Identification of quality care indicators in prostate cancer.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 213-213
Author(s):  
Vicente Guillem ◽  
Eduardo Diaz Rubio ◽  
Carlos Camps ◽  
Javier Cassinello ◽  
Daniel E. Castellano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Quality Indicators ◽  
Clinical Care ◽  
Quality Care ◽  
Pathology Report ◽  
Clinical Practices ◽  
Improvement Program ◽  
Cancer Management ◽  
Delphi Approach ◽  
Level Of Agreement

213 Background: Despite the attempts made to improve prostate cancer management with the development and implementation of clinical practice guidelines, the inefficiencies and differences that usually occur in ordinary clinical care of patients with prostate cancer significantly contribute to increase the variations in the patterns of care and patients outcomes, and costs to the health system. The goal of this project was to establish parameters for improving the care of patients with prostate cancer through the development and validation of quality indicators for the management of this disease. Methods: The ECO Foundation is a platform of experts representing the major Spanish hospitals involved in the treatment of cancer patients. A multidisciplinary group of experts supported by ECO, extracted potential indicators for prostate cancer care from the relevant medical literature. After two consecutive rounds of rating in a modified Delphi approach, followed by a consensus discussion, the expert panel prioritized the indicators selected. Results: Forty indicators were selected with a high level of agreement. They were grouped into four main groups: general, localized disease, metastasized disease, and results-related indicators. Only two indicators did not reach an agreement or disagreement. The indicators with the highest level of agreement ( > 95%) were the appropriateness of diagnostic confirmation through the pathology report; patient participation in clinical decisions; complete re-staging with study of regional and bone extension; or the establishment of individual therapeutic plan with multidisciplinary participation. Conclusions: We conclude that currently available prostate cancer quality indicators represent clinical practices that are necessary for high-quality care in prostate cancer. The finalized indicator list can be directly adopted or adapted for deployment within a performance improvement program.

scholarly journals Identification of performance indicators across a network of clinical cancer programs

2016 ◽  
Vol 23 (2) ◽  
pp. 81 ◽  
Author(s):  
S.R. Khare ◽  
G. Batist ◽  
G. Bartlett
Keyword(s):  
Prostate Cancer ◽  
Lung Cancer ◽  
Quality Indicators ◽  
Tumour Site ◽  
Improvement Program ◽  
Clinical Cancer ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Confounding Variables ◽  
Selection Of

Background Cancer quality indicators have previously been described for a single tumour site or a single treatment modality, or according to distinct data sources. Our objective was to identify cancer quality indicators across all treatment modalities specific to breast, prostate, colorectal, and lung cancer.Methods Candidate indicators for each tumour site were extracted from the relevant literature and rated in a modified Delphi approach by multidisciplinary groups of expert clinicians from 3 clinical cancer programs. All rating rounds were conducted by e-mail, except for one that was conducted as a face-to-face expert panel meeting, thus modifying the original Delphi technique. Four high-level indicators were chosen for immediate data collection. A list of confounding variables was also constructed in a separate literature review.Results A total of 156 candidate indicators were identified for breast cancer, 68 for colorectal cancer, 40 for lung cancer, and 43 for prostate cancer. Iterative rounds of ratings led to a final list of 20 evidence- and consensus-based indicators each for colorectal and lung cancer, and 19 each for breast and prostate cancer. Approximately 30 clinicians participated in the selection of the breast, lung, and prostate indicators; approximately 50 clinicians participated in the selection of the colorectal indicators.Conclusions The modified Delphi approach that incorporates an in-person meeting of expert clinicians is an effective and efficient method for performance indicator selection and offers the added benefit of optimal clinician engagement. The finalized indicator lists for each tumour site, together with salient confounding variables, can be directly adopted (or adapted) for deployment within a performance improvement program.

scholarly journals HIV/AIDS Indicators for Clinical Care Quality Assessment: Relevance and Utility Assessed by Health Professionals

