The Challenge of Conducting Comparative Effectiveness Research in Cancer: The Impact of a Fragmented US Health-Care System
Comparative effectiveness research (CER) can make important contributions to the transformation of US health care by filling gaps left by tightly controlled clinical trials. However, without comprehensive and comparable data that reflect the diversity of the US health-care system, CER’s value will b...
Gespeichert in:
Veröffentlicht in: | Journal of the National Cancer Institute. Monographs 2013-08, Vol.2013 (46), p.99-105 |
---|---|
Hauptverfasser: | , , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 105 |
---|---|
container_issue | 46 |
container_start_page | 99 |
container_title | Journal of the National Cancer Institute. Monographs |
container_volume | 2013 |
creator | Fishman, Paul A. Hornbrook, Mark C. Ritzwoller, Debra P. O’Keeffe-Rosetti, Maureen C. Lafata, Jennifer Elston Salloum, Ramzi G. |
description | Comparative effectiveness research (CER) can make important contributions to the transformation of US health care by filling gaps left by tightly controlled clinical trials. However, without comprehensive and comparable data that reflect the diversity of the US health-care system, CER’s value will be diminished. We document the limits of observational CER by examining the age at diagnosis, disease stage, and select measures of health-care use among individuals diagnosed with incident cancer aged 65 or older from four large health maintenance organizations (HMOs) relative to seniors identified through the linked Surveillance, Epidemiology, and End Results (SEER)–Medicare data for the period 1999–2007. Aged individuals in the HMOs were younger, diagnosed at earlier stages, and more likely to receive care in inpatient settings than individuals in the linked SEER–Medicare data. These differences highlight the need for comprehensive and comparable datasets that reflect the diversity of US health care to support CER that can inform health-care reform in the United States. |
doi_str_mv | 10.1093/jncimonographs/lgt008 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3748001</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/jncimonographs/lgt008</oup_id><sourcerecordid>1426999046</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3678-bec65488eb96b3bd3f0dc1f16a3f1e4be42b04c0bfc7ed82915c257451011cf83</originalsourceid><addsrcrecordid>eNqNkVFL3zAUxYNsqFM_wkYe99J506Rpu4fBKDoFYTD1OaTpTVtpky5pBf30y5-_k_m2pxzIOb97uYeQjwy-MKj5-YMz4-yd74Nehng-9StAdUCOWSmKTEom3iUNRZ7JsuRH5EOMDwA5FFAfkqOc1zIvGD8mz3cD0mbQ04SuR-otbbzrNrOOrk9yXnTQ6_iI9MJaNDvlMEb6CyPqYAY6OtpoZzB8pTvSdQqYdYfR9DLofka3Ykfvb-kV6mkdskYHpLdPccX5lLy3eop49vKekPvLi7vmKrv5-eO6-X6TGS7LKmvRyEJUFba1bHnbcQudYZZJzS1D0aLIWxAGWmtK7Kq8ZoXJi3QFBowZW_ET8m3PXbZ2xs6klYKe1BLGWYcn5fWo3v64cVC9f1S8FBUAS4DPL4Dgf28YVzWP0eA0aYd-i4qJXNZ1DUIma7G3muBjDGhfxzBQu97U297UvreU-_Tvjq-pv0UlA-wNflv-k_kHhyqtLA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1426999046</pqid></control><display><type>article</type><title>The Challenge of Conducting Comparative Effectiveness Research in Cancer: The Impact of a Fragmented US Health-Care System</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Fishman, Paul A. ; Hornbrook, Mark C. ; Ritzwoller, Debra P. ; O’Keeffe-Rosetti, Maureen C. ; Lafata, Jennifer Elston ; Salloum, Ramzi G.</creator><creatorcontrib>Fishman, Paul A. ; Hornbrook, Mark C. ; Ritzwoller, Debra P. ; O’Keeffe-Rosetti, Maureen C. ; Lafata, Jennifer Elston ; Salloum, Ramzi G.</creatorcontrib><description>Comparative effectiveness research (CER) can make important contributions to the transformation of US health care by filling gaps left by tightly controlled clinical trials. However, without comprehensive and comparable data that reflect the diversity of the US health-care system, CER’s value will be diminished. We document the limits of observational CER by examining the age at diagnosis, disease stage, and select measures of health-care use among individuals diagnosed with incident cancer aged 65 or older from four large health maintenance organizations (HMOs) relative to seniors identified through the linked Surveillance, Epidemiology, and End Results (SEER)–Medicare data for the period 1999–2007. Aged individuals in the HMOs were younger, diagnosed at earlier stages, and more likely to receive care in inpatient settings than individuals in the linked SEER–Medicare data. These differences highlight the need for comprehensive and comparable datasets that reflect the diversity of US health care to support CER that can inform health-care reform in the United States.