Volume 19, Issue 3
Fall 2007
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CHS Research News
Vol 19, Issue 3, Fall 2007
Center News
by Rebecca Hughes and Joan DeClaire
Group Health awarded $23 million for new vaccine research
unit: UW and Seattle Children’s Hospital will
collaborate in clinical trials
The Group Health Center for Health Studies (CHS) has received a $23.7
million federal contract to establish and lead a Vaccine and Treatment
Evaluation Unit (VTEU) that will conduct clinical trials of promising
vaccines and therapies for infectious diseases.
Group Health will collaborate with the University of Washington (UW)
Department of Medicine, the UW Division of Allergy & Infectious Diseases,
and Seattle Children’s Hospital Research Institute to operate the VTEU. The
National Institute of Allergy and Infectious Diseases will fund the
seven-year contract.
Group Health is now among eight institutions nationwide to host a VTEU,
making it an integral part of national efforts to develop safe and effective
vaccines for the public good.
(See news
release for more information.)
Top
New Findings & Highlights
Statin treatment may curb Alzheimer’s brain changes:
First direct evidence that widely used heart drugs may protect the brain
People who take statin drugs may be less likely to develop the brain
changes that signal Alzheimer’s disease, according to a
study and accompanying
patient page published in the August 28, 2007, issue of Neurology®,
the medical journal of the American Academy of Neurology.
Previous research had suggested that people who received statins might be
less likely to develop Alzheimer’s disease. “But our study is the first to
compare the brains of people who had received statins with those who had
not,” said Gail (Ge) Li, MD, PhD. The paper's lead author, Dr. Li is an
assistant professor of psychiatry and behavioral sciences at the UW School
of Medicine, in Seattle.
She and her colleagues examined the brains of 110 Group Health members,
aged 65 to 79, who had participated in Adult Changes in Thought (ACT) and
who donated their brains for research. A joint project of Group Health and
the UW, ACT is a prospective cohort study started in 1994. It includes a
random sample of Group Health members aged 65 and older who had no thinking
difficulties when enrolled.
(See news
release for more information.)
Top
Yearly mammograms protect breast cancer survivors:
Cancer Research Network finds benefit for older women with no symptoms
Older women who get yearly mammograms after treatment of early-stage
breast cancer are less likely to die from breast cancer, according to a
study in
the July 20, 2007 issue of the Journal of Clinical Oncology.
The researchers examined five years of follow-up on almost 2,000 patients
aged 65 and older with stage I and II breast cancer at six integrated health
care delivery systems in the Cancer Research Network (CRN), including Group
Health.
“Our large study, with nearly complete follow-up, shows that regular
post-therapy surveillance lowers the rate of death from breast cancer,” said
Timothy Lash, DSc, MPH, the paper's lead author. Lash is an associate
professor of epidemiology at Boston University School of Public Health.
“An important finding of this study is that not all older women who are
breast cancer survivors are receiving annual mammograms,” said Rebecca
Silliman, MD, PhD, a professor of medicine and public health at Boston
University Schools of Medicine and Public Health.
(See news
release for more information.)
Top
Research Highlights
A telephone outreach and counseling program not only relieved
employees’ depression but also boosted their productivity, likelihood of
continuing to work at their company, and hours at work: equivalent to 2.5
workweeks a year.
Greg Simon, MD, MPH, a CHS
senior investigator, and CHS Senior Research Associate
Evette Ludman, PhD
developed and tested the program at Group Health. They worked with NIH and
Harvard colleagues on the first randomized controlled
study to
evaluate the effects of a systematic depression care program on work
outcomes, such as productivity, in a population of employees, not patients.
The study by Simon, Ludman, and their colleagues, of 600 depressed employees
enrolled in United Behavioral Health, was published in the September 26,
2007 Journal of the American Medical Association. The researchers
estimate that phone-based outreach and care management costs an extra $100
to $400 yearly, while depression-linked absenteeism alone costs around
$1,800.
