Carrie N Klabunde
Datos Biográficos
| ID | 5534359 |
|---|---|
| NOMBRE | Carrie N Klabunde |
| NOMBRES | Carrie N |
| APELLIDO | Klabunde |
| FIRMA | KLABUNDE C N |
| AFILIACIONES | National Cancer Institute |
| VERIFICADO | No |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAS | 0 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1998 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2023 |
| ÍNDICE H | 0 |
Investment in Prevention Health Care Delivery Research by the National Institutes of Health
BACKGROUND: Research assessing the delivery of preventive health care has considerable potential for improving health outcomes and reducing health care costs for the United States population. OBJECTIVE: To characterize the prevention health care delivery research grant portfolio supported by the National Institutes of Health (NIH). MATERIALS AND METHODS: A random sample of 14,523 NIH research projects funded during 2012-2019 was selected and code…
National Institutes of Health Advancing Multimorbidity Research
BACKGROUND: Multimorbidity, the co-occurrence of 2 or more chronic diseases, is more common than having a single chronic disease, especially among persons age 65 years and older. The routine measurement of multimorbidity can facilitate a better understanding of potential causes and interactions and promote more effective treatment and improved outcomes. OBJECTIVES: To present a multimorbidity research framework and identify gaps in the research l…
Measuring Multimorbidity
BACKGROUND: Adults have a higher prevalence of multimorbidity-or having multiple chronic health conditions-than having a single condition in isolation. Researchers, health care providers, and health policymakers find it challenging to decide upon the most appropriate assessment tool from the many available multimorbidity measures. OBJECTIVE: The objective of this study was to describe a broad range of instruments and data sources available to ass…
Physicians’ Beliefs About Breast Cancer Surveillance Testing are Consistent With Test Overuse
BACKGROUND: Overuse of surveillance testing for breast cancer survivors is an important problem but its extent and determinants are incompletely understood. The objectives of this study were to determine the extent to which physicians' breast cancer surveillance testing beliefs are consistent with test overuse, and to identify factors associated with these beliefs. METHODS: During 2009-2010, a cross-sectional survey of US medical oncologists and …
Multiple Clinical Practice Guidelines for Breast and Cervical Cancer Screening
BACKGROUND: Multiple clinical practice guidelines exist for breast and cervical cancer screening, and differ in aggressiveness with respect to the recommended frequency and target populations for screening. OBJECTIVES: To determine (1) US primary care physicians' (PCPs) perceptions of the influence of different clinical practice guidelines; (2) the relationship between the number, aggressiveness, and agreement of influential guidelines and the ag…
The Contribution of Longitudinal Comorbidity Measurements to Survival Analysis
BACKGROUND: Many clinical and health services research studies are longitudinal, raising questions about how best to use an individual's comorbidity measurements over time to predict survival. OBJECTIVES: To evaluate the performance of different approaches to longitudinal comorbidity measurement in predicting survival, and to examine strategies for addressing the inevitable issue of missing data. RESEARCH DESIGN: Retrospective cohort study using …
Improving Colorectal Cancer Screening Through Research in Primary Care Settings
Klabunde, Carrie N. PhD; Lanier, David MD; Meissner, Helen I. PhD; Breslau, Erica S. PhD; Brown, Martin L. PhD Author Information
Comparison of Cancer Diagnosis and Treatment in Medicare Fee-for-Service and Managed Care Plans
OBJECTIVE: To compare the Medicare managed care (MC) and fee-for-service (FFS) sectors on stage at diagnosis and treatment patterns for prostate, female breast, and colorectal cancers, and to examine patterns across MC plans. DATA: Surveillance, Epidemiology, and End Results-Medicare linked data. METHODS: Among cases diagnosed at ages 65-79 between 1998 and 2002, we selected all MC enrollees (n = 42,467) and beneficiaries in FFS (n = 82,998) who …
Data Systems to Evaluate Colorectal Cancer Screening Practices and Outcomes at the Population Level
Carney, Patricia A. PhD; Hoffman, Richard M. MD; Lieberman, David A. MD; Hornbrook, Mark C. PhD; Dietrich, Allen J. MD; Klabunde, Carrie N. PhD Author Information
Response to Letter from Dr. Steven T. Fleming
Data Sources for Measuring Comorbidity
