保健融资管理局联邦医疗保险账单索赔的数据分析，这些索赔与加州癌症登记处关于乳腺癌分期和治疗的肿瘤登记数据相关联。这些数据将在加州医疗审查公司进行分析，这是一个医疗保险质量改进组织。这位调查员以前也曾成功地分析过类似的数据。具体目标将集中在对65岁以上妇女进行筛查乳房X光检查的结果。该提案将评估以下方面：1)乳腺癌死亡率的差异，2)乳腺癌治疗率的差异，包括乳房切除、肿块切除和放射治疗，以及3)以前接受过乳房X光检查的女性和没有接受过乳房X光检查的女性在乳腺癌肿瘤属性(包括大小和分期)方面的差异。她还将评估患有共病的女性与接受筛查的女性是否有不同的结果。对于该奖项的培训部分，她将参加生物统计学方法方面的额外课程工作，以发展针对混淆的调整方面的专门知识，她将定期与赞助商会面。史密斯-宾德曼博士组建了一个由国家公认的临床研究人员组成的多学科团队。他们对她的研究计划充满热情，致力于帮助她发展杰出的研究技能，并成功完成计划中的研究。职业发展奖将提供五年的监督经验，使Smith-Bindman博士能够成为老年妇女乳房X光检查领域的独立调查员。

Dr. Smith-Bindman is an Assistant Professor in Radiology, and recently completed a two year fellowship in epidemiology, biostatistics, and research design sponsored jointly by the Departments of Epidemiology and Biostatistics and the General Internal Medicine Section, University of California, San Francisco. Her broad research interest is in performing outcome assessment of diagnostic imaging tests in areas targeted to women's health. Specifically her research interest is in evaluating the outcomes of performing mammographic screening in elderly women. A more thorough understanding of the relationship between screening mammography, breast cancer detection and treatment, and breast cancer mortality is critical to the planning of public policy regarding who should undergo mammographic screening. The proposed study involves the design and implementation of a data analysis of California Health Care Financing Administration Medicare billing claims that have been linked with tumor registry data from the California Cancer Registry on breast cancer stage and treatment. The data will be analyzed at the California Medical Review Incorporated, a Medicare quality improvement organization. Similar data has been successfully analyzed by this investigator previously. The specific aims will focus on the outcome of performing screening mammography in women older than age 65 years. The proposal will evaluate the following: 1) differences in breast cancer mortality, 2) differences in breast cancer treatment rates including mastectomy, lumpectomy and radiation and 3) difference in breast cancer tumor attributes including size and stage between women who were previously screened with mammography and women who were not. She will also evaluate if women with co-morbidities have different outcomes from undergoing screening as women without co-morbidities. For the training component of the award, she will take additional course work in biostatistical methods to develop expertise in adjustment for confounding, and she will meet regularly with her sponsors. Dr. Smith-Bindman has assembled a multidisciplinary team of nationally recognized clinical researchers. They are enthusiastic about her research plan and are dedicated to assisting her in developing outstanding research skills and successfully completing the planned research. The Career Development Award will provide five years of supervised experience to enable Dr. Smith-Bindman to become an independent investigator in the area of mammographic screening in elderly women.