事件记录
播音员: 来自犹他大学医生和专家的医学新闻和研究，你可以用它来过上更快乐、更健康的生活. 您正在收听的是范围.
主持人: Colon cancer screening guidelines might fail to catch 10% of colon cancers according to some recent research, 但这只是故事的一部分. 这个故事的独特之处在于，大量非常独特的数据是如何以一种前所未有的方式组合在一起的. 大发娱乐今天请来了. N. 珠宝马德, gastroenterologist at Huntsman Cancer Institute. Tell us a little bit about this study and what made it so unique.
Dr. 某某: 大发娱乐的研究调查了127人,在犹他大学健康科学系统和山间医疗中心接受结肠镜检查的000名患者. These two health systems account for roughly 85% of all health care in the state of Utah. 大发娱乐能够查看结肠镜检查记录并确定在结肠镜检查中发现息肉的患者以及在结肠镜检查中没有发现息肉的患者, 并利用存在于犹他州的独特的家谱记录以及与犹他州癌症登记处的联系, 全州癌症登记处, 看看在结肠镜检查中发现息肉的患者的亲属患息肉和结直肠癌的风险.
在像这样的数据存在的大多数州，它存在于单独的筒仓中，你不容易或永远无法将它们组合在一起. 然而，在犹他州，大发娱乐很独特. One, we have two major health systems that account for the majority of health care in the state. 也, 大发娱乐有一个全州范围的癌症登记处, 犹他州癌症登记处, which has been part of the SEER network of registries since 1973. 州法律要求所有的癌症诊断, 包括结肠直肠癌, from any hospital or health system in this state is reported to 犹他州癌症登记处.
Third, we have genealogical records that are also linked into 犹他州人口数据库. 最后, 大发娱乐有一种独特的能力，可以将犹他大学健康科学系统和山间医疗中心的所有电子医疗记录连接到犹他人口数据库，从而连接到这些家谱记录和癌症登记记录.
面试官: 真正的, 如果我没记错的话, there's no other place that this could've happened other than here in Utah at this moment in time.
Dr. 某某: 完全. 没有其他的美国.S. state or province in Canada that could do this type of research. 与此最接近的是有几个斯堪的纳维亚国家有家谱记录, 但它们的作用范围更有限，而且只适用于一级亲属，而不适用于更远的亲属.
面试官: This type of data, how does it change your trust in the results that you get from it?
Dr. 某某: 这是个好问题. 当大发娱乐研究如此大规模的人口基础研究时，重要的一点是看它是否代表了所有的病人，还是大发娱乐看到的大多数病人. 好吧, 大发娱乐在大发娱乐使用的病人群体是由占该州大多数的两个卫生系统照顾的. We have 127,000 patients nearly in our colonoscopy file that we were able to look at. 再一次。, that is a broad cross-section of the state of Utah, versus limiting it to a single hospital or a single region, 比如一个城市中心.
第二件事是，过去许多试图检验这一点的研究都受到患者回忆家族史数据的限制. By using the genealogical records we take those biases all out of the picture.
面试官: So, if I was to ask how confident are you in these results?
Dr. 某某: 大发娱乐对结果非常有信心.
面试官: That's got to feel good to be able to say that when it comes to doing a study like this.
Dr. 某某: 是的,是的. 我认为它有潜力通过使用结肠镜检查为筛查指南和结肠癌预防大发娱乐提供信息，并适当地针对风险较高的人群, those with a family history of polyps or colon cancer.
面试官: You take a look at currently what the screening guidelines are. 你把它放在你的研究报告旁边. 这将如何改变事情呢?
Dr. 某某: We still recommend the current screening guidelines, that people with no risk factor everyone should undergo some type of colon cancer screening at age 50. The current preferred screening option is a colonoscopy, and that should be repeated every ten years.
有风险因素的人，比如有结肠癌家族史的人或者在他们的近亲中有息肉的人, 60岁以下, start colonoscopy at age 40 or 10 years before the earliest advanced polyp or colon cancer in that family, and repeat more frequently - every 5 years instead of every 10 years.