The flu vaccine does not prevent death in the elderly as well as
has been presumed, according to an October 2007 Lancet
Infectious Diseases
review
that
Lisa Jackson, MD, MPH, a
CHS senior investigator, coauthored with NIH colleagues. Jackson and her
coauthors still advise people age 65 and older to keep getting flu vaccines
each year. But they note that few randomized controlled trials of flu
vaccine have included seniors. In those that have, the vaccine protected the
“young old” (age 65–69) relatively well from flu. However, the vaccine may
provide less protection starting at age 70. An accompanying
editorial in the journal went even farther, calling for a randomized
controlled trial comparing the current vaccine with a placebo.
Health improvement, especially for disadvantaged populations, may
require comprehensive practical support, not just “pay for performance”
(P4P), according to a
study published in the November 2007
Journal of Health Care for the Poor and Underserved.
Katie Coleman, MSPH, a
research associate at the MacColl Institute for Healthcare Innovation at the
CHS, led the study. P4P rewards health care providers with extra payment for
meeting performance targets. She and colleagues used data on more than 1,000
patients with diabetes treated by nearly 50 doctors in the ACCESS Community
Health Network in Chicago. Although the Network’s P4P program seemed to help
patients get tested more often, as recommended, for hemoglobin A1c, it
failed to help improve the control of the patients’ blood sugar. The
researchers think a more comprehensive strategy, including more practical
support for patients, may be needed to improve health, especially the health
of disadvantaged populations.
Young people with asthma are about twice as likely to suffer from
depressive and anxiety disorders as are children without asthma. So
concluded a
study published in the November 2007
Journal of Adolescent Health. The research team
included CHS Affiliate Investigator Wayne
Katon, MD, vice chair of Psychiatry and Behavioral Sciences at the
UW; CHS Associate Investigator
Paula Lozano, MD, MPH; and
Terry Bush, PhD, who is now at
Free & Clear, Inc. but conducted the research while at the CHS. They
interviewed more than 1,300 11- to 17-year-old Group Health patients, of
whom more than half had asthma. About 16 percent of youth with asthma had
depressive or anxiety disorders, compared to about 9 percent without asthma.
Multifactorial interventions are likely to be beneficial for
childhood obesity, according to
David Arterburn, MD, MPH,
an assistant investigator at the CHS, in his recent review of childhood
obesity interventions for
BMJ Clinical Evidence (online). By contrast, he
also wrote, the effectiveness of neither diet nor physical activity nor
behavioral intervention on its own is known yet. BMJ Clinical Evidence
is a project of the British Medical Journal that provides
evidence-based clinical guidelines.
New low-dose birth control pills may speed up bone loss in young
women, according to a presentation by
Delia Scholes, PhD,
senior investigator at the CHS, to the annual meeting of the
American Society for Bone and Mineral
Research in Hawaii in September 2007. Scholes and her colleagues
are following 600 female Group Health members age 14 to 30 years. Initial
results suggest a link between the lowest doses of estrogen and the least
bone density. The study is continuing to collect data on long-term
effects—as well as the possibility that bone recovery may occur after women
stop taking birth control pills.
Genomics will yield translational benefits, but it is unlikely to
revolutionize “personalized medicine,” according to CHS Senior
Investigator
Bruce Psaty, MD, PhD, and
CHS Affiliate Investigator Wylie Burke, MD,
PhD. Writing in the October 10, 2007
Journal of the American Medical Association, they
cautioned that genetic risk resembles other health risks that personalized
medicine, as currently practiced, already takes into account. Before
implementing each genetic test in practice, they called for it to be
thoroughly evaluated and assessed to demonstrate that its overall health
benefits exceed its harms. They wrote that genetic risk information will be
useful only if it guides more effective, or more cost-effective, use of
medical interventions than can be achieved without that information.
