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Using VA administrative data to measure colorectal cancer screening adherence among average-risk non-elderly veterans

机译：使用VA管理数据来衡量中等风险的非老年退伍军人大肠癌筛查依从性

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This study represents a new application of Veterans Affairs (VA) administrative data for measuring VA system-wide performance of colorectal cancer (CRC) screening adherence among veterans at average-risk for CRC. Our new measurement has two features: it is specifically designed for average-risk populations and is applied repeatedly at the veteran level each year over the study period. Using 1997-2007 VA administrative data, we developed an algorithm that first constructed 7 independent cohorts of average-risk veterans eligible for CRC screening, one for each year from 2001 to 2007, and then appended the seven cohorts together to form 2001-2007 veteran-level panel data. Veterans in a cohort for a given year were considered adherent if they received fecal occult blood test (FOBT) during that given year, or received flexible sigmoidoscopy (FS), double-contrast barium enema (DCBE), or colonoscopy during that given year or the 4 previous years. The main analysis shows that VA CRC screening rates increased from 30.11% in 2001 to 35.51% in 2004, but declined to 31.54% in 2007. Among the screened, the proportion adherent to colonoscopy increased over the 7-year period while the proportion adherent to FOBT, FS, or DCBE decreased during the same period. Sensitivity analyses, including use of a 10-year retrospective window for determining the screening adherence of colonoscopy, show the robustness of the main analysis. This new algorithm demonstrates that VA administrative data may be used for assessing VA performance of CRC screening adherence of average-risk veterans. Furthermore, our panel data may enhance understanding of factors associated with CRC screening adherence.
机译：这项研究代表了退伍军人事务（VA）行政数据在测量VA系统范围内结直肠癌（CRC）平均风险的退伍军人中依从性的新应用。我们的新衡量标准具有两个特点：它是专门为中等风险人群设计的，并在研究期间每年在退伍军人级别重复使用。利用1997-2007年的VA行政数据，我们开发了一种算法，该算法首先构建了7个有资格进行CRC筛查的平均高风险退伍军人独立队列，从2001年至2007年每年一次，然后将这7个队列合在一起形成2001-2007年的退伍军人级面板数据。如果在该年中接受排便隐血测试（FOBT）或在该年中接受了柔性乙状结肠镜检查（FS），双对比钡灌肠（DCBE）或结肠镜检查，则该年中同一队列中的退伍军人被认为是依从性的。前四年。主要分析显示，VA CRC筛查率从2001年的30.11％增加到2004年的35.51％，但在2007年下降到31.54％。在筛查的7年期间，结肠镜检查的依从率增加了同期FOBT，FS或DCBE下降。敏感性分析（包括使用10年回顾性窗口来确定结肠镜检查的筛查依从性）显示出主要分析的稳健性。这种新算法表明，VA管理数据可用于评估VA筛查中等风险退伍军人的CRC依从性。此外，我们的面板数据可能会增强对与CRC筛查依从性相关的因素的了解。

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