然而, 目前的指导方针是如果你的亲属在60岁以上得了结肠癌或晚期息肉你可以从50岁开始治疗这是标准的指导方针. 大发娱乐的证据和研究可能会支持考虑在更早的年龄开始这些人，比如40岁.
面试官: How do you even go about changing the guidelines, then? 如果这是你真正相信的, 你真的相信你的研究是可靠的, 在这个过程中你的下一步是什么?
Dr. 某某: I think the next step in this process is generating more data. We have now also looked at colorectal cancer in this colonoscopy population, and the risk of adenomas or polyps and colorectal cancer in their relatives and showing that the risk, 再一次。, is increased regardless of the age in which the initial colon cancer is diagnosed.
我认为当这项研究发表的时候它将为大发娱乐大发娱乐提供更多的燃料，然后接近不同的筛选指导组织，说大发娱乐有来自大发娱乐人群的多项研究的证据，支持在亲属中息肉和结肠癌的风险增加，无论最初的病人是在什么年龄发展为晚期息肉或结肠癌.
面试官: What kind of man hours work went into bringing all this data together? 给我画一幅画. 你需要多少台电脑? 你需要多少人来检查? 这是一个多么艰巨的任务?
Dr. 某某: This was really a collaborative venture between the Huntsman Cancer Institute, 犹他州人口数据库, 和山间医疗. It was having staff at all three sites that allowed us to do this project.
例如, 大发娱乐在山间医疗中心有程序员他们识别了1995年到2009年这段时间内做的所有结肠镜检查并据此生成了一个电子清单. 这些信息与已识别的医疗记录信息一起被安全地传输到犹他州人口数据库，然后与犹他大学健康科学系统的数据合并, 一个程序员也同样平行提取所有结肠镜检查记录并安全地传输到犹他州人口数据库. 最后, that data was then linked with the genealogical records and 犹他州癌症登记处 records.
In terms of manpower or person power of effort, 这是10到15个人在三个站点工作投入数百小时的编程时间只是为了把所有这些数据库连接起来. 然后, 思考问题和分析数据也是数百小时的编程时间来做统计分析.
面试官: It's not just as easy as taking some data from here, 从那里取一些数据, 把它们放在一起, 看看你得到了什么.
Dr. 某某: 不，不幸的是没有.
面试官: 花了多少计算时间? 你知道吗? 你有意识到这一点吗? 一旦他们把这些东西都放进去，然后他们...
Dr. 某某: 其实也没那么长. It's not like the old days where you have these supercomputers.
面试官: 这部分比较简单.
Dr. 某某: 这是简单的部分.
面试官: 困难的部分是提取你需要的东西，然后弄清楚大发娱乐如何让这个数据库与这个数据库通信.
Dr. 某某: 是的,是的. It's probably, like, 10 minutes, 20 minutes of actually the computer thinking it and doing it. 这不是限制.
面试官: 是的,是的. 对于这种类型的研究, 大发娱乐需要克服的最大挑战是什么，才能让未来的研究变得更容易，这样大发娱乐才能更容易地进行更多的伟大研究?
Dr. 某某: Probably the most important thing is what we have in Utah, these unique linkages that occur between our health system, 大发娱乐的癌症登记处, and 犹他州人口数据库 to allow these data pieces to come together.
Why that's important is we want to look at the entire population. We want the data we generate to represent not just the care at a university hospital, not just the care at a managed care organization, not just the care at an urban center like Salt Lake City, 但它可以扩展到概括或总结整个犹他州在多个不同的城市和农村的医疗机构中大发娱乐提供的护理类型.
面试官: Your next study, how long do you think before that's going to be out?
Dr. 某某: 大发娱乐的下一个研究, looking at the risk of polyps and colorectal cancer in relatives of patients with colorectal cancer, is currently at a journal and hopefully will get published soon and will be the next one.
播音员: We're your daily dose of science, conversation, medicine. This is 范围, University of Utah Health Sciences Radio.