Women who have experienced sexual intimate partner violence (IPV)
tend to have adverse health effects, according to a
study in the September 2007 Journal of Women’s
Health. In this study of nearly 3,000 women Group Health members, women
with no IPV exposure were healthier (mentally, socially, and physically)
than were those who had experienced IPV. Adverse effects were strongest for
those women who had experienced both sexual and physical IPV. The
researchers were Amy Bonomi, PhD, MPH,
who is now at the Ohio State University but was at the CHS during the study;
CHS Biostatistician
Melissa Anderson, MS;
CHS Affiliate Investigator Fred Rivara, MD,
MPH, based at the UW; and
Robert S. Thompson, MD,
CHS senior investigator emeritus. They wrote that their findings suggest the
need for more efforts to screen for sexual IPV in health settings and
increased primary prevention efforts that address sexual violence using an
ecological approach.
Early mercury exposure from thimerosal-containing vaccines
appears not to affect neuropsychological function in grade-school-age
children. So concluded a September 27, 2007 New England Journal
of Medicine
article
that Lisa
Jackson, MD, MPH, a CHS senior investigator, coauthored with
CHS Immunization Research Program Director
Patti Benson, MPH, Group Health pediatrician
John Dunn, MD, MPH, and Centers
for Disease Control and Prevention (CDC), Kaiser Permanente, Harvard,
Stanford, and UCLA colleagues. Their retrospective cohort study enrolled
1,000 children aged 7–10 from four health plans, including Group Health.
Thimerosal is no longer in most vaccines given to U.S. children, but it was
widely used to preserve vaccines before the late 1990s. This study did not
evaluate a possible association between thimerosal exposure and risk of
autism—nor was it designed to.
Use and satisfaction with MyGroupHealth were greatest for
accessing services and information about ongoing active care and
communication between providers and patients, according to a
study
led by CHS Assistant Investigator
James Ralston, MD, MPH.
Published on August 21, 2007 by the Journal of the American Medical
Informatics Association, the study concluded that to meet patients'
needs, it may be important to integrate Web services tightly with clinical
information systems and patient-provider relationships. Dr. Ralston and his
fellow researchers used data on the adoption and use of the site from 2002
through 2005, including a satisfaction survey mailed to a random sample of
2,000 Group Health patients (response rate of 46%) who used the site in
August 2004. His CHS coauthors are David
Carrell, PhD, analyst/programmer;
Rob Reid, MD, PhD, assistant
investigator and an associate director in Group Health's Department of
Preventive Care; and
Melissa Anderson, MS,
biostatistician.
Among people treated for bipolar disorder, modest changes in
severity of depression are associated with changes in functional impairment
and disability, according to an
article
in the August 2007 Journal of Clinical Psychiatry. The authors
included Greg
Simon, MD, MPH, a CHS senior investigator;
Evette
Ludman, PhD, a CHS senior research associate;
Belinda Operskalski-Haile, a CHS
research project manager; and Jurgen
Unützer, MD, MPH, a CHS affiliate investigator based at the UW. By
contrast, in this study of more than 400 patients, they did not consistently
link changes in the severity of mania or hypomania to differences in
functioning. They suggested that conventional measures of functioning may
not be sensitive to the effects of mania symptoms.
There appears to be a link between falling rates of breast cancer
and of postmenopausal hormone therapy. The August 15, 2007
Journal of the
National Cancer Institute published the
first study to investigate this link in a large population (more than
600,000) of women getting routine mammograms from 1997 through 2003. Group
Health runs one of the five mammography registries from sites around the
United States involved in this study. Previous reports suggesting this link
had spurred criticism that the drop in U.S. breast cancer detection might be
due to fewer American women getting screening mammograms over the same
period. The previous reports did not take into account wide variations in
how often women were getting screening mammograms. By contrast, the new
study eliminated that variable, because the entire population got regular
screening for all seven years. This enabled the new study's researchers to
rule out the frequency of screening mammography as a factor—and attribute
the decline of 13 percent per year, which they saw from 2001 to 2003, to the
"precipitous" decline in hormone therapy over that same period. Authors
included
Diana Buist, PhD, MPH, a
CHS associate investigator,
Diana Miglioretti, PhD,
a CHS associate investigator, of the University of California San Francisco.