</description><identifier>ISSN: 1052-6773</identifier><identifier>EISSN: 1745-6614</identifier><identifier>DOI: 10.1093/jncimonographs/lgt008</identifier><identifier>PMID: 23962513</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Comparative Effectiveness Research ; Delivery of Health Care ; Female ; Health Maintenance Organizations - economics ; Health Maintenance Organizations - organization & administration ; Humans ; Male ; Medicare - economics ; Neoplasms - diagnosis ; Neoplasms - economics ; Neoplasms - epidemiology ; SEER Program ; United States - epidemiology</subject><ispartof>Journal of the National Cancer Institute. Monographs, 2013-08, Vol.2013 (46), p.99-105</ispartof><rights>The Author 2013. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3678-bec65488eb96b3bd3f0dc1f16a3f1e4be42b04c0bfc7ed82915c257451011cf83</citedby><cites>FETCH-LOGICAL-c3678-bec65488eb96b3bd3f0dc1f16a3f1e4be42b04c0bfc7ed82915c257451011cf83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23962513$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fishman, Paul A.</creatorcontrib><creatorcontrib>Hornbrook, Mark C.</creatorcontrib><creatorcontrib>Ritzwoller, Debra P.</creatorcontrib><creatorcontrib>O’Keeffe-Rosetti, Maureen C.</creatorcontrib><creatorcontrib>Lafata, Jennifer Elston</creatorcontrib><creatorcontrib>Salloum, Ramzi G.</creatorcontrib><title>The Challenge of Conducting Comparative Effectiveness Research in Cancer: The Impact of a Fragmented US Health-Care System</title><title>Journal of the National Cancer Institute. Monographs</title><addtitle>JNCMON</addtitle><addtitle>J Natl Cancer Inst Monogr</addtitle><description>Comparative effectiveness research (CER) can make important contributions to the transformation of US health care by filling gaps left by tightly controlled clinical trials. However, without comprehensive and comparable data that reflect the diversity of the US health-care system, CER’s value will be diminished. We document the limits of observational CER by examining the age at diagnosis, disease stage, and select measures of health-care use among individuals diagnosed with incident cancer aged 65 or older from four large health maintenance organizations (HMOs) relative to seniors identified through the linked Surveillance, Epidemiology, and End Results (SEER)–Medicare data for the period 1999–2007. Aged individuals in the HMOs were younger, diagnosed at earlier stages, and more likely to receive care in inpatient settings than individuals in the linked SEER–Medicare data. These differences highlight the need for comprehensive and comparable datasets that reflect the diversity of US health care to support CER that can inform health-care reform in the United States.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Comparative Effectiveness Research</subject><subject>Delivery of Health Care</subject><subject>Female</subject><subject>Health Maintenance Organizations - economics</subject><subject>Health Maintenance Organizations - organization & administration</subject><subject>Humans</subject><subject>Male</subject><subject>Medicare - economics</subject><subject>Neoplasms - diagnosis</subject><subject>Neoplasms - economics</subject><subject>Neoplasms - epidemiology</subject><subject>SEER Program</subject><subject>United States - epidemiology</subject><issn>1052-6773</issn><issn>1745-6614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkVFL3zAUxYNsqFM_wkYe99J506Rpu4fBKDoFYTD1OaTpTVtpky5pBf30y5-_k_m2pxzIOb97uYeQjwy-MKj5-YMz4-yd74Nehng-9StAdUCOWSmKTEom3iUNRZ7JsuRH5EOMDwA5FFAfkqOc1zIvGD8mz3cD0mbQ04SuR-otbbzrNrOOrk9yXnTQ6_iI9MJaNDvlMEb6CyPqYAY6OtpoZzB8pTvSdQqYdYfR9DLofka3Ykfvb-kV6mkdskYHpLdPccX5lLy3eop49vKekPvLi7vmKrv5-eO6-X6TGS7LKmvRyEJUFba1bHnbcQudYZZJzS1D0aLIWxAGWmtK7Kq8ZoXJi3QFBowZW_ET8m3PXbZ2xs6klYKe1BLGWYcn5fWo3v64cVC9f1S8FBUAS4DPL4Dgf28YVzWP0eA0aYd-i4qJXNZ1DUIma7G3muBjDGhfxzBQu97U297UvreU-_Tvjq-pv0UlA-wNflv-k_kHhyqtLA</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Fishman, Paul A.</creator><creator>Hornbrook, Mark C.</creator><creator>Ritzwoller, Debra P.</creator><creator>O’Keeffe-Rosetti, Maureen C.</creator><creator>Lafata, Jennifer Elston</creator><creator>Salloum, Ramzi G.