Clinical Molecular Marker Testing Data Capture to Promote Precision Medicine Research Within the Cancer Research Network

PURPOSE: To evaluate health care systems for the availability of population-level data on the frequency of use and results of clinical molecular marker tests to inform precision cancer care. METHODS: We assessed cancer-related molecular marker test data availability across 12 US health care systems in the Cancer Research Network. Overall, these systems provide care to a diverse population of more than 12 million people in the United States. We performed qualitative analyses of test data availability for five blood-based protein, nine germline, and 14 tissue-based tumor marker tests in each health care system\u27s electronic health record and tumor registry using key informants, test code lists, and manual review of data types and output. We then performed quantitative analyses to estimate the proportion of patients with cancer with test utilization data and results for specific molecular marker tests. RESULTS: Health systems were able to systematically capture population-level data on all five blood protein markers, six of 14 tissue-based tumor markers, and none of the nine germline markers. Successful, systematic data capture was achievable for tests with electronic data feeds for test results (blood protein markers) or through prior manual abstraction by tumor registrars (select tumor-based markers). For test results stored in scanned image files (particularly germline and tumor marker tests), information on which test was performed and test results was not readily accessible in an electronic format. CONCLUSION: Even in health care systems with sophisticated electronic health records, there were few codified data elements available for evaluating precision cancer medicine test use and results at the population level. Health care organizations should establish standards for electronic reporting of precision medicine tests to expedite cancer research and facilitate the implementation of precision medicine approaches

Tobacco Control Legislation in the Netherlands

An short introduction or overview in Dutch Tobacco Control legislation, including a smoking ban in bars and restaurants and regulation of Tobacco Sale

Inventory of projects : Progress report: Implementation of A Public Health Action Plan To Combat Antimicrobial Resistance : progress through 2007

Publication date from document properties.2007_report/ann_rept.pdf20181069

Diffusion of the EGFR Assay: The Underutilization and the Urban/Rural Divide

Purpose - The EGFR assay is a molecular diagnostic test which identifies a targetable mutation in lung tumors. Guidelines call for EGFR testing for non-small cell lung cancer patients to direct first line treatment. We explored institutional and regional factors predicting the likelihood acute care hospitals ordered the assay. Methods: This was a retrospective study which analyzed US acute care hospitals (n=4780). We linked proprietary industry data for orders of the EGFR assay to public datasets that provided hospital and regional characteristics. We conducted logistic regression to identify significant characteristics that predict likelihood a hospital ordered the assay. Results - Of acute care hospitals in the US, 12% (n=592) ordered the EGFR assay. In 49 counties with an NCI designated cancer center (NCI CC), 19% of hospitals ordered the assay. Significant institutional predictors of ordering the assay included: Participation in an NCI clinical research cooperative group (odds ratio [OR], 1.91, 95% CI 1.55 to 2.35), inpatient chemotherapy (OR, 1.32; 95% CI, 1.00 to 1.74), Cardio Thoracic Surgery (OR, 1.70; 95% CI, 1.37 to 2.11), and affiliation with academic medical center (OR, 1.40; 95% CI, 1.14 to 1.72). Significant regional predictors included: metropolitan county (OR, 1.70; 95% CI, 1.24 to 2.32), education above the mean (OR, 1.45; 95% CI, 1.10 to 1.91). Negative predictors were distance from an NCI CC (OR, .996, 95% CI, .995 to .998), a 34% decrease in likelihood for every 100 miles further from an NCI CC, and characterization as a critical access hospital (OR, .02, 95% CI, .00 to .09)

Inventory of projects : Progress report: Implementation of A Public Health Action Plan To Combat Antimicrobial Resistance : progress through 2008

Last revised: December 29, 200

Medicine + Health, Fall 2011

https://hsrc.himmelfarb.gwu.edu/smhs_medhealth/1002/thumbnail.jp