Since the landmark Women’s Health Initiative (WHI) Postmenopausal
Hormone Therapy Trial was published, physicians have been conflicted about
the results and implications, according to a
study
e-published ahead of print on July 18, 2007 in the Journal of General
Internal Medicine. Terry Bush, PhD,
led the qualitative study while at CHS, but is now at Free & Clear, Inc. Her
coauthors included Amy Bonomi, PhD, MPH,
now at the Ohio State University;
CHS Senior Research Associate
Evette Ludman, PhD; CHS
Associate Director
Katherine Newton, PhD; CHS
Biostatistician
Lou Grothaus, MA; and CHS Affiliate Investigators
Susan Reed, MD, MPH and
Andrea LaCroix, PhD. They
conducted in-depth telephone interviews with 22 physicians—family
practitioners, internists, and gynecologists—from Group Health and Harvard
Pilgrim Health Care. The physicians said they would like decision aids to
guide discussions with women about menopause and hormone therapy. The
authors suggested that better guidance when the WHI study was published in
2002 could have helped ensure best practices.
Many women who have had prophylactic mastectomy wish they had
been better informed beforehand, especially about the results of
breast reconstruction, according to a
paper in the July/August 2007 issue of Cancer Nursing. This was
particularly true for those who had bilateral prophylactic mastectomy. The
authors, who included CHS Research Associate
Sarah Greene, MPH, and Joann Elmore, MD, MPH, a CHS affiliate
investigator at the UW, surveyed nearly 1,000 women, from six health care
systems. They concluded that clinicians and health educators should be aware
of patient needs—and should counsel them accordingly, showing them
photographs of reconstructed breasts.
Nearly one in 10 tobacco sales in U.S. gas station convenience
stores are to people younger than 18, according to a
study
led by Dave Pearson, PhD, a
medical sociologist who directs evaluation for Group Health’s
Center for Community Health and Evaluation
(CCHE), which recently joined the CHS. The study was published in
the August 2007 American Journal of Preventive Medicine. Pearson
and his colleagues analyzed data from nearly 9,000 King County compliance
checks, which use “youth operatives” to assess compliance with age
requirements. They found that convenience stores that sell gas were more
likely to sell tobacco to minors than were other retailers, such as
restaurants, bars, and tobacco discount stores.
Top
New Funding
The following grants are among several projects recently funded at CHS:
Vaccine and Treatment Evaluation Unit (VTEU):
Evaluation of Control Measures against Diseases Other than AIDS: A
seven-year, $23,703,958 grant from National Institute of Allergy and
Infectious Diseases. Major Goals: To design and conduct phase 1–4 clinical
trials and clinical studies of candidate vaccines and therapeutics, and to
conduct other evaluations and analyses for vaccines against infectious
diseases other than human immunodeficiency virus (HIV). Principal
investigator: Lisa Jackson.
Global Longitudinal Osteoporosis study in Women (GLOW):
An eight-month, $250,000 grant from Massachusetts Commonwealth. Major Goals:
The goal of this research is to improve understanding of the risk and
prevention of osteoporosis-related fractures among female residents of nine
countries who are 55 and older. CHS lead investigator:
Andrea LaCroix.
HMO Research Network CERTs 3: Infrastructure & Adverse Drug
Reaction—Pilot Project: A four-year, $180,986 grant from Agency for
Healthcare Research and Quality. Major Goals: To continue studies on drug
safety and pharmaco-vigilance in a population-based setting. CHS lead
investigator: Denise Boudreau.
Pharmaco-epidemiology in the Elderly: Medications, Pneumonia
Risk, and Confounding: A five-year, $863,999 grant from National
Institute on Aging. Major Goals: To investigate relationships between
functional and cognitive status and (1) use of prescription medications
commonly used by the elderly, and (2) the risk of community acquired
pneumonia in the elderly. Principal investigator:
Sascha Dublin.
