Cancer Research Network Across Health Care Systems

描述（由申请人提供）：NIH路线图和NCI战略计划反复呼吁医疗保健系统更多地参与研究。综合交付系统提供从预防到姑息的全面护理，可以解决在许多其他环境中无法回答的有关癌症预防和控制的关键研究问题。具有内部研究能力的医疗保健系统联盟为研究癌症预防和护理的政策和模式的变化创造了前所未有的机会。认识到这一潜力，美国国家癌症研究所于1997年发布了一项申请，以“促进NCI赞助的癌症预防……检测……研究的开展”。[和]治疗”，通过卫生保健提供系统之间的合作。作为回应，一组HMO（最初有10个合作者，申请中有13个）组成了HMO癌症研究网络（CRN），其总体目标是通过研究确定影响结果的个人、提供者、系统和治疗因素来开展研究，提高癌症预防和治疗的有效性。我们在此提出了一个研究基础设施和一系列项目，利用一个交付系统网络的独特方面和贡献。拟议的癌症研究网络包括四个核心，五个项目和一个研究重点，即社区环境中癌症护理创新的转化。CRN基础设施通过丰富的、相互关联的共享资源来支持我们的总体目标，这些项目共同利用了CRN的地理多样性及其复杂的自动化数据能力。CRN项目旨在确定社区卫生保健系统能够通过以下方式对其注册成员做出最佳反应的方式：1)确保他们获得正确的癌症预防服务；2)设计易于理解和使用的防癌信息；3)为癌症患者提供既有效又具有成本效益的治疗；4)全面响应患者的生理和心理需求。CRN的研究将很容易适用于整个卫生保健机构，并将有助于全面提高癌症护理的质量。

DESCRIPTION (provided by applicant): The NIH Roadmap and NCI strategic plans repeatedly invoke the need for greater involvement of healthcare systems in research. Integrated delivery systems, which provide comprehensive care from prevention to palliation, can address key research questions about cancer prevention and control that cannot be answered in many other settings. A consortium of healthcare systems with internal research capabilities creates an unprecedented opportunity to study variations in policy and patterns of cancer prevention and care. In recognition of this potential, the National Cancer Institute issued a Request for Applications in 1997 to "facilitate the conduct of NCI sponsored research on cancer prevention...detection... [and] treatment" through collaboration among health care delivery systems. In response a group of HMOs (10 collaborators initially, and 13 in the proposed application), formed the HMO Cancer Research Network (CRN), whose overall objective is to conduct research that improves the effectiveness of cancer prevention and treatment through research that identifies individual, provider, system and treatment factors that affect outcomes. We propose herein a research infrastructure and array of projects that capitalize on the unique facets and contributions of a network of delivery systems. The proposed Cancer Research Network consists of four cores, five projects, and a research emphasis on translation of cancer care innovations in community settings. The CRN infrastructure supports our overall goals through a rich, interconnected set of shared resources, and collectively, the projects exploit the CRN's geographic diversity and its sophisticated automated data capabilities. CRN projects are designed to pinpoint the ways in which community-based health care systems can best respond to their enrolled members by: 1) ensuring that they receive the right cancer prevention services; 2) devising cancer prevention messages that are readily understood and used; 3) providing treatment that is both effective and cost effective to those patients with cancer; and 4) responding holistically to patients' physical and psychosocial needs. Research in the CRN will be readily applicable across health care settings and will contribute to overall improvements in the quality of cancer care.