Grant Number:	1R01CA095664-01A1 Interpret this number
Primary Investigator:	Silber, Jeffrey
Organization:	Children'S Hosp Of Philadelphia
Project Title:	Provider Specialty and Outcomes in Ovarian Cancer
Fiscal Year:	2003

DESCRIPTION (provided by investigator): The goal of this application is to study practice variations and outcomes across specialty type in Ovarian Cancer, and also to develop an approach for conducting chart review in the Surveillance, Epidemiology, and End Results (SEER)-Medicare database that takes into consideration issues of patient confidentiality. In particular, the application will study how provider specialty influences surgery and chemotherapy, and how such differences influence mortality in Ovarian Cancer using multivariate counter-matching and conditional logistic regression, in order to control for chemotherapy and surgical treatment in a manner not previously accomplished. Counter-matching will allow for adjustment by factors such as age, patient co-morbidities, stage, year, chemotherapy (as determined from Medicare claims), and other provider information when appropriate, while utilizing the minimum number of pairs needed to detect important differences. Matching will be complemented with regression modeling using all available claims data in order to utilize maximum information available. The aims of the application are to: (1) determine whether outcomes after chemotherapy differ with the specialty of the provider delivering that chemotherapy; (2) determine whether chemotherapy intensity differs across the specialty of the provider delivering that chemotherapy; (3) Determine whether survival is a function of the type of surgical specialist performing the primary cancer surgery; (4) study the referral patterns associated with different surgical specialties; and (5) develop a Phase-II "minimally intrusive" approach that is sensitive to the concerns of forthcoming federal regulations regarding patient privacy, while at the same time allowing for important health services research questions to be answered using the data resources of the SEER-Medicare data base with chart review. We will propose a second phase of this research (not part of the present application), to examine those specific charts deemed interesting from this initial application or "Phase-I" analysis. Our hope is that this study could serve as a model for other matched cohort studies involving chart review utilizing the SEER-Medicare database.




Amplification of Sensitivity Analysis in Matched Observational Studies.
Authors: Rosenbaum P.R. , Silber J.H. .
Source: Journal Of The American Statistical Association, 2009-12-01 00:00:00.0; 104(488), p. 1398-1405.
PMID: 22888178
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Exact, distribution free confidence intervals for late effects in censored matched pairs.
Authors: Daniel S.R. .
Source: Biometrical Journal. Biometrische Zeitschrift, 2009 Feb; 51(1), p. 31-44.
PMID: 19219909
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An Algorithm for Optimal Tapered Matching, With Application to Disparities in Survival.
Authors: Daniel S.R. , Armstrong K. , Silber J.H. , Rosenbaum P.R. .
Source: Journal Of Computational And Graphical Statistics : A Joint Publication Of American Statistical Association, Institute Of Mathematical Statistics, Interface Foundation Of North America, 2008 Dec; 17(4), p. 914-924.
PMID: 25580069
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Does ovarian cancer treatment and survival differ by the specialty providing chemotherapy?
Authors: Silber J.H. , Rosenbaum P.R. , Polsky D. , Ross R.N. , Even-Shoshan O. , Schwartz J.S. , Armstrong K.A. , Randall T.C. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2007-04-01 00:00:00.0; 25(10), p. 1169-75.
PMID: 17401005
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Variation in chemotherapy utilization in ovarian cancer: the relative contribution of geography.
Authors: Polsky D. , Armstrong K.A. , Randall T.C. , Ross R.N. , Even-Shoshan O. , Rosenbaum P.R. , Silber J.H. .
Source: Health Services Research, 2006 Dec; 41(6), p. 2201-18.
PMID: 17116116
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The case-only odds ratio as a causal parameter.
Authors: Rosenbaum P.R. .
Source: Biometrics, 2004 Mar; 60(1), p. 233-40.
PMID: 15032794
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