Study of the HIPAA Privacy Rule and Its Effects on Health
Research: An eight-month, $118,475 grant from Institute of
Medicine. Major Goals: (1) To examine the effects of the HIPAA Privacy Rule
on health research; (2) To characterize the range of different
interpretations of the HIPAA Privacy Rule provisions by covered entities in
the HMO Research Network; (3) To determine whether HIPAA Privacy Rule
requirements have resulted in additional administrative or research costs to
projects. Principal investigator: Sarah
Greene.
Total Xenoestrogen Body Burden in Relation to Mammographic
Density, A Marker of Breast Cancer Risk: A two-year, $79,121 grant
from the U.S. Department of Defense. Major Goals: To evaluate the
association of total xenoestrogen exposure with mammographic density, a
strong intermediate marker of breast cancer risk. We hypothesize that women
with higher serum xenoestrogen levels will have greater mammographic
density, indicating increased breast cancer risk. The secondary aim of this
proposal is to identify important sources of xenoestrogen exposure. CHS lead
investigator: Diana Buist.
Development and Use of Network Infrastructure for High-Throughput
Genome-Wide Association Studies: A four-year, $3,876,835 grant from
NIH. Major Goals: This project will develop methods and create the
infrastructure to perform high-throughput Genome Wide Analyses (GWA) in a
population-based sample of persons with Alzheimer's disease and in
well-characterized controls from the same population base without dementia.
Principal investigator: Eric Larson.
Health Care Improvement for Aging Woman: A five-year,
$797,110 grant from the National Institutes of Health. Major Goals: To
prepare post-doctoral public health scientists to produce the evidence that
will guide optimum, efficient, and cost-effective health care practices for
older women in the future. Principal investigator:
Andrea LaCroix.
Ectopic Pregnancy: Assessing Long-Term Trends in Rates and Risk
Factors: A two-year, $166,000 grant from National Institutes of
Health. Major Goals: To provide population-based data on long-term
(15-year) trends in ectopic pregnancy rates within a large U.S. health
maintenance organization via analysis of existing administrative data
sources, including evaluation of inpatient vs. outpatient management and
medical vs. surgical treatment modalities. Principal investigator:
Delia Scholes.
Medical Care Burden of Cancer: System and Data Issues: A
four-year, $417,119 grant from National Cancer Institute. Major Goals: To
estimate costs of cancer care from a managed care perspective. CHS lead
investigator: Paul Fishman.
Step Up Wellness Program for Depression, Physical Inactivity, and
Smoking: A three-year, $631,800 grant from National Institute of
Mental Health. Major Goals: In this pilot study we will design and evaluate
a treatment program to address depression, physical activity level, and
smoking simultaneously. This work will provide valuable information about
the feasibility, acceptability, and impact of this comprehensive treatment
approach and will lay the ground work for future research in this area.
Principal investigator: Jennifer McClure.
Systems of Support (SOS) to Increase Colon Cancer Screening and
Follow-Up: A five-year, $4,214,309 grant from National Cancer
Institute. Major Goals: 1) To increase rates of colon cancer screening in
adults age 50-79; and 2) to increase rates of follow-up for abnormal tests
in those screened. Principal investigator:
Bev Green.
Cancer Research Network (CRN) across Health Care Systems—Cores 2
and 3: Two five-year, $400,000 grants from the National Cancer
Institute. Principal investigator: Ed
Wagner.
- Core 2 Major Goals: To estimate cancer-related
costs among aged Medicare HMO beneficiaries omitted from coverage due to
the exclusion of outpatient medication use/cost from SEER-Medicare data,
using data from four study sites—Group Health, Henry Ford Health System,
Kaiser Permanente Colorado, and Kaiser Permanente Northwest. To test the
hypothesis that SEER-Medicare data undercount the full economic burden of
U.S. cancer care because of lack of complete coverage of outpatient
prescribed medications for aged Medicare beneficiaries. To develop
reusable infrastructure that will enhance the CRN Virtual Data Warehouse
for other uses, including efforts focused on diffusion of pharmacotherapy
among cancer patients.
