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Emily Ray, MD, MPH
Assistant Professor, Hematology and Oncology
The University of North Carolina at Chapel Hill
Chapel Hill, North Carolina
Conquer Cancer Foundation of ASCO
Goal: To develop predictive models that accurately determine breast cancer prognosis in late stage breast cancer patients.
Impact: Decisions about end-of-life care are difficult for patients, their families and doctors to make. For breast cancer patients, who often live longer under hospice care, there is a temptation to continue with more aggressive therapy in the absence of a clear prognosis of continued survival. Dr. Ray and her colleagues will create a breast cancer-specific prognostic tool to assess risk of death so at-risk patients can avoid unnecessary treatments.
What’s next: Dr. Ray will analyze real-world cancer care data from many data sources, including community providers, academic institutions, and large healthcare systems to develop a prognostic model for 30-day risk of death in patients with advanced breast cancer.
End-of-life care is an important component of patient support for the terminally ill. Hospice provides the supportive care patients and families need when end of life is near. Oncologists may find it difficult to accurately assess risk of death in breast cancer patients, who often live longer than other cancer patients with advanced disease. Dr. Ray will address this gap by developing a breast cancer specific prognostic tool to assist oncologists in determining which patients are near the end of life.
Full Research Summary
Research area: Improving treatment and end-of-life care decisions with precision tools to identify patients with a high risk of death.
Impact: Metastatic breast cancer is incurable, and patients will be on treatment for the rest of their lives. While the goal of treatment is to extend life, it is equally important to know when the patient has advanced beyond any treatment benefit. At this point, hospice care offers medical and emotional support for patients and their families as the end of life draws near. Oncologists struggle, however, to identify which patients are likely to benefit from ongoing cancer treatment and which patients would benefit from a transition to supportive care alone. This is particularly true with breast cancer patients. Dr. Ray is developing a breast cancer-specific prognostic tool to help clinicians in making these important determinations.
Current investigation: Oncologists need tools that better quantify risk of death in order to improve delivery of high-quality care that is appropriate and in accordance with the goals of the patient. Dr. Ray will utilize clinical and demographic data from the Cancer LINQ Discovery database, a cutting-edge IT platform created by the American Society of Clinical Oncology (ASCO) to capture real-world cancer patient outcomes from a variety of health care settings.
Dr. Emily Ray is an Assistant Professor in the Division of Hematology-Oncology and a member of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill. Her clinical work focuses on the care of patients with breast cancer. Her research centers on the study of cancer outcomes and cancer care delivery, with a particular interest in utilization of resources and cost of care for patients with advanced cancer.
Dr. Ray has experience using administrative data to examine healthcare utilization among cancer patients. She has received competitive internal and external funding to study healthcare utilization among patients with newly diagnosed advanced lung cancer; patterns and predictors of loco-regional treatment for brain metastases; and patterns of end-of-life healthcare utilization among patients with brain metastases. Her research aims to identify patients most vulnerable to low-value healthcare utilization, especially near the end of life, and develop interventions to decrease this utilization. In doing so, she hopes to demonstrate how better utilization of resources can dually benefit patients and the healthcare system. Dr. Ray has a master’s degree in public health from the UNC Gillings School of Global Public Health and received her medical degree from the UNC School of Medicine. She completed her internal medicine residency at Duke University prior to returning to UNC for her hematology-oncology fellowship. During her fellowship, Dr. Ray was a participant in the National Research Service Award T32 Postdoctoral Research Fellowship through the UNC Sheps Center for Health Services Research. She joined the faculty at UNC in July 2019.