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...

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Veröffentlicht in:Journal of the National Cancer Institute. Monographs 2013-08, Vol.2013 (46), p.99-105
Hauptverfasser: Fishman, Paul A., Hornbrook, Mark C., Ritzwoller, Debra P., O’Keeffe-Rosetti, Maureen C., Lafata, Jennifer Elston, Salloum, Ramzi G.
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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
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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
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