- Core 3 Major Goals: To use the Prevention Index
(PI) methodology and the CRN Virtual Data Warehouse to develop and apply
Cancer Prevention Indices (CPI) to assess the quality of primary,
secondary, and tertiary preventive care for cancer. To identify
retrospectively the variation in CPI scores across clinics and clinical
practices and determine the association of these variations to selected
event rates several years later. To help determine the association of
clinician adherence to guidelines to subsequent events among their
patients. To analyze performance scores for primary care practices in each
health care system and provide personalized feedback on performance
variation at the system, clinic, and clinician levels to system and clinic
managers. To determine if such feedback leads to changes in care delivery
and reductions in performance problems and determine the persistence of
intervention effects in the involved systems and assess the degree to
which the methods have been adopted. To provide assistance and
consultation to systems that would like to use this methodology to monitor
future quality of care.
Cancer Research Network (CRN) across Health Care Systems—Project
4 (Health Literacy): A five-year, $2,226,639 grant from the
National Cancer Institute. Major Goals: To develop a test to assess
comprehension of oral (i.e., spoken) messages about cancer prevention and
screening, to examine the relationship between health literacy and cancer
prevention, and to test whether modifications to oral messages can improve
comprehension. To will lay the foundation for future research into the
prevalence of inadequate oral health literacy; identification of groups and
individuals with inadequate comprehension skills; identification of risk
factors and causes of limited comprehension; and development and evaluation
of interventions to improve comprehension of orally transmitted messages. To
use quantitative and qualitative methods to identify the factors that affect
comprehensibility of oral messages about cancer prevention and screening. To
develop recommendations for modifying oral messages so they are easily
comprehensible. To test the impact of specific enhancements in a randomized
experiment. Principal investigator: Ed
Wagner.
Design and Inference for Hybrid Ecological Studies: A
three-year, $563,353 grant from the National Institutes of Health. Major
Goals: Development of statistical methods for the combination of ecological
and case-control data. Extending commonly used designs that combine various
sources of information to the ecological setting. Development of strategies
for optimal design. Principal investigator:
Sebastien Haneuse.
Top
People and Programs
Two Group Health physician researchers elected to the Institute
of Medicine
Two leaders from the CHS—Drs. Eric B. Larson and Ed Wagner—have been
elected to
The Institute of Medicine (IOM), one of the nation’s top honors in
medicine.
Larson is executive
director of the CHS and a scientist well known for his research on
Alzheimer’s disease and healthy aging.
Wagner is director of
Group Health’s MacColl Institute for Health Care Innovation, which is part
of the CHS, and served as the CHS’ founding director from 1983 to 1995. He
is recognized internationally for his development of the
Chronic Care Model.
The IOM is part of the
National Academy of Sciences and a national resource for independent,
scientific analysis and recommendations on health issues. IOM members
advise the federal government on issues involving medical care, research,
and education. The IOM announced the names of 65 new members on Monday,
including Larson and Wagner, raising its total active membership to 1,538.
(See news
release for more information.)
Dr. Ed Wagner receives Picker Award for Excellence
Dr. Ed Wagner, director of
the
MacColl Institute for Healthcare Innovation at Group Health Cooperative,
is this year’s individual winner of the Picker Award for Excellence® in the
Advancement of Patient-Centered Care.
The Picker Institute is honoring Dr. Wagner for advocating that health
care be delivered to chronically ill patients in ways that respect patients’
values, preferences, and perspectives.
(See news
release for more information.)
Grossman wins Native American Child Health Advocacy Award
CHS Senior Investigator and Medical Director of Group Health’s Preventive
Care Department,
David Grossman, MD, MPH,
won the 2007 Native American Child Health
Advocacy Award. He received the award at the national meeting of
the American Academy of Pediatrics
(AAP) in San Francisco in October 2007. The AAP Committee on Native American
Child Health confers the award yearly to recognize significant contributions
to Native American children's health. Grossman has authored many
peer-reviewed publications related to American Indian and Alaska Native
child health.
