Anne Nemecek’s research while affiliated with University of Manitoba and other places

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Publications (6)


Mapping the journey of cancer patients through the health care system Part 3: An approach to staging
  • Article
  • Full-text available

February 2005

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45 Reads

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1 Citation

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

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Anne Nemecek

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This is the third in a series of articles relating results from a line of research whose intent was to construct a complete history of patient interactions with the health care system using available data sources for all patients diagnosed in 1990 with a primary breast, colorectal, or lung tumour in Manitoba. This article presents details of the development and application of methods to produce TNM staging data on the roughly 2,000 patients in this population. The operational definitions constructed for this research can be adapted for other tumour sites and data sources. Findings include methods developed to overcome the sometimes ambiguous and inconsistent available documentation, which ultimately produced reliable TNM staging data. Survival data for this population by stage of disease are given.

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Cartographier le cheminement, dans le système de soins, des patients atteints de cancer. Partie III: Une approche de la stadification

January 2005

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17 Reads

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

Il s’agit du troisieme article de recherche d’une serie qui visait a elaborer un historique complet des interactions des patients avec le systeme des soins de sante en utilisant les sources de donnees disponibles pour tous les patients du Manitoba diagnostiques, en 1990, d’une tumeur primitive au sein, au colon-rectum ou au poumon. Cet article fournit des details sur l’elaboration et l’application de methodes en vue de produire les donnees de stadification TNM sur les quelque 2000 patients composant cette population. Les definitions operationnelles crees dans le cadre de cette recherche peuvent etre adaptees a d’autres sieges tumoraux et sources de donnees. Les resultats comprennent notamment les methodes mises au point pour surmonter l’ambiguite et l’incoherence occasionnelles de la documentation disponible et pour produire, en bout de ligne, des donnees de stadification TNM fiables. Les taux de survie de cette population de patients sont fournis en fonction du stade.


Figure 1: Organigramme de construction de l'ensemble de données
Cartographier le cheminement, dans le système de soins, des patients atteints de cancer. Partie II: Approches méthodologiques et résultats de base

October 2004

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112 Reads

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

Il s’agit du deuxième article de recherche d’une série qui visait à élaborer un historique complet des interactions des patients avec le système des soins de santé. Cet article fournit des détails sur les méthodes mises au point pour recueillir et assembler les renseignements épars relatifs à l’historique des interventions (trajectoire) que subit un patient atteint de cancer qui navigue dans le système des soins de santé du Manitoba et ce, à partir d’un an avant le diagnostic jusqu’à deux ans après ce dernier. Les données sur la survie ont été obtenues jusqu’à la fin de 1994. Les données démographiques fondamentales obtenues dans le cadre de ces travaux sont également présentées, y compris l’information sur la survie jusqu’à quatre ans après l’annonce du diagnostic. On traite également des questions liées à l’enregistrement des données standards et du niveau de détail des interventions cliniques indiquées dans le dossier. Cette partie de la recherche démontre que des sources de données éparses du système de santé peuvent être fusionnées avec un haut degré d’exactitude et d’exhaustivité des données.


Figure 1: Trajectoire d'un patient de la FMTCRC
Cartographier le cheminement, dans le système de soins, des patients atteints de cancer. Partie 1: Élaboration de la question de recherche

July 2004

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48 Reads

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

Il s’agit du premier article d’une série rapportant les résultats detravaux de recherche qui élaboraient, à partir des sources de données disponibles, un historique complet des interactions avec le système de santé de tous les patients diagnostiqués en 1990, au Manitoba, de tumeurs primitives mammaires, colorectales ou pulmonaires et ce, à partir d’un an avant le diagnostic jusqu’à deux ans après ce dernier. Cet article présente la motivation derrière cet axe de recherche ainsi que sa genèse. L’étude qui avait pour point de départ la question “Qu’est-ce qui arrive à la personne diagnostiquée d’un cancer?” s’est transformée en une initiative de recherche majeure englobant un large éventail de questions de recherche philosophiques et cliniques. Une équipe interdisciplinaire a élaboré en collaboration les méthodes opérationnelles permettant de combiner des sources de données existantes afin de présenter sous un format uniforme les antécédents des patients atteints de cancer.


Figure One: Flow chart of data set construction
Mapping the journey of cancer patients through the health care system. Part 2: Methodological approaches and basic findings

February 2004

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91 Reads

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3 Citations

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

This is the second in a series of articles from a line of research whose intent was to construct a complete history of interactions with the health care system. This paper provides details of the methods developed to collect and collate the scattered information regarding the event history (trajectory) that a cancer patient experiences in traveling through the Manitoba health care system from one year prior to diagnosis through to two years post-diagnosis. Survival data were obtained through 1994. Basic population data obtained from this work are also presented, including survival information through to four years post-diagnosis. Issues regarding standardized data recording and detail level of clinical events in the chart record are discussed. This part of the research demonstrates that diverse data sources in the health care system can be linked with a high degree of accuracy and completeness of data.


Figure One: The MCTRF patient trajectory
Mapping the journey of cancer patients through the health care system. Part 1: Developing the research question

February 2004

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485 Reads

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1 Citation

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

This is the first in a series of articles relating results from research which constructed a complete history of interactions with the health care system from available data sources for all patients diagnosed in 1990 with primary breast, colorectal, or lung tumours in Manitoba from one year prior to diagnosis through to two years post-diagnosis. This article presents the motivation and genesis for this line of research. The study evolved from the question of "What happens to a person who is diagnosed with cancer?" into a major research endeavour encompassing a broad spectrum of philosophic and clinical research questions. A large interdisciplinary team collaborated on developing operational methods to combine existing data sources into unified cancer patient histories.

Citations (3)


... It could, therefore, be helpfully supplemented by methods such as process mapping, which are able to capture the sequence and time-dependency of interactions in documenting continuity [15,16]. A team of Canadian researchers has successfully applied process mapping techniques to describe the journey of patients through the health care system171819. ...

Reference:

Using network analysis to map the formal clinical reporting process in pediatric palliative care: A pilot study
Mapping the journey of cancer patients through the health care system. Part 1: Developing the research question

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

... Published studies mapping other medical journeys (eg, cancer, rheumatoid arthritis, and hearing loss) have provided valuable insight into patient perspectives and key areas for improving clinical management strategies. [20][21][22][23] Data on such journeys through hypertension are limited 24 and this is the first study to explore the processes of the US health care system, specifically examining the experience of highrisk postmenopausal women. Participants were members of the database of WomenHeart: The National Coalition for Women With Heart Disease, which is the only national organization supporting women living with or at risk for cardiovascular disease through advocacy, education, and patient support. ...

Mapping the journey of cancer patients through the health care system. Part 2: Methodological approaches and basic findings

Canadian oncology nursing journal = Revue canadienne de nursing oncologique

... It could, therefore, be helpfully supplemented by methods such as process mapping, which are able to capture the sequence and time-dependency of interactions in documenting continuity [15,16]. A team of Canadian researchers has successfully applied process mapping techniques to describe the journey of patients through the health care system171819. ...

Mapping the journey of cancer patients through the health care system Part 3: An approach to staging

Canadian oncology nursing journal = Revue canadienne de nursing oncologique