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.
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.
|McCarthy, Anne Marie; Barlow, William E; Conant, Emily F et al. (2018) Breast Cancer With a Poor Prognosis Diagnosed After Screening Mammography With Negative Results. JAMA Oncol 4:998-1001|
|Hill, Deirdre A; Haas, Jennifer S; Wellman, Robert et al. (2018) Utilization of breast cancer screening with magnetic resonance imaging in community practice. J Gen Intern Med 33:275-283|
|Miles, Randy; Wan, Fei; Onega, Tracy L et al. (2018) Underutilization of Supplemental Magnetic Resonance Imaging Screening Among Patients at High Breast Cancer Risk. J Womens Health (Larchmt) 27:748-754|
|Rutter, Carolyn M; Kim, Jane J; Meester, Reinier G S et al. (2018) Effect of Time to Diagnostic Testing for Breast, Cervical, and Colorectal Cancer Screening Abnormalities on Screening Efficacy: A Modeling Study. Cancer Epidemiol Biomarkers Prev 27:158-164|
|Onega, Tracy; Tosteson, Tor D; Weiss, Julie et al. (2018) Multi-level Influences on Breast Cancer Screening in Primary Care. J Gen Intern Med 33:1729-1737|
|Trentham-Dietz, Amy; Ergun, Mehmet Ali; Alagoz, Oguzhan et al. (2018) Comparative effectiveness of incorporating a hypothetical DCIS prognostic marker into breast cancer screening. Breast Cancer Res Treat 168:229-239|
|Chubak, Jessica; McLerran, Dale; Zheng, Yingye et al. (2018) Receipt of Colonoscopy Following Diagnosis of Advanced Adenomas: An Analysis within Integrated Healthcare Delivery Systems. Cancer Epidemiol Biomarkers Prev :|
|Clark, Cheryl R; Tosteson, Tor D; Tosteson, Anna N A et al. (2017) Diffusion of digital breast tomosynthesis among women in primary care: associations with insurance type. Cancer Med 6:1102-1107|
|Haas, Jennifer S; Baer, Heather J; Eibensteiner, Katyuska et al. (2017) A Cluster Randomized Trial of a Personalized Multi-Condition Risk Assessment in Primary Care. Am J Prev Med 52:100-105|
|Weiss, Julie E; Goodrich, Martha; Harris, Kimberly A et al. (2017) Challenges With Identifying Indication for Examination in Breast Imaging as a Key Clinical Attribute in Practice, Research, and Policy. J Am Coll Radiol 14:198-207.e2|
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