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BACKGROUND Life-sustaining medical care of patients with advanced cancer at the end of life (EOL) is costly. Patient-physician discussions about EOL wishes are associated with lower rates of intensive interventions. METHODS Funded by the National Institute of Mental Health and the National Cancer Institute, Coping With Cancer is a longitudinal(More)
BACKGROUND A systematic review was conducted to evaluate the literature regarding the impact of follow-up on colorectal cancer patient survival and, in a second phase, recommendations were developed. METHODS The MEDLINE, CANCERLIT, and Cochrane Library databases, and abstracts published in the 1997 to 2002 proceedings of the annual meeting of the American(More)
BACKGROUND Providers have been reluctant to disclose patient data for public-health purposes. Even if patient privacy is ensured, the desire to protect provider confidentiality has been an important driver of this reluctance. METHODS Six requirements for a surveillance protocol were defined that satisfy the confidentiality needs of providers and ensure(More)
BACKGROUND There is limited capacity to assess the comparative risks of medications after they enter the market. For rare adverse events, the pooling of data from multiple sources is necessary to have the power and sufficient population heterogeneity to detect differences in safety and effectiveness in genetic, ethnic and clinically defined subpopulations.(More)
To better understand the extent of diagnostic and referral delays from primary care providers (PCPs) for chronic hematologic malignancies, causes of these delays, and their possible effects on cancer outcomes, an extensive review of the literature was performed. Over 50 studies were reviewed, including many that concern delays in referral and diagnosis for(More)
BACKGROUND The purpose of this study was to estimate the relative impact of changes in demographics, stage at detection, treatment mix, and medical technology on 5-year survival among older colorectal cancer (CRC) patients. METHODS We selected older patients diagnosed with CRC between 1992 and 2000 from the SEER-Medicare database and followed them through(More)
OBJECTIVE To evaluate measures that could use existing administrative data to assess the intensity of end-of-life cancer care. METHODS Benchmarking standards and statistical variation were evaluated using Medicare claims of 48,906 patients who died from cancer from 1991 through 1996 in 11 regions of the United States. We assessed accuracy by comparing(More)
BACKGROUND For many diseases, specialized care (i.e., care rendered by a specialist) has been associated with superior-quality care (i.e., better outcomes). We examined associations between physician specialty and outcomes in a population-based cohort of elderly ovarian cancer surgery patients. METHODS We analyzed the Medicare claims, by physician(More)
To determine the accuracy with which Medicare claims data measure disease-free survival in elderly Medicare beneficiaries with cancer, we performed a criterion validation study. We merged gold-standard clinical trial data of 45 elderly patients with node-positive breast cancer who were treated on the Cancer and Leukemia Group B (CALGB) adjuvant breast trial(More)
PURPOSE The impact of cancer and cancer treatment on the long-term health and quality of life of survivors is substantial, leading to questions about the most appropriate configuration of services and models of care for follow-up of post-primary treatment survivors. METHODS A systematic review and quality appraisal of the health literature for structure(More)