Why you might consider where you are treated

Well at least someone is looking at the numbers. If there were data banks for those under medicare age i wonder what they would look like? I mean numbers that are out there do seem to indicate you have a much better chance if you choose an institution that see's a lot of bladder cancer......rather than trust your operation to the local uro who may do 2 neobladders a year. Germany and the UK now referring all bladder cancer patients to larger institutions as their numbers are lousy for blc.
Anyway appreciate your input.
Pat

Thanks, Pat.

So looking at the SEER data base the authors used for their study we realize the population studied was Medicare patients. The link you provided had words to the effect and I quote, "Overview of the SEER-Medicare data: Content, research applications, and generalizability to the United States elderly population". The key word being elderly. If I read the abstract correctly, the data base pretains to the elderly population. Not that this is not of importance in of itself, i.e. health care for the elderly (especially, since I am a member of that population of interest!! ) but to generalize to the population as a whole is misleading. There are bound to be some built in bias in treatment of this population, i.e. treatment of a 90 year old is different than that of a 65 year old. I received a neobladder at age 65, not so sure I would have at age 90. I will attempt to follow up on this observation with the authors of the study. If I am wrong on this point I will certainly report it to the forum. However, the abstract's statement, "An explicit review of claims data indicated that between 31.6% and 46.8% of the 6326 bladder cancer deaths identified in the SEER-Medicare data potentially were avoidable" would seem to support my obseration.

I certainly do not mean to criticize your posting of the study. And I don't want to make a big deal of this. I would just like to remind us all of the "generalizablilty" of some of the research findings we run across.
We have to be careful re: the "research conclusions" and general applications.

Thank you for your efforts on our behalf. Keep those research studies coming. I will certainly keep reading them.

Gordon

I was going to suggest the same thing as Jack...sometimes there is an email link associated with these but not always. About SEER
Surveillance, Epidemiology and End Results (SEER)
cat.inist.fr/?aModele=afficheN&cpsidt=13834547
Here's Weizers contact info...maybe call his number?

www2.med.umich.edu/healthcenters/provider_profile.cfm?individual_id=123286
Pat

Hi Jack,

I'll give it a try.

Thank you.

Gordon

Hi, Gordon
I have asked for a few original studies that were done at the Princess Margaret Hospital in Toronto Canada. I had to email the Department of Urology and they would email the original studies on PDF, usually several pages long.
I think if you emailed University of Michigan, Urology Department, they would send the report to you. Just an idea.
Jack

Pat:

I've surfed the UroToday web site and don't seem to be able to see a link to the orignal study. Can you help in this regard? Am I just not seeing the link? This abstract has a distressing conclusion and as an academic who has a background in statistics I would like to study the orignal research report. I would be interested in more information on the study population, i.e. the difference between "institutional (n = 126 patients) and administrative (n = 6326 patients) data sources". In particular does the n to which they refer represent the sample size or the population? Can the conclusions they draw be infered to the health care of the US popluation in general or just to the specific populations from which they drew the samples?

The interesting study would be of the "potentially avoidable deaths from bladder cancer" group that they discovered, i.e. geographic location, types of MD's, clinics versus individual practice, involvement of bladder cancer with other types of cancer, etc. For all we know they may have all occured in a specific well known clinic.

With the generalized conclusion that they drew it would warrant reading the orignal research study.

Thank you for directing our attention to research such as this and for your help. Sorry for such a long post.

Gordon