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Grant Details

Grant Number: 5R01CA052192-09 Interpret this number
Primary Investigator: Stukel, Therese
Organization: Dartmouth College
Project Title: Longitudinal Methods in Cancer Research
Fiscal Year: 2002


DESCRIPTION: (Adapted from the Investigator's Abstract) The long-term goal of this research is to develop, implement, and apply innovative statistical methodology for the analysis of longitudinal studies involving clustered binary or counted data in cancer treatment, prevention, and health services research. Clustered longitudinal studies play an increasingly important role in cancer research. Current studies in our group address issues of how differences in local health system resources influence the delivery of care and how greater capacity and increased utilization affect health outcomes. The studies share key statistical features in that each involves the measurement of repeated binary or counted outcomes on individual cancer patients clustered within hospital referral regions (HRRs); and the primary focus is in describing overall variations in outcomes across HRRs and in determining the influence of HRR-level covariates, such as physician supply and practice patterns, on these variations. While statistical methodology is currently available to analyze such data, analyses are hampered by their technical and computational complexity. Specifically, we will extend our computationally simple, robust, efficient two-stage method of estimation previously used for modeling linear and nonlinear growth curves to large clustered longitudinal studies involving binary or counted data; develop regression diagnostic methods for the assessment of quality of fit and sensitivity to outliers in clustered longitudinal regression models; and apply the new approaches to the study of geographic variations in surveillance patterns following potentially curative resection for colorectal cancer among U.S. Medicare beneficiaries. These analyses will examine how surveillance strategies for colorectal cancer patients vary across geographic regions and how local availability of resources, the specialty mix of physicians in the region, and patient attributes interact to influence downstream decisions. The methods we propose will circumvent many of the above technical difficulties and would not require either special software or high performance computer workstations.


Survival after hepatic resection of colorectal cancer metastases: a national experience.
Authors: Robertson D.J. , Stukel T.A. , Gottlieb D.J. , Sutherland J.M. , Fisher E.S. .
Source: Cancer, 2009-02-15; 115(4), p. 752-9.
PMID: 19130462
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Influence analysis for linear mixed-effects models.
Authors: Demidenko E. , Stukel T.A. .
Source: Statistics in medicine, 2005-03-30; 24(6), p. 893-909.
PMID: 15558803
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The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care.
Authors: Fisher E.S. , Wennberg D.E. , Stukel T.A. , Gottlieb D.J. , Lucas F.L. , Pinder E.L. .
Source: Annals of internal medicine, 2003-02-18; 138(4), p. 288-98.
PMID: 12585826
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The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care.
Authors: Fisher E.S. , Wennberg D.E. , Stukel T.A. , Gottlieb D.J. , Lucas F.L. , Pinder E.L. .
Source: Annals of internal medicine, 2003-02-18; 138(4), p. 273-87.
PMID: 12585825
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Two-stage methods for the analysis of pooled data.
Authors: Stukel T.A. , Demidenko E. , Dykes J. , Karagas M.R. .
Source: Statistics in medicine, 2001-07-30; 20(14), p. 2115-30.
PMID: 11439425
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Effect on regrowth delay in a murine tumor of scheduling split-dose irradiation based on direct pO2 measurements by electron paramagnetic resonance oximetry.
Authors: O'Hara J.A. , Goda F. , Demidenko E. , Swartz H.M. .
Source: Radiation research, 1998 Nov; 150(5), p. 549-56.
PMID: 9806597
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Covariate measurement error and the estimation of random effect parameters in a mixed model for longitudinal data.
Authors: Tosteson T.D. , Buonaccorsi J.P. , Demidenko E. .
Source: Statistics in medicine, 1998-09-15; 17(17), p. 1959-71.
PMID: 9777689
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Two-stage method of estimation for general linear growth curve models.
Authors: Stukel T.A. , Demidenko E. .
Source: Biometrics, 1997 Jun; 53(2), p. 720-8.
PMID: 9192460
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Standardized rates of recurrent outcomes.
Authors: Stukel T.A. , Glynn R.J. , Fisher E.S. , Sharp S.M. , Lu-Yao G. , Wennberg J.E. .
Source: Statistics in medicine, 1994-09-15; 13(17), p. 1781-91.
PMID: 7997711
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Comparison of methods for the analysis of longitudinal interval count data.
Authors: Stukel T.A. .
Source: Statistics in medicine, 1993-07-30; 12(14), p. 1339-51.
PMID: 8210830
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