Ensuring Quality Cancer Care (1999) / Chapter Skim
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7 Health Services Research in Cancer Care
7 Health Services Research in Cancer Care
Pages 180-210
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From page 180... ...
Agency for Health Care Policy and Research Health Care Financing Administration Centers for Disease Control and Prevention · Department of Defense Department of Veterans Affairs Privately Sponsored Research · American Cancer Society · Foundations (e.g., Robert Wood Johnson Foundation) Although these organizations are not the only sponsors of cancer-related health services research, they represent the major funding sources for such research.
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, and randomized controlled clinical trials (e.g., studies of the effectiveness of health care technologies in situations representative of community practice)
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From page 182... ...
Although the number of health services research citations increased during this period, by ~ 997 they represented less than 3 percent of all cancer-related citations indexed in the medical literature (Figure 7.21. These trends reflect publications in English, but not necessarily articles written by U.S.
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From page 183... ...
Research citations were identified in the NEM's Medline database using the MESH heading "neoplasms" (for cancer) and any one of the following major MESH headings "health services research," "quality of health care," and "quality assurance." The last terms encompass cancer citations addressing guideline adherence, outcomes and process assessment, accreditation, and health planning.
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From page 184... ...
listings of research projects provided by some organizations (e.g., National Cancer Institute, Agency for Health Care Policy and Research, American Cancer Society) ; · review of annual reports of research arms of certain agencies (e.g., the Department of Veterans Affairs)
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From page 185... ...
· Breast Cancer Surveillance Consortium (a national mammography screening and outcomes clatabase9: The performance of mammography screenings (i.e., its sensitivity, specific .
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From page 186... ...
providers; breast cancer treatment patterns and trends; prostate cancer detection practices; and trends and variations in initial treatment for early-stage prostate cancer. HMO Cancer Research Network.
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From page 187... ...
(Martin Brown, Head, Health Services and Economics Section, Applied Research Branch, Cancer Surveillance Research Program, Division of Cancer Control and Population Sciences, NCI, personal communication, December 16, 19981. ale- r~-~~ Office of Cancer Survivorship.
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From page 189... ...
HEALTH SERVICES RESEARCH IN CANCER CARE 189 ~ ~ ~ ~ BOX 7.4 Current Ektram:ura-l Health Services Research Resects on - : ..
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From page 191... ...
HEALTH SERVICES RESEARCH IN CANCER CARE ; ~ ~ ~ ~ A ~os~uall~ty~ trade-oRs~ bind cancer screen~i~n~g~, ~ diagnosis, and ::treatm::e~n:t ~:~ I~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ .~ ~ ~ ~ ~ ~ ~:~ ~ ~. ~ ~ ~mpam o ~ easy~o-read~ informed consent statements on clin:~ica~l trials ~:~-~Ba~rrie~rs~:~to~::L:atino:~:oa:r:~i~Gi~Dati~on::i~nGlinical~:t:ri~a;~ls~:~:;~:~: :: ~ ~ :~: ~:::~: I;: : I: ~: : : ~: I: :: C:: ~ ~ onzm~uea~::~
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From page 192... ...
~-~.~.~.~.~.~.~.~,,~.~. -.,..~.~,.,-,~-.~...~,-.~...~..~., ~..~.~..~..~ancer.~.s welllan~ce~.-~ust~.~l~-~,~l~,~cia~ms-~as~eu~.~u .-~,~is:$u - ~id age ~ ~ ~ ~ ~ ~ ~I| TABLE 7.l Current Extramural Health Services Research Projects Supported Elsewhere at NTH and Listed on HSRProj Institute Project National Institute on Aging National Institute of Dental Research National Eye Institute National Library of Medicine Family and the health of African-American elderly: cancer prevention videos in a community setting Health technologies' cost and outcomes in the elderly Improving breast cancer care through patient activation Caregiver responses to managing elderly patients at home Breast and cervical cancer control in the elderly Breast-cancer prevention and control in older women Patterns of care, outcomes, and cost of oral cavity pharyngeal cancer Collaborative Ocular Melanoma Study (2 grants)
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From page 193... ...
. Support for intramural and extramural cancer-related health services research projects active since FY 1995 totals $20 million and represents an estimated 6 percent of the research budget during this period (Wendy Perry, AHCPR, personal communication to Maria Hewitt, December 19981.
