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Abstract PS1-09: The Feasibility of a Feasibility Study: Using the VDW to Assess the Diffusion of Ovarian Cancer Treatment

Leah Tuzzio, MPH, Group Health Center for Health Studies; Erin J. Aiello Bowles, MPH, Group Health Center for Health Studies; Andrea Altschuler, PhD, Kaiser Permanente Northern California; Andrew E. Williams, PhD, Kaiser Permanente Hawaii; Debra P. Ritzwoller, PhD, Kaiser Permanente Colorado; Larissa Nekhlyudov, MD, MPH, Harvard Pilgrim Health Care

Abstract

Background: The Virtual Data Warehouse (VDW) has potential for studying diffusion of proven cancer treatments within the Cancer Research Network (CRN). Assessing the feasibility of VDW diffusion studies is important in guiding the development and conduct of future studies. The purpose of this study was to assess the feasibility of a low-budget, multi-site CRN feasibility study using the VDW to evaluate the diffusion of intraperitoneal chemotherapy among women with ovarian cancer.

Methods: Using an online open-ended survey, project staff answered eight questions about the issues and challenges they experienced in conducting the study, including VDW-related data pulls and medical chart abstractions. For each question, we asked whether and how they resolved these challenges.

Results: We received responses from staff at all eight sites (n=19). Having one macro VDW program developed at one site and run at the other sites was recognized as an efficient process. Issues related to the VDW included site-specific homegrown codes, limited data sources, and source data values. Some sites did not have VDW formatted data. Concerns related to the chart abstraction included the lack of a separate instruction guide and having numerous site specific data sources. Insufficient funding was cited often and some sites overspent their budgeted allowance (mostly for chart abstraction). The responses included issues related to the scientific aspects of the study that the respondents felt were not adequately resolved, partly due to lack of regular communication and conference calls. Several respondents commented that the project team did the best they could under the financial and time constraints.

Conclusions: A low-budget, multi-site feasibility study using the VDW may be feasible, but has a number of significant limitations. The utility of the VDW remains variable across sites and data sources are not uniform; the inclusion of chart abstractions for validation required more effort than anticipated; and scarce project team conference calls limited discussion of methodological and scientific aspects of the study. Future VDW studies should carefully assess the data available from automated sources at each participating site, budget sufficient time for medical record abstraction and provide adequate funding for investigators, programmers, and medical record abstractors.