Dartmouth's Population-based Research Optimizing Screening through Personalized Regimens Breast Cancer Screening Center was founded by researchers at the Norris Cotton Cancer Center, The Dartmouth Institute for Health Policy and Clinical Practice and Brigham and Women's Hospital, an affiliate of Harvard Medical School, according to a DHMC press release.
While DHMC works "more with the data," the hospital's two partners provide the majority of clinical research, community and family medicine professor Tracy Onega said.
The project's primary goal is to gather more information about what types of breast cancer screenings are best for individual women, according to Tosteson, who is also a researcher at TDI.
"We're trying to find the best way to have the most women screened appropriately," she said. "We're looking for information for providers and women. We want to promote the right test at the right time for each woman."
Tosteson and Onega, who also leads the project, said they previously worked with the New Hampshire Mammography Network, a statewide network that relies on female patients and doctors to submit data regarding mammograms. Tosteson said the data from the network was extremely limited, however.
"It tells you a lot about effectiveness of mammograms, but not about personalized regiments," Tosteson said. "PROSPR is about tailoring preventive care to individual women."
Several years ago, Onega and her colleagues began brainstorming innovative ways to gather more diverse and comprehensive data regarding preventive care for breast cancer, she said.
"Information technology has really been a recent focus," Onega said. "I've worked in mammography data collection from patients and clerks, but we recognized this is not the way to do it."
Research focusing on the meaningful use of electronic health care records is extremely timely given the state of the health care field, according to Tosteson.
"Health care for performance is one of the things that's tracked for preventive care and that's being looked at now by Medicare as a quality marker," she said.
One of the researchers' goals is to focus on health care in the "delivery-based area," Onega said.
"We want to further or promote the use of IT tools that are coming down the pipe, to try to think forwardly and to harness them to work to patient benefits and provider benefits," Onega said.
Tosteson said she does not expect the researchers' findings to contradict general norms of preventive care.
"I think a lot of good care is happening now, but I hope we'll find ways to improve it," Tosteson said. "I don't think there are very glaring gaps, but there are quite a few women who don't get screened in a timely way."
The researches hope to identify different treatments for women depending on their risk factors, Onega said.
"At the basic level, we'd rather get away from using a $5,000 MRI for low and medium-risk women," Onega said. "As expensive technologies are more and more disseminated, we want to make sure they're used judiciously."
Tosteson said she expects to share PROSPR's research results with a national audience within a year.
"I think the first year is going to be kind of slow, because the mechanism and infrastructure has to be put in place in a systematic way," she said. "There's quite a bit of start-up work."
The "major thrust" of the research, though, will come in the later portion of the five years, Onega said.
"The second year is when we'll be more mature in terms of the data and analytics," she said.
The grant, announced at the end of August, arrived "just in time" for October, which is national Breast Cancer Awareness Month, Tosteson said.
The funding is the maximum amount that DHMC was eligible to receive from NCI, which capped the grant at $1.5 million per year, Onega said.
While the NCI funding will cover most of the initial costs, Tosteson said she anticipates some "spin-off projects down the road" for which she and her fellow researchers will seek separate funding sources.
Two other health care provider centers located at the University of Pennsylvania and the University of Vermont also received NIC funding, Tosteson said.
"We're one of three different breast screening centers in the country funded by NCI, and we're all going to be sharing data across centers and doing some comparative studies, taking advantage of some of the differences in how breast cancer screening is done across the country and within our own institution," she said.
The application process for the grant which opened in November 2010 concluded in February, Tosteson said.
"The actual structure of the application was not known and it was a short time to put together what was really a complex application because we had to have a center organized about a screening unit," she said.
The researchers also had to collaborate on various research projects and integrate them thematically with each other as part of the grant application process, according to Tosteson.
"So to put that together in a short period of time was challenging and we were very fortunate to be successful in doing that," she said.
Jennifer Haas, a professor of Medicine at Brigham and Women's Hospital and Harvard Medical School, is the third collaborator on the project, according to the DHMC release.
