The proposed PROSPR Center will focus on developing and evaluating systems-based approaches to optimize care across the breast cancer screening continuum, for both individuals and populations, using health information technology (IT). This approach is timely as the widespread deployment and "meaningful use" of electronic health records (EHRs) provides infrastructure, opportunity, and incentive to develop systems-based solutions. We will address these issues within a regional network comprised of integrated clinical delivery systems, based in primary care with comprehensive data capture through breast imaging, pathology, and initial cancer treatment. Our three over-arching Projects/Specific Aims, supported by two cores, address key priorities and promote the quality of care:
Aim 1 : To improve breast cancer screening systems through measurement and feedback using a micro-systems approach to map the entire screening process and develop generalizable metrics to assess change, characterize process and screening outcomes, and develop and implement dashboard tools to measure and report these screening metrics;
Aim 2 : To promote personalized decisions for breast cancer screening for women and their providers by developing an EHR-integrated, personalized breast cancer screening module that will generate tailored risk assessment and screening recommendations for women and tailored decision support for their providers. and measure the reach, effectiveness, adoption and implementation in a practice-based randomized controlled trial;
Aim 3 : To compare the effectiveness of care processes across systems for established and emerging breast cancer screening modalities, promoting integration across the Center's projects by providing both quantitative and population estimates for Aims 1 and 2, and to assess the impact of emerging modalities (e.g., tomosynthesis). Our regional collaborative, with seasoned, multi-disciplinary expertise and a track record of collaboration in a national breast screening consortium, offers data on diverse populations and care settings and projects that are designed to improve the quality of care across the breast care continuum.

Public Health Relevance

Our Center will address several major gaps in the knowledge and practice of breast cancer screening by promoting innovative, systems-based approaches using health information technology (IT). These types of systems and tools are necessary to achieve the triad of 'right test for the right patient at the right time'across the breast cancer continuum of screening, prevention, diagnosis, and treatment.

Agency
National Institute of Health (NIH)
Type
Specialized Center--Cooperative Agreements (U54)
Project #
5U54CA163307-04
Application #
8715707
Study Section
Special Emphasis Panel (ZCA1)
Program Officer
Parker, Tonya
Project Start
Project End
Budget Start
Budget End
Support Year
4
Fiscal Year
2014
Total Cost
Indirect Cost
Name
Dartmouth College
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
City
Hanover
State
NH
Country
United States
Zip Code
03755
Klabunde, Carrie N; Zheng, Yingye; Quinn, Virginia P et al. (2016) Influence of Age and Comorbidity on Colorectal Cancer Screening in the Elderly. Am J Prev Med 51:e67-75
McCarthy, Anne Marie; Kim, Jane J; Beaber, Elisabeth F et al. (2016) Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity. Am J Prev Med 51:507-12
Conant, Emily F; Beaber, Elisabeth F; Sprague, Brian L et al. (2016) Breast cancer screening using tomosynthesis in combination with digital mammography compared to digital mammography alone: a cohort study within the PROSPR consortium. Breast Cancer Res Treat 156:109-16
Weiss, Julie E; Goodrich, Martha; Harris, Kimberly A et al. (2016) Challenges With Identifying Indication for Examination in Breast Imaging as a Key Clinical Attribute in Practice, Research, and Policy. J Am Coll Radiol :
Kim, Jane J; Tosteson, Anna Na; Zauber, Ann G et al. (2016) Cancer Models and Real-world Data: Better Together. J Natl Cancer Inst 108:
Tosteson, Anna N A; Beaber, Elisabeth F; Tiro, Jasmin et al. (2016) Variation in Screening Abnormality Rates and Follow-Up of Breast, Cervical and Colorectal Cancer Screening within the PROSPR Consortium. J Gen Intern Med 31:372-9
Haas, Jennifer S; Sprague, Brian L; Klabunde, Carrie N et al. (2016) Provider Attitudes and Screening Practices Following Changes in Breast and Cervical Cancer Screening Guidelines. J Gen Intern Med 31:52-9
Chen, Jane S; Sprague, Brian L; Klabunde, Carrie N et al. (2016) Take the money and run? Redemption of a gift card incentive in a clinician survey. BMC Med Res Methodol 16:25
Corley, Douglas A; Haas, Jennifer S; Kobrin, Sarah (2016) Reducing Variation in the "Standard of Care" for Cancer Screening: Recommendations From the PROSPR Consortium. JAMA 315:2067-8
Schapira, Marilyn M; Sprague, Brian L; Klabunde, Carrie N et al. (2016) Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice. J Gen Intern Med 31:1148-55

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