Treatment Sequencing for Resectable Disease

2019 ◽  
pp. 47-53
Author(s):  
Mariana I. Chavez
Keyword(s):  
Resectable Disease ◽  
Treatment Sequencing

Outcomes of Various Treatment Sequencing Strategies in Octogenarians with Gastric Adenocarcinoma: A National Cancer Database Analysis

2019 ◽  
Vol 229 (4) ◽  
pp. S270-S271
Author(s):  
Tommy Ivanics ◽  
Shravan Leonard-Murali ◽  
Xiaoxia Han ◽  
Christopher P. Steffes ◽  
Rupen A. Shah ◽  
...  
Keyword(s):  
Gastric Adenocarcinoma ◽  
National Cancer Database ◽  
Database Analysis ◽  
Treatment Sequencing

Short-course radiotherapy in stage IV rectal cancer with resectable disease

2021 ◽  
Author(s):  
M. Cambray ◽  
J. González-Viguera ◽  
M. Macià ◽  
F. Losa ◽  
G. Soler ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Stage Iv ◽  
Resectable Disease ◽  
Short Course ◽  
Short Course Radiotherapy

OP179 Quantitative Evidence Synthesis Methods For Assessing The Effectiveness Of Treatment Sequences For Clinical And Economic Decision-Making: Methodology Review

2021 ◽  
Vol 37 (S1) ◽  
pp. 4-4
Author(s):  
Ruth Lewis ◽  
Dyfrig Hughes ◽  
Alex Sutton ◽  
Clare Wilkinson
Keyword(s):  
Decision Making ◽  
Chronic Conditions ◽  
Evidence Synthesis ◽  
Policy Decision ◽  
Clinical Effectiveness ◽  
Synthesis Methods ◽  
Economic Decision Making ◽  
Treatment Sequencing ◽  
Policy Decision Making ◽  
Treatment Sequences

IntroductionThe sequential use of alternative treatments for chronic conditions represents a complex, dynamic intervention pathway; previous treatment and patient characteristics affect both choice and effectiveness of subsequent treatments. Evidence synthesis methods that produce the least biased estimates of treatment-sequencing effects are required to inform reliable clinical and policy decision-making. A comprehensive review was conducted to establish what existing methods are available, outline the assumptions they make, and identify their shortcomings.MethodsThe review encompassed both meta-analytic techniques and decision-analytic modelling, any disease condition, and any type of treatment sequence, but not diagnostic tests, screening, or treatment monitoring. It focused on the estimation of clinical effectiveness and did not consider the impact of treatment sequencing on the estimation of costs or utility values.ResultsThe review included ninety-one studies. Treatment-sequencing is usually dealt with at the decision-modelling stage and is rarely addressed using evidence synthesis methodology for clinical effectiveness. Most meta-analyses are of discrete treatments, sometimes stratified by line of therapy. Prospective sequencing trials are scarce. In their absence, there is no single best way to evaluate treatment sequences, rather there is a range of approaches, each of which has advantages and disadvantages and is influenced by the evidence available and the decision problem. Due to the scarcity of data on sequential treatments, modelling studies generally apply simplifying assumptions to data on discrete treatments. A taxonomy for all possible assumptions was developed, providing a unique resource to aid the critique of decision-analytic models.ConclusionsThe evolution of network meta-analysis in HTA demonstrates that clinical and policy decision-making should account for the multiple treatments available for many chronic conditions. However, treatment-sequencing has yet to be accounted for within clinical evaluations. Economic modelling is often based on the simplifying assumption of treatment independence. This can lead to misrepresentation of the true level of uncertainty, potential bias in estimating the effectiveness and cost effectiveness of treatments and, eventually, the wrong decision.

scholarly journals Trends and variation in antidepressant prescribing in English primary care

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0020
Author(s):  
Paul Bogowicz ◽  
Helen J Curtis ◽  
Alex J Walker ◽  
Philip Cowen ◽  
John Geddes ◽  
...  
Keyword(s):  
Primary Care ◽  
Regression Analysis ◽  
Mixed Methods Research ◽  
Descriptive Statistics ◽  
Marked Variation ◽  
Substantial Variation ◽  
National Guidelines ◽  
Level Data ◽  
Prescribing Behaviour ◽  
Treatment Sequencing

BackgroundAntidepressants are commonly prescribed. There are clear national guidelines in relation to treatment sequencing. The study examined trends and variation in antidepressant prescribing across English primary care.AimTo examine trends and variation in antidepressant prescribing in England, with a focus on: monoamine oxidase inhibitors (MAOIs); paroxetine; and dosulepin and trimipramine.Design & settingRetrospective longitudinal study using national and practice level data on antidepressant items prescribed per year (1998–2018) and per month (2010–2019).MethodClass- and drug-specific proportions were calculated at national and practice levels. Descriptive statistics were generated, percentile charts and maps were plotted, and conducted logistic regression analysis was conducted.ResultsAntidepressant prescriptions more than tripled between 1998 and 2018, from 377 items per 1000 population to 1266 per 1000. MAOI prescribing fell substantially, from 0.7% of all antidepressant items in 1998 to 0.1% in 2018. There was marked variation between practices in past year prescribing of paroxetine (median practice proportion [MPP] = 1.7%, interdecile range [IDR] = 0.7% to 3.3%) and dosulepin (MPP = 0.7%, IDR = 0% to 1.9%), but less for trimipramine (MPP = 0%, IDR = 0% to 0.2%).ConclusionRapid growth and substantial variation in antidepressant prescribing behaviour was found between practices. The causes could be explored using mixed-methods research. Interventions to reduce prescribing of specific antidepressants, such as dosulepin, could include review prompts, alerts at the time of prescribing, and clinician feedback through tools like OpenPrescribing.net.

Targeting HER2 in Breast Cancer: Latest Developments on Treatment Sequencing and the Introduction of Biosimilars

Drugs ◽  
2020 ◽  
Vol 80 (17) ◽  
pp. 1811-1830
Author(s):  
Megan E. Tesch ◽  
Karen A. Gelmon
Keyword(s):  
Breast Cancer ◽  
Treatment Sequencing
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