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201308</creationdate><title>The Challenge of Conducting Comparative Effectiveness Research in Cancer: The Impact of a Fragmented US Health-Care System</title><author>Fishman, Paul A. ; Hornbrook, Mark C. ; Ritzwoller, Debra P. ; O’Keeffe-Rosetti, Maureen C. ; Lafata, Jennifer Elston ; Salloum, Ramzi G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3678-bec65488eb96b3bd3f0dc1f16a3f1e4be42b04c0bfc7ed82915c257451011cf83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Comparative Effectiveness Research</topic><topic>Delivery of Health Care</topic><topic>Female</topic><topic>Health Maintenance Organizations - economics</topic><topic>Health Maintenance Organizations - organization & administration</topic><topic>Humans</topic><topic>Male</topic><topic>Medicare - economics</topic><topic>Neoplasms - diagnosis</topic><topic>Neoplasms - economics</topic><topic>Neoplasms - epidemiology</topic><topic>SEER Program</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fishman, Paul A.</creatorcontrib><creatorcontrib>Hornbrook, Mark C.</creatorcontrib><creatorcontrib>Ritzwoller, Debra P.</creatorcontrib><creatorcontrib>O’Keeffe-Rosetti, Maureen C.</creatorcontrib><creatorcontrib>Lafata, Jennifer Elston</creatorcontrib><creatorcontrib>Salloum, Ramzi G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of the National Cancer Institute. Monographs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fishman, Paul A.</au><au>Hornbrook, Mark C.</au><au>Ritzwoller, Debra P.</au><au>O’Keeffe-Rosetti, Maureen C.</au><au>Lafata, Jennifer Elston</au><au>Salloum, Ramzi G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Challenge of Conducting Comparative Effectiveness Research in Cancer: The Impact of a Fragmented US Health-Care System</atitle><jtitle>Journal of the National Cancer Institute. Monographs</jtitle><stitle>JNCMON</stitle><addtitle>J Natl Cancer Inst Monogr</addtitle><date>2013-08</date><risdate>2013</risdate><volume>2013</volume><issue>46</issue><spage>99</spage><epage>105</epage><pages>99-105</pages><issn>1052-6773</issn><eissn>1745-6614</eissn><abstract>Comparative effectiveness research (CER) can make important contributions to the transformation of US health care by filling gaps left by tightly controlled clinical trials. However, without comprehensive and comparable data that reflect the diversity of the US health-care system, CER’s value will be diminished. We document the limits of observational CER by examining the age at diagnosis, disease stage, and select measures of health-care use among individuals diagnosed with incident cancer aged 65 or older from four large health maintenance organizations (HMOs) relative to seniors identified through the linked Surveillance, Epidemiology, and End Results (SEER)–Medicare data for the period 1999–2007. Aged individuals in the HMOs were younger, diagnosed at earlier stages, and more likely to receive care in inpatient settings than individuals in the linked SEER–Medicare data. These differences highlight the need for comprehensive and comparable datasets that reflect the diversity of US health care to support CER that can inform health-care reform in the United States.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>23962513</pmid><doi>10.1093/jncimonographs/lgt008</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1052-6773 |
ispartof | Journal of the National Cancer Institute. Monographs, 2013-08, Vol.2013 (46), p.99-105 |
issn | 1052-6773 1745-6614 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3748001 |
source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
subjects | Aged Aged, 80 and over Comparative Effectiveness Research Delivery of Health Care Female Health Maintenance Organizations - economics Health Maintenance Organizations - organization & administration Humans Male Medicare - economics Neoplasms - diagnosis Neoplasms - economics Neoplasms - epidemiology SEER Program United States - epidemiology |
title | The Challenge of Conducting Comparative Effectiveness Research in Cancer: The Impact of a Fragmented US Health-Care System |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T14%3A43%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Challenge%20of%20Conducting%20Comparative%20Effectiveness%20Research%20in%20Cancer:%20The%20Impact%20of%20a%20Fragmented%20US%20Health-Care%20System&rft.jtitle=Journal%20of%20the%20National%20Cancer%20Institute.%20Monographs&rft.au=Fishman,%20Paul%20A.&rft.date=2013-08&rft.volume=2013&rft.issue=46&rft.spage=99&rft.epage=105&rft.pages=99-105&rft.issn=1052-6773&rft.eissn=1745-6614&rft_id=info:doi/10.1093/jncimonographs/lgt008&rft_dat=%3Cproquest_pubme%3E1426999046%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1426999046&rft_id=info:pmid/23962513&rft_oup_id=10.1093/jncimonographs/lgt008&rfr_iscdi=true |