2016 ◽  
Vol 29 (6) ◽  
pp. 389
Author(s):  
Emanuel Castro Cassoco Catumbela ◽  
Cristina Santos ◽  
Alberto Freitas ◽  
Carlos Costa ◽  
António Sarmento ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Clinical Relevance ◽  
Clinical Symptoms ◽  
Clinical Care ◽  
Quality Care ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Care Quality ◽  
Cross Sectional ◽  
Hiv Aids

<p><strong>Introduction:</strong> After conducting a systematic review of quality indicators for assessing HIV/AIDS clinical care, we aimed to assess the clinical relevance and practice utility of those indicators from the point of view of HIV/AIDS physician experts.<br /><strong>Material and Methods:</strong> This is an observational, cross-sectional study, in which we selected, by convenience, physicians who work in an Infectious Disease Department of a central hospital to complete two questionnaires with a core set of indicators to establish the most relevant and useful indicators for assessment of the clinical HIV/AIDS care. A Likert scale was used to rank the indicators.<br /><strong>Results:</strong> Eleven of thirteen physicians filled two questionnaires. From the initial list of 53 quality indicators, 21 were identified as the most relevant and useful in HIV/AIDS clinical care. The internal consistency for clinical relevance in each indicators domain was for clinical signs and symptoms (<em>p</em> = 0.971), for therapy (<em>p</em> = 0.900), for prognosis (<em>p</em> = 0.820) and diagnosis (<em>p</em> = 0.733) and for practice utility were diagnosis (<em>p</em> = 0.934), clinical signs (<em>p</em> = 0.964), laboratory examinations (<em>p</em> = 0.947), therapy (<em>p</em> = 0.583) and prognosis (<em>p</em> = 0.368).<br /><strong>Discussion:</strong> In the process of assessing the clinical relevance and practice utility of HIV/AIDS quality care indicators, it was found that the majority of physicians agreed that diagnosis and clinical symptoms and signs indicators domains are the most important for assessing the quality of care for HIV/AIDS patients.<br /><strong>Conclusion:</strong> This instrument should be considered as a diagnostic tool, allowing hospital administrators to identify if HIV/AIDS care is properly delivered or needs improvement.</p>

scholarly journals Cohort profile: the TrueNTH Global Registry - an international registry to monitor and improve localised prostate cancer health outcomes

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017006 ◽  
Author(s):  
Sue M Evans ◽  
Jeremy L Millar ◽  
Caroline M Moore ◽  
John D Lewis ◽  
Hartwig Huland ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Quality Indicators ◽  
Steering Committee ◽  
Ethical Review ◽  
Local Data ◽  
Modified Delphi ◽  
Delphi Approach ◽  
International Registry ◽  
Project Coordination ◽  
Global Registry

PurposeGlobally, prostate cancer treatment and outcomes for men vary according to where they live, their race and the care they receive. The TrueNTH Global Registry project was established as an international registry monitoring care provided to men with localised prostate cancer (CaP).ParticipantsSites with existing CaP databases in Movember fundraising countries were invited to participate in the international registry. In total, 25 Local Data Centres (LDCs) representing 113 participating sites across 13 countries have nominated to contribute to the project. It will collect a dataset based on the International Consortium for Health Outcome Measures (ICHOM) standardised dataset for localised CaP.Findings to dateA governance strategy has been developed to oversee registry operation, including transmission of reversibly anonymised data. LDCs are represented on the Project Steering Committee, reporting to an Executive Committee. A Project Coordination Centre and Data Coordination Centre (DCC) have been established. A project was undertaken to compare existing datasets, understand capacity at project commencement (baseline) to collect the ICHOM dataset and assist in determining the final data dictionary. 21/25 LDCs provided data dictionaries for review. Some ICHOM data fields were well collected (diagnosis, treatment start dates) and others poorly collected (complications, comorbidities). 17/94 (18%) ICHOM data fields were relegated to non-mandatory fields due to poor capture by most existing registries. Participating sites will transmit data through a web interface biannually to the DCC.Future plansRecruitment to the TrueNTH Global Registry-PCOR project will commence in late 2017 with sites progressively contributing reversibly anonymised data following ethical review in local regions. Researchers will have capacity to source deidentified data after the establishment phase. Quality indicators are to be established through a modified Delphi approach in later 2017, and it is anticipated that reports on performance against quality indicators will be provided to LDCs.

