option for expanding the set of variables for analysis. For example, linking information about hospitals or other facilities that provide care with patient-level databases would allow the analyses of important structural components of care. To improve the timeliness of data, data collection has to be standardized and automated to provide relatively quick turnaround of information. It is important to assess the following aspects of care, which could affect quality, but also will present analytic challenges: multidisciplinary care teams, referral patterns to specialists, second opinions, and the communication skills of health providers.


Aass N, Klepp O, Cavallin-Stahl E, et al. 1991. Prognostic factors in unselected patients with nonseminomatous metastatic testicular cancer: A multicenter experience. Journal of Clinical Oncology 9:818-826.

Ballard-Barbash R, Potosky A, et al. 1996. Factors associated with surgical and radiation therapy for early stage breast cancer in older women. Journal of the National Cancer Institute 88(11):716-726.

Basnett I, Gill M, Tobias JS. 1992. Variations in breast cancer management between a teaching and a non-teaching district. European Journal of Cancer 28A:1945-1950.

Begg CB, Cramer LD, Hoskins WJ, Brennan MF. 1998. Impact of hospital volume on operative mortality for major cancer surgery. Journal of the American Medical Association 280(20):1747-1751.

Charlson ME, Pomei P, Ales KL, MacKenzie CR. 1987. A new classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases 40:373-383.

Clancy CM, Brody H. 1995. Managed care: Jekyll or Hyde? Journal of the American Medical Association 273:338-339.

Clarke K, Howard GC, Elia MH, et al. 1995. Referral patterns within Scotland to specialist oncology centres for patients with testicular germ cell tumours. The Scottish Radiological Society and the Scottish Standing Committee of the Royal College of Radiologists. British Journal of Cancer 72:1300-1302.

Davis S, Dahlberg S, Myers MH, et al. 1987. Hodgkin's disease in the United States: A comparison of patient characteristics and survival in the Centralized Cancer Patient Data System and the Surveillance, Epidemiology, and End Results Program

. Journal of the National Cancer Institute 78:471-478.

Dent DM. Cancer surgery: Why some survival benefits may be artefactual. British Journal of Surgery 85(4):433-434.

Dickersin K. 1997. How important is publication bias? A synthesis of available data. AIDS Education and Prevention 9(Suppl. A):15-21.

Eley JW, Hill HA, Chen VW, et al. 1994. Racial differences in survival from breast cancer. Results of the Cancer Institute Black/White Cancer Survival Study. Journal of the American Medical Association 272(12):947-954.

Ellis SG, Weintraub, D Holmes, et al. 1997. Relation of operator volume and experience to procedural outcome or percutaneous coronary revascularization at hospitals with high interventional volumes . Circulation 95(11):2479-2484.

Farrow D, Hunt W, Samet J. 1995. Biased comparisons of lung cancer survival across geographic areas: Effects of stage bias. Epidemiology 6(5):558-560.

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