====== Treatment Pathways in Patients with Cancer ======


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**Objective:** Among patients with cancer, characterize the prevalence, variety, and distribution of different initial treatment pathways for three chronic diseases: Hypertension, Type II Diabetes, and Depression.  We will systematically summarize the treatment pathways observed among patients who have a diagnosis of cancer and at least **12 months of continuous observation and persistent treatment** following initiation of the first treatment for one of the three conditions.  We will stratify the results by year to evaluate temporal trends, and will further stratify by data-source to determine if treatment pathways vary by population, geography, and data capture process.

**Rationale:** Despite our recent characterization of treatment pathways, there is still little known about the prevalence real-world pathways for the treatment of chronic co-morbid conditions in patients with cancer. While numerous treatment guidelines exist for chronic conditions, it is unclear whether such guidelines are appropriate or followed for cancer patients and how real-world cancer patients are treated for such diseases. Understanding these pathways will establish context around questions of drug utilization, effectiveness, and adherence in this uniquely vulnerable population, and also demonstrate the feasibility of carrying out large-scale network studies in patients with cancer.

**Project Leads:** George Hripcsak, Ray Chen, Thomas Falconer

**Coordinating Institution(s):** Columbia University

** Additional Participants:** Janssen R&D

**Full Protocol:** [[https://github.com/rchen-cumc/StudyProtocols/blob/master/TreatmentPathways-Cancer12mo/Protocol/OHDSITxPathCancer12moProtocol.docx|Treatment Pathways in Patients with Cancer 12 months Study Protocol]]

**Initial Proposal Date:**  12/19/2017

**Launch Date:**  12/20/2017

**Study Closure Date:**  Pending

**Results Submission:** [[mailto:rc3179@cumc.columbia.edu|Email]] or SFTP

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===== Requirements =====
**CDM:** V5

**Database Dialect:** SQL Server, Postgres, Oracle, Redshift

**Software:**  SQL, R
 
===== Code ===== 
[[https://github.com/rchen-cumc/StudyProtocols/tree/master/TreatmentPathways-Cancer12mo|Github repo]]

===== Discussion ===== 
[[http://forums.ohdsi.org/t/ohdsi-study-treatment-pathways-in-patients-with-cancer/3778|Cancer Treatment Pathways Discussion Thread]] 

===== Datasets Run ===== 
  * Columbia University


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