Data gaps and opportunities for modeling cancer health equity.

Amy Trentham-Dietz, Douglas A Corley, Natalie J Del Vecchio, Robert T Greenlee, Jennifer S Haas, Rebecca A Hubbard, Amy E Hughes, Jane J Kim, Sarah Kobrin, Christopher I Li, Rafael Meza, Christine M Neslund-Dudas, Jasmin A Tiro
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Abstract

Population models of cancer reflect the overall US population by drawing on numerous existing data resources for parameter inputs and calibration targets. Models require data inputs that are appropriately representative, collected in a harmonized manner, have minimal missing or inaccurate values, and reflect adequate sample sizes. Data resource priorities for population modeling to support cancer health equity include increasing the availability of data that 1) arise from uninsured and underinsured individuals and those traditionally not included in health-care delivery studies, 2) reflect relevant exposures for groups historically and intentionally excluded across the full cancer control continuum, 3) disaggregate categories (race, ethnicity, socioeconomic status, gender, sexual orientation, etc.) and their intersections that conceal important variation in health outcomes, 4) identify specific populations of interest in clinical databases whose health outcomes have been understudied, 5) enhance health records through expanded data elements and linkage with other data types (eg, patient surveys, provider and/or facility level information, neighborhood data), 6) decrease missing and misclassified data from historically underrecognized populations, and 7) capture potential measures or effects of systemic racism and corresponding intervenable targets for change.

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癌症健康公平建模的数据缺口和机会。
癌症的人口模型通过利用大量现有数据资源进行参数输入和校准目标,反映了美国的总体人口。模型要求数据输入具有适当的代表性,以协调的方式收集,具有最小的缺失或不准确值,并反映足够的样本量。支持癌症健康公平的人口建模的数据资源优先事项包括增加数据的可用性,这些数据1)来自未投保和保险不足的个人以及传统上不包括在医疗保健提供研究中的个人,3)分解类别(种族、民族、社会经济地位、性别、性取向等)及其交叉点,以掩盖健康结果的重要变化,4)在健康结果研究不足的临床数据库中确定感兴趣的特定人群,5)通过扩展数据元素和与其他数据类型(例如,患者调查、提供者和/或设施级别的信息、社区数据)的联系来增强健康记录,6)减少历史上被低估的人群中缺失和错误分类的数据,7)捕捉系统性种族主义的潜在措施或影响以及相应的可干预的变革目标。
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