OUTCOMES OF SCREENING MAMMOGRAPHY IN ELDERLY WOMEN

Smith-Bindman博士是放射学助理教授，最近完成了由加州大学旧金山分校流行病学、生物统计学和普通内科联合赞助的为期两年的流行病学、生物统计学和研究设计奖学金。她广泛的研究兴趣是在针对妇女健康的领域进行诊断成像测试的结果评估。具体来说，她的研究兴趣是评估在老年妇女中进行乳房x光检查的结果。更全面地了解乳房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，对于制定关于谁应该接受乳房x光检查的公共政策至关重要。拟议的研究涉及设计和实施加州卫生保健融资管理局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有关。这些数据将在加州医疗审查公司进行分析，该公司是一家医疗保险质量改进组织。类似的数据也曾被这位研究者成功地分析过。具体目标将集中在65岁以上妇女进行筛查乳房x光检查的结果。该提案将评估以下内容：1)乳腺癌死亡率的差异；2)乳腺癌治疗率（包括乳房切除术、乳房肿瘤切除术和放疗）的差异；3)之前接受过乳房x光检查的女性与未接受过乳房x光检查的女性在乳腺癌肿瘤特征（包括大小和分期）方面的差异。她还将评估有合并症的妇女与没有合并症的妇女进行筛查是否有不同的结果。对于该奖项的培训部分，她将参加生物统计方法方面的额外课程，以发展调整混杂的专业知识，她将定期与她的赞助人会面。史密斯-宾德曼博士组建了一个由全国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，并致力于帮助她培养出色的研究技能，顺利完成计划的研究。职业发展奖将提供五年的监督经验，使史密斯-宾德曼博士成为老年妇女乳房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.