My goal is to determine the clinical role of a minimally invasive therapy - percutaneous radiofrequency ablation (RFA) - for patients with small, incidentally detected renal tumors, by comparing RFA to surgery, the current standard of care. 1 will accomplish this goal using a decision-analytic approach. First, I will estimate the long-term effectiveness of RFA and surgery by developing a computer model that simulates the natural history of incidentally detected renal tumors, based on data from the literature and the SEER cancer registry. Second, I will collect patient data to improve quality-of-life and cost estimates associated with RFA and surgery, respectively - these estimates are either unavailable or insufficiently reported in the literature to, date. Third, I will perform a cost-effectiveness analysis in which I will compare RFA to surgery, using the effectiveness, quality-of-life, and cost data obtained. Finally, I will perform an extensive, probabilistic sensitivity analysis to estimate the uncertainty associated with analysis results. My career objective is to improve cancer outcomes by defining the best roles for imaging-based technologies in the care of cancer patients. I have pursued a unique career path that integrates cancer outcomes research, decision analysis, and radiology. I am part of a clinical division that serves as a large referral center for renal tumor RFA, and an outcomes research institute that has a wealth of resources to support decision analysis research. I have formulated a multidisciplinary team in decision science, epidemiology, radiology, urology, oncology, and pathology who currently advise in my research and career development, and will continue to do so during the award period. The research and career development plan that I outline in this proposal will provide me with a solid foundation for ongoing renal tumor therapy evaluation, from which I will transition to an independent investigator and leader in cancer outcomes research.
My research will establish the role of percutaneous radiofrequency ablation - a minimally invasive tumor therapy - in the treatment of small, incidentally detected renal tumors. Insights from my research will improve practice guidelines for the use of radiofrequency ablation, and may ultimately preclude the need for surgery in patients with small, incidentally detected renal tumors.
|Pandharipande, Pari V; Heberle, Curtis; Dowling, Emily C et al. (2015) Targeted screening of individuals at high risk for pancreatic cancer: results of a simulation model. Radiology 275:177-87|
|Eisenberg, Jonathan D; Lewin, Sarah O; Pandharipande, Pari V (2014) The fisherman's cards: how to address past and future radiation exposures in clinical decision making. AJR Am J Roentgenol 202:362-7|
|Kiatpongsan, Sorapop; Meng, Lesley; Eisenberg, Jonathan D et al. (2014) Imaging for appendicitis: should radiation-induced cancer risks affect modality selection? Radiology 273:472-82|
|Lam, Diana L; Pandharipande, Pari V; Lee, Janie M et al. (2014) Imaging-based screening: understanding the controversies. AJR Am J Roentgenol 203:952-6|
|Eisenberg, Jonathan D; Gilmore, Michael E; Kalra, Mannudeep K et al. (2014) Prioritizing examination-centered over patient-centered dose reduction: a hazard of institutional "benchmarking". AJR Am J Roentgenol 202:1062-8|
|Harvey, H Benjamin; Gowda, Vrushab; Gazelle, G Scott et al. (2014) The ephemeral accountable care organization-an unintended consequence of the Medicare shared savings program. J Am Coll Radiol 11:121-4|
|Kang, Stella K; Huang, William C; Pandharipande, Pari V et al. (2014) Solid renal masses: what the numbers tell us. AJR Am J Roentgenol 202:1196-206|
|Pandharipande, Pari V; Eisenberg, Jonathan D; Lee, Richard J et al. (2013) Patients with testicular cancer undergoing CT surveillance demonstrate a pitfall of radiation-induced cancer risk estimates: the timing paradox. Radiology 266:896-904|
|Hartman, Rebecca I; Chang, Connie Y; Wo, Jennifer Y et al. (2013) Optimizing adjuvant treatment decisions for stage t2 rectal cancer based on mesorectal node size: a decision analysis. Acad Radiol 20:79-89|
|Harvey, H Benjamin; Pandharipande, Pari V (2012) The federal government's oversight of CT safety: regulatory possibilities. Radiology 262:391-8|
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