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all right welcome back everyone we are going to head into our last segment of the morning I am Helen Parsons as Beth mentioned this morning I am an associate professor in the division of health policy and management of the University of Minnesota I have been working with your Medicare data for well over a decade now and most of my work centers around measuring and evaluating the quality of care for cancer survivors so with that I'd like to get started on our what I would say was a very challenging segment to really pare down into an hour so today we are going to look at how you identify and measure cancer directed therapy within the seer Medicare data now we had a number of different options for which therapies and treatments to include however just given the scope of today and that it was a one-day workshop we really decided to focus on three of the most common cancer directed treatments that researchers tend to study within the data so today we'll be looking at cancer directed surgery radiation therapy receipt of chemotherapy or biologics as well as how you might measure a combination and of these three types of therapies so let's step back and take a 10,000 foot view of what is it that you are actually able to measure within the seer Medicare data as it relates to cancer directed therapy so in many cases here in measure Medicare both measure cancer directed therapies but they do measure them differently and so that's really important to keep in mind as you're trying to think about which source you might consider using for your study of interest importantly it is very critical to understand the similarities and differences between the two data sources in what they measure and how they measure it to decide which measure will be best for your study as well as what to do if the two sources point in different directions for example one source might might say that this individual received cancer directed surgery and the other source may have no evidence of that surgery so you'll have to decide what you will do when those two sources conflict before we dive into each of the individual types of therapy let's step back and consider why we would measure treatment what is the benefit of measuring treatment and what are some applications for using it to understand care patterns in this population many researchers often study treatment in order to understand who gets what and variation between treatments across populations you may be interested in evaluating variations in treatment or guideline concordant care across region or across demographics you may obese also be interested in evaluating whether or not a procedure or a new procedure and established procedure influences outcomes for individuals with a particular type of cancer this allows you to step back and look at real world effectiveness of some types of treatment and this is...