Studying Socioeconomic Disparities in Cancer Survival with Tapered Matching
The overall goal of this study is to better understand why breast and colon cancer patients with lower SES in the Medicare system have worse survival and to suggest potential remedies to improve these disparities. This is a retrospective observational study that utilizes secondary data in the SEER-Medicare database for over 250,000 elderly breast and colon cancer patients diagnosed between 1992 and 2010.
Recently Completed Projects
Describing and Understanding Racial Disparities
This project explores “Tapered Multivariate Matching,” a new theory and conceptual framework for examining racial disparities and quality of care. The aims of the study are to apply the tapered multivariate matching framework to breast and colorectal cancer using the national Medicare-SEER database to identify specific aspects of patient care that lead to quality differences by race and to demonstrate how tapered multivariate matching results can be conveyed in a clear and understandable report to policy analysts and the public.
Provider Specialty and Outcomes in Ovarian Cancer
This project studied practice variations and outcomes across specialty type in ovarian cancer. The project used multivariate counter-matching, which allowed for adjustment by factors such as age, comorbidities, disease stage, chemotherapy and provider information when appropriate, utilizing the minimum number of matched pairs needed to detect important differences.
Race, Treatment and Endometrial Cancer Survival
Between 1992 and 1998, five-year survival for African-American women with endometrial cancer was 58.9 percent, compared to 85.8 percent for Caucasian women. Prior studies have identified several factors that contribute to this disparity, including later stage at diagnosis and higher tumor grade. However, significant differences in survival between African-American women persist even after adjusting for these factors. This project explored the contribution of differences in treatment to the higher mortality among African-American women.
An Economic Study of Adverse Events Across Conditions
The aim of this project was to develop a global model to estimate adverse events accounting for the distribution of cancer types. In particular, the relationship between adverse effects such as neutropenia and anemia, chemotherapy usage and cancer types was analyzed though a process of direct standardization. This work allowed for future comparisons across institutions on the management of adverse events given chemotherapy regimen and cancer types.