BACKGROUND: Identifying appropriate comorbidity data sources is a key consideration in health services and outcomes research. OBJECTIVE: Using cancer patients as an example, we compared comorbid conditions identified: 1) on the discharge facesheet versus full hospital medical record and 2) in the hospital record versus Medicare claims, both precancer diagnosis and associated with a cancer treatment-related index hospitalization. METHODS: We used …
In Search of the Perfect Comorbidity Measure for Use With Administrative Claims Data
BACKGROUND: Numerous measures of comorbidity have been developed for health services research with administrative claims. OBJECTIVE: We sought to compare the performance of 4 claims-based comorbidity measures. RESEARCH DESIGN AND SUBJECTS: We undertook a retrospective cohort study of 5777 Medicare beneficiaries ages 66 and older with stage III colon cancer reported to the Surveillance, Epidemiology, and End Results Program between January 1, 1992…
Barriers to Colorectal Cancer Screening
BACKGROUND: Barriers to colorectal cancer (CRC) screening are not well understood. OBJECTIVES: We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a major barrier to CRC screening. RESEARCH DESIGN: This was a comparative study using data from the 1999-2000 Survey of Colorectal Ca…
Do Patients Consistently Report Comorbid Conditions Over Time
BACKGROUND: Comorbidity is an important dimension of patient health status. However, limited attention has been given to assessing the reliability of patient-reported data on comorbid conditions. OBJECTIVES: We sought to evaluate the consistency of self-report of 12 comorbid conditions at 3 distinct time points and examine the sociodemographic, clinical, health status, and survey factors associated with reliability. STUDY DESIGN: We undertook a l…
Race/Ethnicity and the Intensity of Medical Monitoring Under ‘Watchful Waiting’ for Prostate Cancer
BACKGROUND: Previous studies have found that racial/ethnic minority patients with prostate cancer are more frequently managed with "watchful waiting." Little, however, is known about the medical care received among men managed with watchful waiting. We examine the type and intensity of medical monitoring received by African American, Hispanic, and white patients with prostate cancer managed with "watchful waiting" in fee-for-service systems. METH…
Assessing Comorbidity Using Claims Data
Comorbidity, additional disease beyond the condition under study that increases a patient's total burden of illness, is one dimension of health status. For investigators working with observational data obtained from administrative databases, comorbidity assessment may be a useful and important means of accounting for differences in patients' underlying health status. There are multiple ways of measuring comorbidity. This paper provides an overvie…
Overview of the Seer-Medicare Data
Background. The Surveillance, Epidemiology and End Results (SEER)-Medicare–linked database combines clinical information from population-based cancer registries with claims information from the Medicare program. The use of this database to study cancer screening, treatment, outcomes, and costs has grown in recent years. Research Design. This paper provides an overview of the SEER-Medicare files for investigators interested in using these data for…
Linking Physician Characteristics and Medicare Claims Data
BACKGROUND: Increasingly, investigators are using administrative databases to answer research questions requiring physician characteristics information. This article provides a roadmap for investigators who use Medicare data to answer such questions, focusing on use of the Surveillance, Epidemiology, and End Results (SEER)-Medicare files. METHODS: Three data sources that can be linked to identify physician characteristics-Medicare claims, the Uni…
Utility of the Seer-Medicare Data to Identify Chemotherapy Use
Background. Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. Objectives. This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. Methods. Persons with breast, colorectal, and …
Studying Radiation Therapy Using Seer-Medicare-Linked Data
BACKGROUND: Numerous studies have used the SEER or Medicare data to assess the use of radiation therapy. However, the completeness of these data has not been evaluated. METHODS: Using linked SEER-Medicare data, a cohort was created that included incident cases of breast, endometrial, lung, prostate, or rectal cancer from 1991 to 1996 in persons 65 years and older. For each of these cases, use of radiation therapy as an initial course of treatment…
