A Million Person Study Innovation: Evaluating Cognitive Impairment and other Morbidity Outcomes from Chronic Radiation Exposure Through Linkages with the Centers for Medicaid and Medicare Services Assessment and Claims Data

Journal Article · Mon Oct 28 00:00:00 EDT 2024 · Radiation Research

DOI:https://doi.org/10.1667/RADE-23-00186.1· OSTI ID:3002162

Dauer, Lawrence T. ^[1]; Mumma, Michael T. ^[2]; Lima, Julie C. ^[3]; Cohen, Sarah S. ^[4]; Andresen, Daniel ^[5]; Bahadori, Amir A. ^[5]; Bellamy, Michael ^[1]; Bierman, David A. ^[1]; Blattnig, Steve ^[6]; French, Benjamin ^[7]; Giunta, Eric ^[5]; Held, Kathryn ^[8]; Hertel, Nolan ^[9]; Keohane, Laura ^[7]; Leggett, Richard Wayne ^[10]; Lipworth, Loren ^[7]; Miller, Kathleen B. ^[11]; Norman, Ryan B. ^[6]; Samuels, Caleigh ^[10]; Thomas, Kali S. ^[12] ; Tolmachev, Sergei Y. ^[13]; Walsh, Linda ^[14]; Boice, Jr., John D. ^[15]

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1. Memorial Sloan Kettering Cancer Center, New York, NY (United States). Sloan Kettering Institute
2. Vanderbilt Univ. Medical Center, Rockville, MD (United States). International Epidemiology Field Station (IEFS)
3. Brown Univ., Providence, RI (United States)
4. DLH, LLC, Bethesda, MD (United States)
5. Kansas State Univ., Manhattan, KS (United States)
6. NASA Langley Research Center, Hampton, VA (United States)
7. Vanderbilt Univ., Nashville, TN (United States)
8. National Council on Radiation Protection and Measurements, Inc., Bethesda, MD (United States)
9. Georgia Institute of Technology, Atlanta, GA (United States)
10. Oak Ridge National Laboratory (ORNL), Oak Ridge, TN (United States)
11. National Institute for Aerospace, Hampton, VA (United States)
12. Johns Hopkins Univ., Baltimore, MD (United States)
13. Washington State Univ., Richland, WA (United States)
14. Univ. of Zurich (Switzerland)
15. National Council on Radiation Protection and Measurements, Inc., Bethesda, MD (United States); Vanderbilt Univ., Nashville, TN (United States)

Here, the study of One Million U.S. Radiation Workers and Veterans, the Million Person Study (MPS), examines the health consequences, both cancer and non-cancer, of exposure to ionizing radiation received gradually over time. Recently the MPS has focused on mortality patterns from neurological and behavioral conditions, e.g., Parkinson's disease, Alzheimer's disease, dementia, and motor neuron disease such as amyotrophic lateral sclerosis. A fuller picture of radiation-related late effects comes from studying both mortality and the occurrence (incidence) of conditions not leading to death. Accordingly, the MPS is identifying neurocognitive diagnoses from fee-for-service insurance claims from the Centers for Medicare and Medicaid Services (CMS), among Medicare beneficiaries beginning in 1999 (the earliest date claims data are available). Linkages to date have identified ∼540,000 workers with available health information. Such linkages provide individual information on important co-factor and confounding variables such as smoking, alcohol consumption, blood pressure, obesity, diabetes and many other health and demographic characteristics. The total person-level set of time-dependent variables, outcomes, organ-specific dose measures, co-factors, and demographics will be massive and much too large to be evaluated with standard software. Thus, development of specialized open-source software designed for large datasets (Colossus) is nearly complete. The wealth of information available from CMS claims data, coupled with individual dose reconstructions, will thus greatly enhance the quality and precision of health evaluations for this new field of low-dose radiation and neurocognitive effects.

• Research Organization: Oak Ridge National Laboratory (ORNL), Oak Ridge, TN (United States)
• Sponsoring Organization: Centers for Disease Control and Prevention (CDC); National Aeronautics and Space Administration (NASA); National Institutes of Health (NIH); U.S. Naval Sea Systems Command (NAVSEA); USDOE
• Grant/Contract Number: AC05-00OR22725; AU0000042; AU0000046
• OSTI ID: 3002162
• Journal Information: Radiation Research, Journal Name: Radiation Research Journal Issue: 6 Vol. 202; ISSN 0033-7587
• Publisher: Radiation Research Society
• Country of Publication: United States
• Language: English