Evidence-based benchmarks for use of cancer surgery in high-income countries: a population-based analysis

Unwarranted clinical variation in healthcare impacts access, productivity, performance, and outcomes. A strategy proposed for reducing unwarranted clinical variation is to ensure that population-based data describing the current state of health care services are available to clinicians and healthcare decision-makers. The objective of this study was to measure variation in colorectal cancer surgical treatment patterns and surgical quality in Manitoba and identify areas for improvement. This descriptive study included individuals aged 20 years or older who were diagnosed with invasive cancer (adenocarcinoma) of the colon or rectum between 1 January 2010 and 31 December 2014. Laparoscopic surgery was higher in colon cancer (24.1%) compared to rectal cancer (13.6%). For colon cancer, the percentage of laparoscopic surgery ranged from 12.9% to 29.2%, with significant differences by regional health authority (RHA) of surgery. In 86.1% of colon cancers, ≥12 lymph nodes were removed. In Manitoba, the negative circumferential resection margin for rectal cancers was 96.9%, and ranged from 96.0% to 100.0% between RHAs. The median time between first colonoscopy and resection was 40 days for individuals with colon cancer. This study showed that high-quality colorectal cancer surgery is being conducted in Manitoba along with some variation and gaps in quality. As a result of this work, a formal structure for ongoing measuring and reporting surgical quality has been established in Manitoba. Quality improvement initiatives have been implemented based on these findings and periodic assessments of colorectal cancer surgery quality will continue.

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Improvement of the initial management of sarcomas after the dissemination of evidence-based guidelines depends on the primary sarcoma location: a population-based study

BMC Cancer ◽

10.1186/s12885-015-1225-x ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Karine Ligier ◽

Carlos Maynou ◽

Xavier Leroy ◽

Yves-Marie Robin ◽

Philippe Martin ◽

...

Keyword(s):

Population Based ◽

Evidence Based ◽

Population Based Study ◽

Initial Management ◽

Primary Sarcoma ◽

Evidence Based Guidelines

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Evidence for racial/ethnic disparities in emergency department visits following breast cancer surgery among women in California: a population-based study

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06119-5 ◽

2021 ◽

Author(s):

Mary Falcone ◽

Lihua Liu ◽

Albert Farias ◽

JuanJuan Zhang ◽

Irene Kang ◽

...

Keyword(s):

Breast Cancer ◽

Emergency Department ◽

Ethnic Disparities ◽

Population Based ◽

Cancer Surgery ◽

Emergency Department Visits ◽

Breast Cancer Surgery ◽

Population Based Study ◽

Racial Ethnic

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Evidence-based stroke rehabilitation: do priorities for practice change and feasibility of implementation vary across high income, upper and lower-middle income countries?

Disability and Rehabilitation ◽

10.1080/09638288.2021.1910737 ◽

2021 ◽

pp. 1-8

Author(s):

Sanjana Gururaj ◽

Marie-Louise Bird ◽

Karen Borschmann ◽

Janice J. Eng ◽

Caroline Leigh Watkins ◽

...

Keyword(s):

Stroke Rehabilitation ◽

High Income ◽

Practice Change ◽

Evidence Based ◽

Middle Income ◽

Middle Income Countries

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Abstract WP418: A Systematic Comparison of Key Features of Ischaemic Stroke Prevention Guidelines in Low- and Middle-income vs High-income Countries

Stroke ◽

10.1161/str.48.suppl_1.wp418 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Hernan O Bayona ◽

Mayowa Owolabi ◽

Wayne Feng ◽

James R Sawers ◽

Paul Olowoyo ◽

...

Keyword(s):

Stroke Prevention ◽

High Income ◽

Evidence Based ◽

Vascular Risk ◽

Eligibility Criteria ◽

Middle Income ◽

Middle Income Countries ◽

Prevention Guideline ◽

Prevention Guidelines ◽

Low And Middle Income

Introduction: Implementation of contextually appropriate, evidence-based, expert-recommended stroke prevention guideline is particularly important in Low- and Middle-Income Countries (LMICs), which bear disproportional larger burden of stroke while possessing fewer resources. Focus therefore, should be on approaches enabling healthcare systems to improve control of vascular risk factors. Objective: We aimed to compare important features of stroke prevention guidelines between LMICs and High Income Countries (HICs). Methods: We systematically searched PubMed, AJOL, SciELO, and LILACS databases for stroke prevention guidelines published between January 2005 and December 2015 by country. Primary search items included: “Stroke” and “Guidelines”. We critically appraised the articles for evidence level, issuance frequency and implementation aspects to clinical practice. Results: Among 45 stroke prevention guidelines published, 28 (62%) met eligibility criteria: 7 from LMICs (25%) and 21 from HICs (75%). LMIC-issued guidelines were less likely to have conflict of interest declarations (57% vs. 100%, p=0.01), involve high quality systematic reviews (57% vs. 95%, p= 0.03), had good dissemination channels (14% vs 71%, p=0.02). The patient views and preferences were the most significant stakeholder considerations in HICs (43%, p=0.04) compared with LMICs. Conclusion: The quality and quantity of stroke prevention guidelines in LMICs are less than those of HICs and need to be significantly improved upon.

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