Oncology Practice Guidelines: Do They Work?

2004 ◽  
Vol 2 (4) ◽  
pp. 276-282 ◽  
Author(s):  
Rodger J. Winn
Keyword(s):  
Practice Guidelines ◽  
Oncology Practice

Patterns and predictors of chemotherapy and trastuzumab use for early-stage breast cancer in Kaiser Permanente Northern California, 2004-2007.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 256-256
Author(s):  
Allison W. Kurian ◽  
Daphne Lichtensztajn ◽  
Theresa H.M. Keegan ◽  
Rita W. Leung ◽  
Sarah J. Shema ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Practice Guidelines ◽  
Early Stage ◽  
Local Population ◽  
Early Stage Breast Cancer ◽  
Care Organization ◽  
Northern California ◽  
Kaiser Permanente ◽  
Oncology Practice

256 Background: Chemotherapy regimens for early-stage breast cancer have been extensively tested by randomized clinical trials, and specified by evidence based-practice guidelines. However, little is known about the translation of trial results and guidelines to oncology practice. Methods: We extracted individual-level data on chemotherapy administration from the electronic medical records of Kaiser Permanente Northern California (KPNC), a pre-paid integrated health-care delivery system serving 29% of the local population. We linked data to the California Cancer Registry, incorporating demographic and tumor factors, and performed multivariable logistic regression analyses on the receipt of specific chemotherapy regimens. Results: We identified 6,178 women diagnosed with stage I to III breast cancer at KPNC during 2004 to 2007; 2,735 (44.3%) received at least one chemotherapy infusion at KPNC within 18 months of diagnosis. Factors associated with receiving chemotherapy, and specifically receiving anthracyclines, taxanes, and/or trastuzumab, included young age, large tumor size, involved lymph nodes, hormone receptor-negative or HER2/neu-positive tumors, and high tumor grade; comorbid conditions were inversely associated with chemotherapy use (heart disease for anthracyclines, neuropathy for taxanes). We observed less chemotherapy use by unmarried women, less anthracycline and taxane use by low-socioeconomic status (SES) non-Hispanic whites, and more anthracycline use by high-SES Asian/Pacific Islanders (versus high-SES non-Hispanic whites). Concordance with relevant measures of the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) was highest among younger women with larger, higher grade tumors. Conclusions: In this health care organization with essentially equal access, we discovered that chemotherapy use was concordant with practice guidelines, yet may vary according to socio-demographic factors. These findings may inform efforts to optimize treatment, and guide studies of quality in breast cancer care.

scholarly journals Promoting Best Gynecologic Oncology Practice: A Role For The Society of Gynecologic Oncologists of Canada

2006 ◽  
Vol 13 (3) ◽  
pp. 94-98
Author(s):  
L. M. Elit ◽  
M. Johnston ◽  
M. Brouwers ◽  
M. Fung- Kee-Fung ◽  
G. Browman ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Gynecologic Oncology ◽  
Gynecologic Cancer ◽  
Cancer Control ◽  
Recurrent Ovarian Cancer ◽  
Primary Treatment ◽  
Evaluation Tool ◽  
Full Spectrum ◽  
Canadian Guideline ◽  
Oncology Practice

During March 30–April 1, 2005, the Society of Gynecologic Oncologists of Canada (GOC) and the Canadian Strategy for Cancer Control (CSCC) Clinical Practice Guidelines Action Group (CPG-AG) met to • determine how GOC would like to influence practice in the care of women with gynecologic cancer. • explore a collaborative model for developing and implementing evidence-based practice guidelines. • investigate the utility of the CPG evaluation and adaptation cycle as a tool for selecting, adapting, and adopting guidelines. At the workshop meeting, 21 members of the GOC and the CPG-AG heard presentations from various Canadian guideline initiatives. As an example of adaptation and adoption processes, the AGREE (Appraisal of Guidelines for Research and Evaluation) tool was applied to guidelines in recurrent ovarian cancer, and the group explored their opportunity to use knowledge translation to influence the care of women with gynecologic cancer. The themes influencing practice are consistent with GOC’s mandate. The future is expected to involve partnering with other groups to maximize scarce resources. Resources should be directed to facilitating implementation of existing guidelines rather than to developing new documents. The full spectrum of cancer care includes prevention, screening, diagnosis, primary treatment, follow-up, treatment of recurrent disease, and palliation. High-quality evidence is available in some areas, but gaps exist where guideline panels could provide guidance. Development of a pan-Canadian gynecologic oncology process could provide an opportunity to influence access to care at the political and policy levels. The GOC will develop linkages such that the toolbox available through CSCC-CPG-AG can be incorporated into future collaboration.

