GIS and Marshfield Clinic Collaborate on Mammogram Follow-up

MyKayla Hilgart

The Geographic Information Systems (GIS) Center of the University of Wisconsin-Stevens Point is looking to follow up on their collaboration with Marshfield Clinic to continue researching missed mammograms in relation to the proximity of screening facilities.

The 2010 study funded by the Marshfield Clinic Research Foundation was led by Adedayo Onitilo, M.D., an ontologist/haematologist at Marshfield Clinic. He collaborated with Professor Doug Miskoviak, a GIS education specialist at UWSP.

The study was published in November of 2013 in the American Journal of Roentgenology and has since gained international attention.  It will also soon be published in the Rural and Remote Health Journal.

“The findings derived from this study revealed that patterns and trends in geography matter and can have a great effect on public health,” Miskoviak said.

Miskoviak pointed out that when women miss mammograms, they miss the opportunity to detect and diagnose breast cancer in its earliest stages of development. This is especially dangerous for younger women for whom the cancer is typically more aggressive and will be at a higher stage when treated.

The GIS team at UWSP converted addresses from Marshfield Clinic’s health records of 1,300 people from 2001 through 2008 to data points and then used a road network to analyze travel time the proper facilities.

“The farther women are away from facilities, thirty minutes seeming to be the turning point, the less likely they are to be diagnosed early on. Seasonal factors also have an influence. Women are less likely to go to their appointments in the winter when it is more difficult to get around,” Miskoviak said.

According to a news brief on the study from UWSP’s website, “each additional minute of travel time decreases the odds of undergoing at least one mammography examination in five years before diagnosis. Those who missed five of their last five lived twice as far from the nearest mammogram facility as those who missed none.”

In addition, the news brief indicated that “women who had not undergone mammography screening in the year before diagnosis were 12 percent more likely than those who had mammograms to be diagnosed with late stage breast cancer.”

To help minimize missed mammograms, the study suggests enhanced usage of mobile mammogram equipment to reach areas in which women do not have direct access to care.

Another suggestion is to maximize the use of patients’ time by scheduling a mammogram at the same time as a routine check-up, flu shot, or other medical appointment.

Miskoviak indicated that he hopes to work with Marshfield Clinic again for a follow-up study involving 13,000 patients from 2008 through 2012 which would feature a control group to further aid the process. The research team is currently seeking funding for this project and hopes to receive a grant to get students involved.

Dr. Onitilo is also interested in investigating the geographic trends in relation to pancreatic cancer and other diseases and comparing trends by city.

“GIS can identify solutions to real problems. Maps can reveal patterns that may not be invisible to us otherwise,” Miskoviak said.





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