Use of Seer-Medicare Data for Measuring Cancer Surgery
BACKGROUND: The accuracy and completeness of the SEER-Medicare data for measuring cancer-related therapy have not been extensively evaluated. OBJECTIVES: To investigate the best method for measuring cancer-related surgery among patients in the SEER-Medicare database. SUBJECTS: A total of 149,970 incident cases of breast, colorectal, endometrial, lung, pancreatic, and prostate cancer diagnosed between 1991 and 1993.MEASURES The most invasive surgi…
Measuring Breast, Colorectal, and Prostate Cancer Screening With Medicare Claims Data
BACKGROUND: Evaluating the use and effectiveness of cancer screening is an important component of cancer control programs. Medicare claims may be a useful source of data when screening older populations, but they are limited in terms of completeness and the ability to distinguish screening tests from those provided for diagnosis or surveillance. RESEARCH DESIGN: A review of the major screening modalities for breast, colorectal, and prostate cance…
Measuring Complications of Cancer Treatment Using the Seer-Medicare Data
BACKGROUND: The linkage of SEER registry data with Medicare claims allows the longitudinal tracking of health care and outcomes for patients after a cancer diagnosis. One category of outcomes amenable to research using Medicare claims is complications of cancer treatments: the unintentional, adverse side effects or sequelae of interventions used to treat or palliate cancer patients. RESEARCH DESIGN: The authors review some of the methods and limi…
Development of a comorbidity index using physician claims data
Trends and Black/White Differences in Treatment for Nonmetastatic Prostate Cancer
OBJECTIVES: Controversy and uncertainty surround use of radical prostatectomy, radiation therapy, and conservative symptomatic management in treating elderly men with nonmetastatic prostate cancer. Prior studies have demonstrated variations in use of these therapies by patient age, race, and geographic region. This study examined trends in treatment for nonmetastatic prostate cancer in black and white men aged 65 and older during the period 1986 …
Sin obras prominentes en esta página.
Trends and Black/White Differences in Treatment for Nonmetastatic Prostate Cancer
OBJECTIVES: Controversy and uncertainty surround use of radical prostatectomy, radiation therapy, and conservative symptomatic management in treating elderly men with nonmetastatic prostate cancer. Prior studies have demonstrated variations in use of these therapies by patient age, race, and geographic region. This study examined trends in treatment for nonmetastatic prostate cancer in black and white men aged 65 and older during the period 1986 …
Development of a comorbidity index using physician claims data
Assessing Comorbidity Using Claims Data
Comorbidity, additional disease beyond the condition under study that increases a patient's total burden of illness, is one dimension of health status. For investigators working with observational data obtained from administrative databases, comorbidity assessment may be a useful and important means of accounting for differences in patients' underlying health status. There are multiple ways of measuring comorbidity. This paper provides an overvie…
Overview of the Seer-Medicare Data
Background. The Surveillance, Epidemiology and End Results (SEER)-Medicare–linked database combines clinical information from population-based cancer registries with claims information from the Medicare program. The use of this database to study cancer screening, treatment, outcomes, and costs has grown in recent years. Research Design. This paper provides an overview of the SEER-Medicare files for investigators interested in using these data for…
Linking Physician Characteristics and Medicare Claims Data
BACKGROUND: Increasingly, investigators are using administrative databases to answer research questions requiring physician characteristics information. This article provides a roadmap for investigators who use Medicare data to answer such questions, focusing on use of the Surveillance, Epidemiology, and End Results (SEER)-Medicare files. METHODS: Three data sources that can be linked to identify physician characteristics-Medicare claims, the Uni…
Utility of the Seer-Medicare Data to Identify Chemotherapy Use
Background. Medicare claims include codes for chemotherapy administration and specific drugs given, and researchers are increasingly using these data to measure the use of chemotherapy. However, the validity and completeness of these data as a source of information has not been established. Objectives. This analysis is intended to assess the utility of the Medicare claims to capture chemotherapy use. Methods. Persons with breast, colorectal, and …
