ROUND ONE OF CRN
PILOT FUND PROJECTS -- PROGRESS REPORT

In Round 1 of the CRN Pilot Fund call for proposals, four projects were awarded funding. The following is an update by the Principal Investigator on the progress of these projects .

“Accuracy of Automated Data on Colorectal Cancer Screening Exams,” PI - Reina Haque (KPSC)
This project was approved by the IRB and commenced March 1, 2003. We developed two computerized algorithms designed to distinguish between screening and diagnostic endoscopy (sigmoidoscopy and colonoscopy) tests using automated databases and determined the ability of the algorithms to correctly classify tests using patient charts as the gold standard. Data collection and data editing are complete. We have submitted a manuscript for consideration in the JNCI Monograph.

“Investigation of Age-Specific Differences and Cancer of the Cecal Colon,” PI - Steven Dudas (HFHS)
In addition to CRN pilot funds, this project has been awarded an R03 from the National Institute on Aging. The focus of the R03 is on determining age related differences in tumors of the sigmoid region of the colon verses the cecal region. And in addition, the object of the R03 is to examine markers of microsatellite instability (MSI) in these tumors as well as markers for oxidative stress and apoptosis. We are proceeding with the immunohistochemical staining, conducting staining for each single marker across all samples at a time. Initial staining is evaluating MSI markers, MLH1 and PMS2.

We anticipate that all work will be done for a June submission date for the R01.

“Do Acute and Chronic Illnesses Trump Preventative Care,” PI - Michael VonKorff/Josh Fenton (GHC)
The project remains in the data collection phase. There are some exciting pilot results from an analogous analysis among a large group of patients with diabetes at Group Health Cooperative. We found that patients with diabetes who had a pattern of predominantly lower-priority outpatient service use were at disproportionate risk of not receiving timely diabetes-related preventive services, such as hemoglobin A1C testing, retinal screening, and microalbuminuria screening. We hypothesize that we will see similar relationships among a general population that is eligible for cancer screening.

“Race/Ethnic Disparities in Lung Cancer: The Role of Comorbidity and Genetic Factors,” PI - C. Martin Tammemagi (HFHS)
We are in the process of developing a HFHS Comorbidity/Symptoms Inventory (C/S Inventory) for investigating the associations between comorbidities/symptoms (ABSMS) and cancer outcomes, including diagnostic intensity, receipt of optimal treatment and survival and evaluating how much race/ethnic disparity in cancer outcomes is explained by comorbidities and symptoms. The findings of our Lung Cancer Comorbidity Study (LCCS) indicate that important associations exist and that adverse comorbidities and symptoms both explain important amounts of race/ethnic disparity

Goals of the pilot study are to determine which ABSMs explain/ predict robustly across cancers and outcomes; do and do not interact with gender and race/ethnicity; and explain most race/ethnic disparity. These determinations should enable the employment in analyses of ABSMs that are more efficient, valid and comparable across cancers and outcomes

We are anticipating a number of publications to result from these efforts and manuscript preparations and submissions are expected to be completed by April 2005. We submitted an R01 on October 1, 2004.

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