Utilization of a National Clinical Trials Infrastructure to Evaluate BreastCancer Patient Outcomes of Importance in Determining Priorities for New Health Care Reform

摘要

The project develops a novel clinical curriculum that utilizes resources fromdiverse disciplines. I have combined subspecialty training in medical oncology with formal courses in biostatistics, epidemiology, and health policy research, in order to develop expertise in clinical trials methodology and health care reform. Preliminary training involved breast cancer specialization in a multi-disciplinary clinic, and completion of a Clinical Research Scholars Program in order to develop a foundation in outcomes research. The second phase of the project involves the development of specific models and instruments to analyze breast cancer treatment options. Such tools will be invaluable in an analysis of the quality of medical care received by women with breast cancer. Moreover, they are important measurements of the impact that existing physician practice has on the quality and cost of health care. Outcomes research methodology will be applied to a comprehensive review of bone marrow transplantation for breast cancer, and subsequently will be utilized in the implementation of an outpatient high-dose chemotherapy program with particular emphasis on managed care practices and cost-benefit analysis. The goal is not only to learn how to properly conduct research, but ultimately to incorporate outcomes assessment into the structure of clinical trial design.