Studying Radiation Therapy Using Seer-Medicare-Linked Data
BACKGROUND: Numerous studies have used the SEER or Medicare data to assess the use of radiation therapy. However, the completeness of these data has not been evaluated. METHODS: Using linked SEER-Medicare data, a cohort was created that included incident cases of breast, endometrial, lung, prostate, or rectal cancer from 1991 to 1996 in persons 65 years and older. For each of these cases, use of radiation therapy as an initial course of treatment…
Use of Seer-Medicare Data for Measuring Cancer Surgery
BACKGROUND: The accuracy and completeness of the SEER-Medicare data for measuring cancer-related therapy have not been extensively evaluated. OBJECTIVES: To investigate the best method for measuring cancer-related surgery among patients in the SEER-Medicare database. SUBJECTS: A total of 149,970 incident cases of breast, colorectal, endometrial, lung, pancreatic, and prostate cancer diagnosed between 1991 and 1993.MEASURES The most invasive surgi…
Measuring Breast, Colorectal, and Prostate Cancer Screening With Medicare Claims Data
BACKGROUND: Evaluating the use and effectiveness of cancer screening is an important component of cancer control programs. Medicare claims may be a useful source of data when screening older populations, but they are limited in terms of completeness and the ability to distinguish screening tests from those provided for diagnosis or surveillance. RESEARCH DESIGN: A review of the major screening modalities for breast, colorectal, and prostate cance…
Measuring Complications of Cancer Treatment Using the Seer-Medicare Data
BACKGROUND: The linkage of SEER registry data with Medicare claims allows the longitudinal tracking of health care and outcomes for patients after a cancer diagnosis. One category of outcomes amenable to research using Medicare claims is complications of cancer treatments: the unintentional, adverse side effects or sequelae of interventions used to treat or palliate cancer patients. RESEARCH DESIGN: The authors review some of the methods and limi…
Race/Ethnicity and the Intensity of Medical Monitoring Under ‘Watchful Waiting’ for Prostate Cancer
BACKGROUND: Previous studies have found that racial/ethnic minority patients with prostate cancer are more frequently managed with "watchful waiting." Little, however, is known about the medical care received among men managed with watchful waiting. We examine the type and intensity of medical monitoring received by African American, Hispanic, and white patients with prostate cancer managed with "watchful waiting" in fee-for-service systems. METH…
Barriers to Colorectal Cancer Screening
BACKGROUND: Barriers to colorectal cancer (CRC) screening are not well understood. OBJECTIVES: We sought to compare barriers to CRC screening reported by primary care physicians (PCPs) and by average-risk adults, and to examine characteristics of average-risk adults who identified lack of provider recommendation as a major barrier to CRC screening. RESEARCH DESIGN: This was a comparative study using data from the 1999-2000 Survey of Colorectal Ca…
Do Patients Consistently Report Comorbid Conditions Over Time
BACKGROUND: Comorbidity is an important dimension of patient health status. However, limited attention has been given to assessing the reliability of patient-reported data on comorbid conditions. OBJECTIVES: We sought to evaluate the consistency of self-report of 12 comorbid conditions at 3 distinct time points and examine the sociodemographic, clinical, health status, and survey factors associated with reliability. STUDY DESIGN: We undertook a l…
Data Sources for Measuring Comorbidity
BACKGROUND: Identifying appropriate comorbidity data sources is a key consideration in health services and outcomes research. OBJECTIVE: Using cancer patients as an example, we compared comorbid conditions identified: 1) on the discharge facesheet versus full hospital medical record and 2) in the hospital record versus Medicare claims, both precancer diagnosis and associated with a cancer treatment-related index hospitalization. METHODS: We used …
In Search of the Perfect Comorbidity Measure for Use With Administrative Claims Data
BACKGROUND: Numerous measures of comorbidity have been developed for health services research with administrative claims. OBJECTIVE: We sought to compare the performance of 4 claims-based comorbidity measures. RESEARCH DESIGN AND SUBJECTS: We undertook a retrospective cohort study of 5777 Medicare beneficiaries ages 66 and older with stage III colon cancer reported to the Surveillance, Epidemiology, and End Results Program between January 1, 1992…