scholarly journals Quality Indicators for Global Benchmarking of Localized Prostate Cancer Management

2018 ◽  
Vol 200 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Fanny Sampurno ◽  
Jia Zheng ◽  
Lydia Di Stefano ◽  
Jeremy L. Millar ◽  
Claire Foster ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Quality Indicators ◽  
Localized Prostate Cancer ◽  
Cancer Management ◽  
Prostate Cancer Management

Establishing metastatic prostate cancer quality indicators using a modified Delphi approach

2022 ◽  
Author(s):  
Jia Zheng ◽  
Fanny Sampurno ◽  
Daniel J. George ◽  
Alicia K. Morgans ◽  
Hannah Nguyen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Quality Indicators ◽  
Metastatic Prostate Cancer ◽  
Modified Delphi ◽  
Delphi Approach

scholarly journals Psychosis Without Meaning: Creating Modern Clinical Psychiatry, 1950 to 1980

2021 ◽  
Author(s):  
Joel T. Braslow
Keyword(s):  
Clinical Psychiatry ◽  
Life Histories ◽  
Psychotic Disorders ◽  
Clinical Care ◽  
Signs And Symptoms ◽  
Primary Treatment ◽  
Social Contexts ◽  
Clinical Practices ◽  
State Hospitals ◽  
1960S And 1970S

AbstractOver the last fifty years, American psychiatrists have embraced psychotropic drugs as their primary treatment intervention. This has especially been the case in their treatment of patients suffering from psychotic disorders such as schizophrenia. This focus has led to an increasing disregard for patients’ subjective lived-experiences, life histories, and social contexts. This transformation of American psychiatry occurred abruptly beginning in the late 1960s and 1970s. My essay looks the ways these major transformations played themselves out in everyday clinical practices of state hospital psychiatrists from 1950 to 1980. Using clinical case records from California state hospitals, I chronicle the ways institutional and ideological forces shaped the clinical care of patients with psychotic disorders. I show there was an abrupt rupture in the late 1960s, where psychiatrists’ concerns about the subjective and social were replaced by a clinical vision focused on a narrow set of drug-responsive signs and symptoms. Major political, economic, and ideological shifts occurred in American life and social policy that provided the context for this increasingly pharmacocentric clinical psychiatry, a clinical perspective that has largely blinded psychiatrists to their patients’ social and psychological suffering.

scholarly journals Challenges and opportunities for ovarian cancer management in the epidemic of Covid-19: lessons learned from Wuhan, China

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Zhilan Chen ◽  
Chun Zhang ◽  
Jiu Yin ◽  
Xin Xin ◽  
Hemei Li ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Large Scale ◽  
Treatment Plan ◽  
Clinical Care ◽  
Gynecologic Cancer ◽  
Treatment Phase ◽  
Tumor Stage ◽  
Current Treatment ◽  
Lessons Learned ◽  
Cancer Management

AbstractChina and the rest of the world are experiencing an outbreak of the 2019 novel coronavirus disease (COVID-19). Patients with cancer are more susceptible to viral infection and are more likely to develop severe complications, as compared to healthy individuals. The growing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Ovarian debulking surgery combined with the frequent need for chemotherapy is most likely why ovarian cancer was rated as the gynecologic cancer most affected by COVID-19. Therefore, ovarian cancer presents a particular challenging task. Concerning the ovarian cancer studies with confirmed COVID-19 reported from large-scale general hospitals in Wuhan, we hold that the treatment plan was adjusted appropriately and an individualized remedy was implemented. The recommendations discussed here were developed mainly based on the experience from Wuhan. We advise that the management strategy for ovarian cancer patients should be adjusted in the light of the local epidemic situation and formulated according to the pathological type, tumor stage and the current treatment phase. Online medical service is an effective and convenient communication platform during the pandemic.

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