scholarly journals Neuro-oncology practice guidelines from a high-volume surgeon at the COVID-19 epicenter

2021 ◽  
Vol 85 ◽  
pp. 1-5
Author(s):  
Evan Luther ◽  
Joshua Burks ◽  
Daniel G. Eichberg ◽  
Gregory Basil ◽  
Katherine Berry ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
High Volume ◽  
Oncology Practice

NCCN Chemotherapy Order Templates: Enhancing patient safety through standardization

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17537-e17537
Author(s):  
E. C. Li ◽  
J. M. Hinkel ◽  
L. Gallagher ◽  
S. R. DeVader ◽  
J. L. Vandergrift ◽  
...  
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Supportive Care ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Median Number ◽  
Multiple Choice Questions ◽  
Convenience Sample ◽  
Safety Parameters ◽  
Oncology Practice

e17537 Background: NCCN Chemotherapy Order Templates (COT), which delineate antineoplastics and associated supportive care agents, monitoring and safety parameters, and instructions for self-administered agents, were launched in 2008 to complement the NCCN Clinical Practice Guidelines in Oncology and NCCN Drugs and Biologics Compendium for nine cancers. Through COT, NCCN sought to enhance patient safety by reducing medication errors, anticipating and managing adverse events, and standardizing care. NCCN developed and distributed a survey to evaluate the reception, use, and impact of COT on oncology practice. Methods: The survey included multiple-choice questions with filtering logic. Questions included 5-point Likert scale. The survey was emailed on December 18, 2008 to a convenience sample of 10,183 registered users of NCCN.org who had clicked at least once to the COT; 110 (1%) survey emails were undeliverable. 734 (7%) responded by 1/5/09 and 588 (6%) completed the survey (80% completion rate). 28 (<1%) recipients opted out of participating. Results: 476 (64%) respondents were providers, including MDs (47%), mid-level (8%) and nurses (10%); 11% were pharmacists. Of the 734 respondents, 465 (63%) had used COT. Among the 465 users, the median number COT accessed was 2 (range 0 - 9) with physicians accessing more than other providers (p = 0.002). Breast cancer COT were accessed most (68%). COT were used as a reference (52%) and for setting up chemotherapy orders (42%). 292 users (63%) agreed that COT impacted patient safety; with MDs more likely to agree (p = 0.001) compared to other providers. Of these, 89% responded that COT made chemotherapy ordering safer. 271 users (58%) agreed that using NCCN COT in practice impacted the ordering of supportive care agents. Among providers, MDs were more likely to agree (p = 0.002). Of those who agreed, 86% responded that COT made it more likely that appropriate supportive care orders were included. Conclusions: Adding NCCN Chemotherapy Order Templates to the core NCCN content was done to make the NCCN Clinical Practice Guidelines in Oncology more accessible to providers. Survey results indicate that COT users feel that template use improves the safety of chemotherapy and supportive care agents. Throughout 2009, NCCN will continue to develop COT to cover most cancers. [Table: see text]

scholarly journals Ocular oncology practice guidelines during COVID-19 pandemic-An expert consensus

2020 ◽  
Vol 68 (7) ◽  
pp. 1281 ◽  
Author(s):  
FairoozP Manjandavida ◽  
SantoshG Honavar ◽  
Usha Kim ◽  
Usha Singh ◽  
Vikas Menon ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Expert Consensus ◽  
Oncology Practice
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