NCI Grant to Supplement Comparative Effectiveness Research Study of Prostate Cancer Treatment
Bryce Reeve, PhD, associate professor of Health Policy and Management in the Gillings School of Global Public Health and Ronald Chen, MD, MPH, assistant professor of Radiation Oncology in the UNC School of Medicine have been awarded a four-year, $1,124,226 grant by the National Cancer Institute (NCI). This grant supplements a parent study funded by the Agency for Healthcare Research and Quality (AHRQ) to monitor the recovery, mental well-being and quality of life of prostate cancer patients during the two years following treatment. Both researchers are members of UNC Lineberger Comprehensive Cancer Center.
The North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study will survey approximately 1,500 prostate cancer patients with diverse age, ethnic characteristics and educational backgrounds from throughout North Carolina. Using patient-provided data, the study will measure patients’ health-related quality of life before treatment and three, 12 and 24 months after treatment. Men receiving treatment for prostate cancer will report their experiences and perspectives as they relate to physical, mental and social aspects of health and impact of treatments on bowel, urinary, and sexual functioning.
Research indicates that these post-treatment periods are critical for assessing patient-centered outcomes, as many symptoms of physical and psychological distress increase significantly following treatment, and then partially recover within one to two years. The study will use the National Institute of Health’s Patient-Reported Outcomes Measure Information System® (PROMIS®) assessment tools.
The NCI funded study will add critical knowledge about the reliability, validity and responsiveness of the PROMIS measures, including how well the PROMIS measures perform across groups that vary in race/ethnicity, age, and education. The data collected on the PROMIS measures will better inform understanding of how prostate cancer and its treatments impact the lives of men and identify the optimal treatment that will improve the quality and quantity of their lives.
“This study brings two strengths of UNC investigators -- population sciences and quality of life research -- together. The study will make important contributions in assessing the use of this quality of life instrument in cancer patients,” said Chen.
Weinberger commentary examines hospital readmission data for veterans
Morris Weinberger, PhD, has co-authored an editorial commentary, published Dec. 18 in Annals of Internal Medicine, reviewing a study that found decreasing length of stay in veterans' hospitals did not cause a rise in hospital readmissions.
Weinberger is Vergil N. Slee Distinguished Professor of Healthcare Quality Management in the health policy and management department in Gillings School of Global Public Health at The University of North Carolina in Chapel Hill. He also is senior research career scientist at the Center for Health Services Research in Primary Care, at the Veterans Affairs Medical Center (VAMC) in Durham, N.C.
His co-author, Eugene Oddone, MD, MHSc, is professor of medicine at Duke University and director of the VAMC health services research center.
Weinberger and Oddone reviewed research conducted by Peter Kaboli, MD, and colleagues, in the article, "Associations Between Reduced Hospital Length of Stay and 30-Day Readmission Rate and Mortality: 14-Year Experience in 129 Veterans Affairs Hospitals," also published in the Dec. 18 issue of Annals of Internal Medicine.
Kaboli and colleagues examined the relationship between hospital length of stay, hospital readmission rates and mortality for more than four million U.S. veterans over a 14-year period. They showed that over that period, average length of stay decreased by 27 percent, while hospital readmissions within a 30-day period decreased by 25 percent and 90-day mortality rates improved.
In their article, "Hospital Readmission Rates: Are We Measuring the Right Thing?," Weinberger and Oddone ask whether hospital readmission is a quality indicator of successful hospital treatment.
"It's not only quality of care during the index hospitalization or the quality of the handoff to post-discharge care," they write. "Rather many important factors affect when and how often patients are hospitalized, including access to post-discharge care, ability to purchase evidence-based medications or services prescribed at discharge, disease and disease severity, socio-economic status, community resources and social support."
The authors reference their earlier research showing that attempts to improve certain of these factors actually resulted in an increase in re-hospitalizations in veterans' medical centers, but also an increase in patients' satisfaction with their care. The authors suggest that 'preventable' re-hospitalizations might be a better measure of successful treatment, despite that descriptor's being difficult to define.
"Better defining the unique factors that explain hospital readmission, and chipping away at them, must be a goal of effective health-care systems," they write. "Perhaps it is time to embrace the VA as the largest U.S. accountable care organization. Let the VA serve as an example of how to enhance both efficiency (reduced length of stay) and quality (reduced readmission rates and mortality). Understanding the effect of the transformation of the VA health care system provides valuable lessons as hospitals and provider organizations partner to share responsibility for the health of defined populations."
HPM student selected as Corris Boyd Scholar
Mohamed Jalloh, first year master of health administration in health policy and management at UNC Gillings School of Global Public Health, was selected as a 2012 Corris Boyd Scholarship recipient.
The Association of University Programs in Health Administration (AUPHA), in partnership with HCA, established the Corris Boyd Scholarship in 2006 in honor of a healthcare leader who dedicated his life to diversity and excellence in leadership - especially among people of color and women.
The HCA Corris Boyd Scholars Program annually provides two deserving minority students with $20,000 per year towards a master's degree in healthcare management from the AUPHA-member school of their choice.
Jalloh is a graduate of the University of Maryland School of Public Health, where he earned a Bachelor of Science degree in Community Health. "I believe that while this scholarship has been given to me, it is not for me," said Mohamed upon hearing of his selection. "To me, it is an investment in what I can do for everyone else. So, on behalf of all my peers, and to those I'll help in the future, I say thank you so very much."
The program was established in 2006 in honor of Corris Boyd, a senior healthcare executive with HealthTrust Purchasing Group and HCA. Mr. Boyd was dedicated to increasing diversity and a proponent of excellence in leadership. He died in 2005.