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Introduction: Colorectal cancer (CRC) incidence and mortality can be reduced by effective screening and/or treatment. However, the influence of health care systems on disparities among insured patients is largely unexplored. Methods: To evaluate insured patients with CRC diagnosed between 2010 and 2014 across 6 diverse US health care systems in the Patient-Centered Outcomes Research Institute (PCORI) Patient Outcomes Research To Advance Learning (PORTAL) CRC cohort, we contrasted CRC stage; CRC mortality; all-cause mortality; and influences of demographics, stage, comorbidities, and treatment between health systems. Results: Among 16,211 patients with CRC, there were significant differences between health care systems in CRC stage at diagnosis, CRC-specific mortality, and all-cause mortality. The unadjusted risk of CRC mortality varied from 27% lower to 21% higher than the reference system (hazard ratio [HR] = 0.73, 95% confidence interval = 0.66-0.80 to HR = 1.21, 95% confidence interval = 1.05-1.40; p < 0.01 across systems). Significant differences persisted after adjustment for demographics and comorbidities (p < 0.01); however, adjustment for stage eliminated significant differences (p = 0.24). All-cause mortality among patients with CRC differed approximately 30% between health care systems (HR = 0.89-1.17; p < 0.01). Adjustment for age eliminated significant differences (p = 0.48). Discussion: Differences in CRC survival between health care systems were largely explained by stage at diagnosis, not demographics, comorbidity, or treatment. Given that stage is strongly related to early detection, these results suggest that variation in CRC screening systems represents a modifiable systems-level factor for reducing disparities in CRC survival. [ABSTRACT FROM AUTHOR]

A transceiver capable of 6.25-Gb/s data transmission across legacy communications equipment backplanes is described. To achieve a bit error rate (BER) < 10-15, transmit and receive equalization that can compensate up to 20 dB of channel loss is employed to remove intersymbol interference (ISI) resulting from finite channel bandwidth and reflections. The transmit feed-forward equalizer (FFE) uses a four-tap symbol-spaced programmable finite impulse response (FIR) filter followed by a 4-bit digital-to-analog converter (DAC) that drives a 50-Ω transmission line. The receiver uses a half-baud-rate adaptive decision feedback equalizer (DFE) that cancels the first four symbol-spaced taps of postcursor ISI without use of speculative techniques. Both the transmitter and receiver use an LC-oscillator-based phase-locked loop (PLL) to provide low jitter clocks. Techniques to minimize the complexity of the FIR and DFE implementations are described. The transceiver is designed to be integrated in a standard ASIC flow in a 0.13-µm digital CMOS technology. System measurements indicate the ability to transmit and recover data eyes that have been fully closed due to crosstalk and signal loss. [ABSTRACT FROM AUTHOR]