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Explore the potential and challenges of registry-based research in cancer surveillance and cohort studies. Learn about the Virtual Data Warehouse model and its benefits in facilitating data linkage across state registries. Discover how this resource saves time, improves efficiency, and fosters rigorous scientific research.
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Enhancing Registry-Based Research: A Virtual Pooled Data Resource Dennis Deapen, DrPH NAACCR, Austin, TX June 13, 2013
NAACCR & the National Program of Cancer Registries • Registry environment prior to NAACCR • Unique aspects of NAACCR • Aspirations met and not met • Potential future areas of contribution Don Austin, MD, MPH NAACCR 2012
Some potentials have not yet been reached. • In particular, some of the advantages of “Population Monitoring” • FDA post-marketing surveillance • Occupational hazards • Large cohort research projects
Cancer Surveillance Systems to the Rescue! Central registry-based research should support: • Population-based research • Post marketing surveillance • Rare tumors research • Rare exposure research • Multi-state or national cohort studies
Cancer Surveillance Systems to the Rescue!...Except • Currently, accessing each individual state cancer registry “silos” is: • Costly • Administratively complex • Time consuming We’re the barrier!
Adventist Health Study-2 (NAACCR conference2010) • Nation-wide diet-cancer cohort requires matching with all US cancer registries (16 completed) • Applications 0-28 pages • Average time from submission to completion 5 months (range 3 weeks to 2.6 years) • Cost $0 - $4500
Adventist Health Study-2 • Now 45 states • 8 years • What if they could have linked with 50 states- overnight?!
Cancer Epidemiology Cohorts • National meeting November 2011: Utilizing Data from Cancer Patient & Survivor Studies • >42 active cancer cohort studies identified which could benefit from a pooled linkage resource
Old News: National Death Index • Broad research benefit • Facilitate survival statistics for cancer registries • 1,568 new applications (1982-2008) • Protection of personal data • All states participating
Cancer Registry Linkage Options NDI-style data aggregation model is not appropriate for state cancer registries • Some patients living • Incompatible data release regulations and policies from state to state
Cancer Research Network (CRN) Model • The Virtual Data Warehouse (VDW) • HMO patient data (including living patients) • a distributed data warehouse • standardized linkage datasets • stored behind separate security firewalls at each participating CRN site
Linkage Coordination Center • Define/maintain input file definition • Coordinate with state registries linkage file definition • Evaluate researcher input file • Distribute researcher input file to state registries (automated) • Review state registry nonconfidential linkage result frequency reports
State Cancer Registries • Prepare annual linkage file • Concurrent with other call(s) for data • Cancer registry retains report of potential matches with researcher records • Deidentified potential match frequency report sent to researcher and Linkage Coordinating Center (automated)
State Cancer Registry Data Release • State-by-state basis (at least initially) including cost recovery • Standardized export file • Adjudication of possible matches (to be determined)
Pooled Linkage Resource:Obvious Benefits • Unprecedented resource for cancer research. • Save years of time. • Researcher time • Registry time • More rapid discovery • Save taxpayer dollars. • Allow a more rigorous and comparable scientific research by adopting a standardized methodology. • Allow some registries to participate in research which otherwise lack the resources.
Progress to Date • 7 states volunteered for demonstration project • Adventist Health Study volunteered • Workgroup meeting by phone • Volunteer state IT and directors • IMS, Inc. (SEER/NAACCR funding) • NPCR informatics (Registry Plus)
Progress to Date • Workgroup developing basic tools • Protocol • Data use agreement • Researcher input file specs • Researcher input file edits • Registry file specs • Will schedule first demonstration project linkage after NAACCR meeting
Final Point… • This process would be convenient method for de-duplication of state registries
Many Thanks to Some Terrific Folks! • Nan Stroup & Kim Herget – Utah • Chris Johnson – Idaho • Andy Lake, Dave Annett, Will Howe – IMS • Kathleen Thoburn, Joe Rogers - CDC • Rich Pinder – Los Angeles • Betsy Kohler - NAACCR