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From page 194... ...
Two of the 14 conditions funded to date relate to cancer, prostate disease, and local breast cancer. Clinical Trials.
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From page 195... ...
in collaboration with NCI and VA. This randomized trial compares radical prostatectomy and palliative expectant management for the treatment of clinically localized prostate cancer.
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From page 196... ...
AHCPR staff have evaluated the effectiveness of several cancerrelated technologies including autologous peripheral stem cell transplantation, hematopoietic stem cell transplantation in multiple myeloma, and cryosurgery for recurrent prostate cancer following radiation therapy. Health Care Financing Administration Intramural Research Office of Strategic Planning.
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From page 197... ...
According to the HSRProj database, HCFA has sponsored one extramural health services research project, "Estimating Mammography Utilization by Elderly Medicare Women. Centers for Disease Contro/ and Prevention Most of the cancer-related health services research supported by CDC is fi~nded through the National Center for Chronic Disease Prevention and Health, Division of Cancer Prevention and Control.
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From page 198... ...
-; ~ ~'. F-unded~bY CDC's National reinter for C~hronic~D~i~sease Prevention and Health" ::: :.::: ~- ~ :~ : : I: ~:~ ~ I:: :::: ~ :::: : ~ :~: ~:~ ~ ~ ~ ~.~.~ ~-~ ~ Division of Cancer Prevention anti Control : : : ~ it: ::: : : :: ::::: : ~ :~: :: :::: ~ :::: :~ I; it: ~ ~ ~ If: ~ ~ ~::~ ~ :~::~:~:::~ :::: ~:~:~ ~: :::; :: aft:::: ~:.~ :~ ~ : ~ ~ :~ · it.
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From page 199... ...
To date, between FY 1992 and 1999, $~.l billion has been targeted by Congress for research on breast cancer, prostate cancer, ovarian cancer, neurofibromatosis, defense women's health, and osteoporosis. The CDMRP strives to identify gaps in funding and provide award opportunities that will enhance program research objectives without duplicating existing funding opportunities.
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From page 200... ...
2. Prostate cancer: Between FY 1997 and 1999, $135 million has been appropriated to the Prostate Cancer Research Program for basic and clinical research.
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PIVOT, a randomized trial comparing radical prostatectomy versus palliative expectant management for the treatment of clinically localized prostate cancer (other sponsors include NCT and AHCPR)
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Funding for this feasibility study is less than $100,000 (P. Wingo, Department of Epidemiology and Surveillance Research, American Cancer Society, personal communication to Maria Hewitt, October 1998)
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This is an intramural research activity of the Department of Epidemiology and Surveillance Research (P. Wingo, Department of Epidemiology and Surveillance Research, American Cancer Society, personal communication to Maria Hewitt, October 19981.
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From page 205... ...
Extramural Research Program Very little ACS extramural research is devoted to health services research, even when broadly defined to include behavioral, psychosocial, and quality-of-life research. Information from the ACS on institutional, research, and training grants in effect as of September I, 199S, indicates that less than 5 percent of the total $171,336,000 grant program is allocated to health services research (Box 7.~.
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From page 206... ...
TABLE 7.2 Current Extramural Health Services Research Projects Supported by Foundations or Private Organizations and Listed on HSRProj Organization Project Robert Wood Johnson Smoking and cancer screening: chronic disease prevention for older Foundation women Supporting quality improvement and loins Commission on Accreditation of Healthcare Organizations standard setting for pain management in hospitals Research on cancer screening among Hispanic women United Hospital Fund Improving clinical care for early-stage breast cancer patients: changing physician practices Aetna, Inc. Preparing African-American men for decision making about prostate can cer and early detection Using performance measures tO motivate process improvement: a ran domized trial SOURCE: HSRProj ~ 998.
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From page 207... ...
. Cancer or cancer-related collaborative review groups that are registered or that are developing include: · breast cancer.
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208 ~S-~S O~/ry ~C~ ~~E ?
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1998. Associate Director, Cancer Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, personal communication to Maria Hewitt, November 2, 1998 Eisenberg IM.
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1997. A Review of the Department of Defense's Program for Breast Cancer Research.
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