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HMO Cancer Research Network

Key web links  

Home page:
http://crn.cancer.gov

General description:
http://crn.cancer.gov/about/
http://www.crn.cancer.gov/about/CRN_fact_sheet.pdf

Dataset Summary

The HMO Cancer Research Network (CRN) is a cooperative agreement and nationwide consortium of 14 non-profit research centers based in integrated health care delivery organizations which provide care to nearly 11 million individuals.  As such, the CRN is not a single dataset, but a consortium of integrated health care delivery sites that collect data on a wide range of aspects of cancer care including cancer prevention, early detection, treatment, long-term care, surveillance, and cancer communication and dissemination and implementation research.  One endeavor of the CRN has been to create a Virtual Data Warehouse (VDW), comprising a series of databases at each participating center with a common set of standardized variables.  This allows for the creation of a program at one site to be distributed and run at other sites participating in a particular research project.  Currently, the portfolio of research studies within CRN encompasses cancer control topics spanning from modification of behavioral risk factors such as smoking to cancer care at the end of life.  The CRN research centers are comprised of scientists with expertise in epidemiology, health services, behavioral medicine, and biostatistics, as well as primary and specialty care clinicians.  This environment facilitates a multidisciplinary approach to studying ways to improve cancer care.

Expert comments  

The CRN is not a database but a consortium of integrated health care plans/delivery sites.  Thus, investigators with a research idea must first connect with scientists at a local site and discuss opportunities for collaboration.  Participation from other sites will be facilitated by the local site and/or the lead CRN site at Group Health (more information on this is provided under the section “dataset accessibility”).  Studies may involve as few as one site, or as many as 14 sites.  With every additional site, an investigator needs to take into account costs of a collaborating site PI, analyst and/or study staff.  Individual IRB approvals are needed at each site, though a common IRB process has been developed for data-only studies.

With the availability of the CRN Virtual Data Warehouse (VDW), an investigator can have access to data, including enrollment, utilization, tumor registry and pharmacy.  Full text medical records may also be available.  Data are standardized at each site via the VDW, but the quality and completeness of the data vary by site.

Dataset Details

Dataset owner   

The CRN is not a dataset but a consortium of health plans/delivery sites and their data.  The CRN is funded by the National Cancer Institute.  Each site owns the data.

Study and sample characteristics   

The overall population of the CRN is approximately 11,000,000.  This number includes those with and without cancers.  The population at each site differs in racial and socioeconomic characteristics.  The sites in the CRN are listed at http://crn.cancer.gov/about/participants.html.

Major foci  

Data available for analysis varies among sites.  Key data resources include:

•    Automated medical record data
•    Administrative Data

o    Membership
o    Outside claims
o    Patient scheduling
o    Deaths
o    Cost

•    Automated clinical data

o    Outpatient visits
o    Hospitalizations
o    Emergency room visits
o    Pharmacy
o    Laboratory procedures and results
o    Long-term care
o    Home health care
o    Hospice care
o    Radiology procedures and results
o    Pathology procedures and results
o    Cancer registry

See:https://crn.cancer.gov/resources/#datares

The eight CRN priority research themes include:  Data Resources and Infrastructure; Enhancing Cancer Communication & Decision-making; Health Care Delivery, Quality, Costs, & Outcomes; Health Insurance Benefit Design & Patterns of Care Utilization; Cancer Epidemiology, Prevention, & Health Promotion; Psychosocial Factors & Burden of Cancer; Research Translation & Patterns of Screening, Treatment, & Care; and Building Capacity to Support Emerging Areas of Cancer Control Research.

Papers published  

Click here for a PubMed search for articles using this dataset. 

Examples of papers published using the CRN data may be searched by topic at http://crn.cancer.gov/publications/.

Examples include:

Racial differences in tumor stage and survival for colorectal cancer in an insured population. 
Doubeni CA, Field TS, Buist DS, et al.
Cancer 2007; 109(3):612-20

Effectiveness of the 5-As tobacco cessation treatments in nine HMOs.Quinn VP, Hollis JF, Smith KS, Rigotti NA, Solberg LI, Hu W, Stevens VJ
J Gen Intern Med 2009; 24(2):149-54

Efficacy of breast cancer screening in the community according to risk level.
Elmore JG, Reisch LM, Barton MB, et al.
J Natl Cancer Inst. 2005 Jul 20;97(14):1035-43.

Cervical cancer in women with comprehensive health care access: attributable factors in the screening process.Leyden WA, Manos MM, Geiger AM, Weinmann S, Mouchawar J, Bischoff K, Yood MU, Gilbert J, Taplin SH
J Natl Cancer Inst 2005; 97(9):675-83

Dataset accessibility   

Data are available via an application process and a collaborative process of study design and execution with internal CRN collaborators.  The process of applying to collaborate with CRN investigators is described at:

http://www.crn.cancer.gov/collaboration/

Help Desk  

For additional information about using the CRN, email Martin Brown mbrown@mail.nih.gov.

Get a brief consultation (SGIM members only)

Members of SGIM may request a one-time consulation with an expert in this dataset, for example to explore research ideas or to troubleshoot a problem or vexing question. Please click here for guidelines and the request process.