Response to Letter from Dr. Steven T. Fleming
Improving Colorectal Cancer Screening Through Research in Primary Care Settings
Klabunde, Carrie N. PhD; Lanier, David MD; Meissner, Helen I. PhD; Breslau, Erica S. PhD; Brown, Martin L. PhD Author Information
Comparison of Cancer Diagnosis and Treatment in Medicare Fee-for-Service and Managed Care Plans
OBJECTIVE: To compare the Medicare managed care (MC) and fee-for-service (FFS) sectors on stage at diagnosis and treatment patterns for prostate, female breast, and colorectal cancers, and to examine patterns across MC plans. DATA: Surveillance, Epidemiology, and End Results-Medicare linked data. METHODS: Among cases diagnosed at ages 65-79 between 1998 and 2002, we selected all MC enrollees (n = 42,467) and beneficiaries in FFS (n = 82,998) who …
Data Systems to Evaluate Colorectal Cancer Screening Practices and Outcomes at the Population Level
Carney, Patricia A. PhD; Hoffman, Richard M. MD; Lieberman, David A. MD; Hornbrook, Mark C. PhD; Dietrich, Allen J. MD; Klabunde, Carrie N. PhD Author Information
The Contribution of Longitudinal Comorbidity Measurements to Survival Analysis
BACKGROUND: Many clinical and health services research studies are longitudinal, raising questions about how best to use an individual's comorbidity measurements over time to predict survival. OBJECTIVES: To evaluate the performance of different approaches to longitudinal comorbidity measurement in predicting survival, and to examine strategies for addressing the inevitable issue of missing data. RESEARCH DESIGN: Retrospective cohort study using …
Multiple Clinical Practice Guidelines for Breast and Cervical Cancer Screening
BACKGROUND: Multiple clinical practice guidelines exist for breast and cervical cancer screening, and differ in aggressiveness with respect to the recommended frequency and target populations for screening. OBJECTIVES: To determine (1) US primary care physicians' (PCPs) perceptions of the influence of different clinical practice guidelines; (2) the relationship between the number, aggressiveness, and agreement of influential guidelines and the ag…
Physicians’ Beliefs About Breast Cancer Surveillance Testing are Consistent With Test Overuse
BACKGROUND: Overuse of surveillance testing for breast cancer survivors is an important problem but its extent and determinants are incompletely understood. The objectives of this study were to determine the extent to which physicians' breast cancer surveillance testing beliefs are consistent with test overuse, and to identify factors associated with these beliefs. METHODS: During 2009-2010, a cross-sectional survey of US medical oncologists and …
National Institutes of Health Advancing Multimorbidity Research
BACKGROUND: Multimorbidity, the co-occurrence of 2 or more chronic diseases, is more common than having a single chronic disease, especially among persons age 65 years and older. The routine measurement of multimorbidity can facilitate a better understanding of potential causes and interactions and promote more effective treatment and improved outcomes. OBJECTIVES: To present a multimorbidity research framework and identify gaps in the research l…
Measuring Multimorbidity
BACKGROUND: Adults have a higher prevalence of multimorbidity-or having multiple chronic health conditions-than having a single condition in isolation. Researchers, health care providers, and health policymakers find it challenging to decide upon the most appropriate assessment tool from the many available multimorbidity measures. OBJECTIVE: The objective of this study was to describe a broad range of instruments and data sources available to ass…
Investment in Prevention Health Care Delivery Research by the National Institutes of Health
BACKGROUND: Research assessing the delivery of preventive health care has considerable potential for improving health outcomes and reducing health care costs for the United States population. OBJECTIVE: To characterize the prevention health care delivery research grant portfolio supported by the National Institutes of Health (NIH). MATERIALS AND METHODS: A random sample of 14,523 NIH research projects funded during 2012-2019 was selected and code…
Medicine (23 obras) · Internal Medicine (19 obras) · Internal Medicine (18 obras) · Cancer (13 obras) · MEDLINE (13 obras) · Family medicine (12 obras) · Global Cancer Incidence and Screening (12 obras) · Primary Care and Health Outcomes (8 obras) · Chronic Disease Management Strategies (7 obras) · Breast cancer (6 obras)