Arterburn helped develop award-winning patient decision aids
David Arterburn, MD, MPH, a CHS assistant investigator, serves as medical
editor for the
Foundation for Informed Medical Decision Making. He helped the
Foundation to develop a DVD called "Weight Loss Surgery: Is It Right for
You?" to assure that patients understand their choices about weight loss
(bariatric) surgery. The DVD recently won two awards: a Chris Award bronze
plaque from the Film Council of Greater Columbus; and a National Health
Information Award merit award for patient education information. The
Foundation is a nonprofit organization dedicated to assuring that people
have the information they need to make sound decisions affecting their
health and well-being. Arterburn recently received a grant from the
Foundation for a randomized trial to evaluate the impact of the same DVD on
patient's knowledge, values, and decisions regarding weight loss surgery.
Cherkin gives NCCAM presentation
CHS Associate Director Dan Cherkin, PhD, was one of three scientists invited
to give a presentation to the September 5, 2007 meeting of the National
Advisory Council of the National Center for
Complementary and Alternative Medicine (NCCAM) in Bethesda, MD. The
audience included the entire NCCAM staff, the NCCAM National Advisory
Council, and the seminar was open to the general public. Cherkin described
the latest findings from his phase III clinical trial of acupuncture for low
back pain, as well as research on the effects of yoga and massage on low
back pain.
CHS research being translated into CME for radiologists
Diana Miglioretti, PhD; Erin Aiello Bowles,
MPH; Andrea Cook, PhD; Linn Abraham, MS; Casey Luce, MSPH; and
Affiliate Investigator Joann Elmore, MD,
MPH, are helping to develop a Web-based continuing medical
education (CME) program called "Enhancing Mammography Interpretation." They
are collaborating on this work with colleagues from the UW, the Universities
of North Carolina and Vermont, Oregon Health & Science University, and
Dartmouth Medical School. Sponsored by the National Cancer Institute (NCI)
and the Agency for Healthcare Research and Quality (AHRQ), the CME will be
taken by radiologists who provide data to mammography registries across the
country as part of the
Breast Cancer Surveillance Consortium. The CME aims to help radiologists
understand: how their mammographic interpretation compares with that of
other radiologists—and with national benchmarks; and how their perception of
patient risk factors, and of the threat of malpractice, may influence their
recall rates and accuracy. The goal of the CME is to help radiologists to
achieve recall rates of 5 percent to 7 percent, while improving the
sensitivity and specificity of their interpretation.
New faculty members join the CHS
- Center for Community Health and Evaluation (CCHE)
Director
Bill Beery, MPH joined
the CHS faculty in August 2007. His work involves evaluating
community-based health promotion and prevention programs for low-income
and high-risk populations. Beery has worked at Group Health since 1985,
including directing Group Health's Disease Prevention and Community
Services as well as the Center for Health Promotion. An affiliate
professor at the UW School of Public Health and Community Medicine, he has
also worked in health programming and evaluation in Africa and Asia.
-
Sascha Dublin, MD, PhD
started in September 2007 as a CHS assistant investigator. She brings to
the CHS a prestigious Beeson
Award for research in aging—as well as experience with refining the
Adult Changes in Thought (ACT) database to improve ways of accounting for
the effects of comorbidities. Her main research interest is in drug safety
in the elderly.
-
Jessica Chubak, PhD
started in October 2007 as a CHS assistant investigator in translational
research with an emphasis in epidemiological methods. She recently
completed her doctorate in epidemiology at UW, conducting her dissertation
research on antidepressant use and breast cancer recurrence at the CHS.
She received much of her pre-doctoral training at Fred Hutchinson Cancer
Research Center on studies of cancer etiology and prevention.
-
Rod Walker, MS started
as a CHS biostatistician in October 2007. For the past two years, while
earning his MS in biostatistics at the UW, he served as a research
assistant/student intern at the CHS, working on the Statistical
Coordinating Center (SCC) of the Breast Cancer Surveillance Consortium (BCSC).
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