Adherence to practice guidelines is associated with reduced referral times for patients with ovarian cancer
被引:5
作者:
Boac, Bernadette M.
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H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Boac, Bernadette M.
[1
]
Xiong, Yin
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H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Xiong, Yin
[1
]
Apte, Sachin M.
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H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Apte, Sachin M.
[1
]
Wenham, Robert M.
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H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Wenham, Robert M.
[1
]
Shahzad, Mian M.
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H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Shahzad, Mian M.
[1
]
Munroe, Donald G.
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机构:
Vermillion Inc, Austin, TX USA
Ventana Med Syst Inc, Tucson, AZ USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Munroe, Donald G.
[3
,4
]
Lancaster, Johnathan M.
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机构:
H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USA
Myriad Genet Inc, Salt Lake City, UT USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Lancaster, Johnathan M.
[2
,5
]
Chon, Hye Sook
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H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USAH Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
Chon, Hye Sook
[1
]
机构:
[1] H Lee Moffitt Canc Ctr & Res Inst, Dept Gynecol Oncol, Tampa, FL 33612 USA
[2] H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USA
BACKGROUND: Patients with ovarian cancer tend to receive the highest quality of care at high-volume cancer centers with gynecological oncologists. However, the care that they receive prior to gynecological oncology consult has not been examined. We investigated the quantity and quality of care given to patients with ovarian cancer before being seen by a gynecological oncologist. OBJECTIVE: We evaluated the variability, quantity, and quality of diagnostic testing and physician-referral patterns prior to consultation with a gynecological oncologist, in women with suspicious pelvic masses seen on imaging. STUDY DESIGN: A chart review was performed on patients treated for ovarian cancer at a single institution from 2001 to 2014. We evaluated their workup in 4 categories, drawn from National Comprehensive Care Network guidelines: provider visits, abdominal/pelvic imaging, chest imaging, and tumor markers. Workup was classified as guideline adherent or guideline nonadherent. RESULTS: We identified 335 cases that met our criteria. In the provider visit category, 83.9% of patients received guideline-adherent workup: 77% in the abdominal/pelvic imaging, 98.2% in the chest imaging, and 95.2% in the tumor marker categories. Each patient's workup was assessed as a compilation of the 4 categories, yielding 65.7% patients as having received an adherent workup and 34.3% of workup as nonadherent to guidelines. The timeframe to see a gynecological oncologist for patients with guideline-adherent workup was significantly shorter than for those whose workup was nonadherant (20 vs 86 days, P<.001). A suspicious pelvic mass was identified by obstetrics-gynecology in only 23.9% of patients; 42.7% of patients did not have tumor marker testing before a gynecological oncologist consult. When an obstetrics-gynecology specialist discovered the suspicious pelvic mass, the remaining workup was more likely to be guideline adherent prior to gynecological oncologist referral than when initial imaging was not ordered by an obstetrics-ynecology specialist (P=.18) Survival was not significantly different (P=.103). CONCLUSION: With a guideline-adherent workup, including tumor marker testing, gynecological oncologist referral times can be shortened, minimizing cost inefficiencies and delays that can compromise the effectiveness of downstream care for patients with ovarian cancer. Guidelines should be disseminated beyond the obstetrics-gynecology field.
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页码:436.e1 / 436.e7
页数:7
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American College of Obstetricians and Gynecologists, 2007, Obstet Gynecol, V110, P201
[2]
[Anonymous], 2011, OBSTET GYNECOL
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[Anonymous], 2015, NCCN clinical practice guidelines in oncology: Prostate cancer
机构:
Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Bankhead, C. R.
Collins, C.
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Univ Birmingham, Dept Obstet & Gynaecol, Birmingham, W Midlands, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Collins, C.
Stokes-Lampard, H.
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Univ Birmingham, Dept Obstet & Gynaecol, Birmingham, W Midlands, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Stokes-Lampard, H.
Rose, P.
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机构:Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Rose, P.
Wilson, S.
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Univ Birmingham, Dept Primary Care, Birmingham, W Midlands, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Wilson, S.
Clements, A.
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Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Clements, A.
Mant, D.
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机构:Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Mant, D.
Kehoe, S. T.
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Univ Oxford, Nuffield Acad Dept Obstet & Gynaecol, Womens Ctr, John Radcliffe Hosp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Kehoe, S. T.
Austoker, J.
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Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Chan, John K.
Kapp, Daniel S.
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Kapp, Daniel S.
Shin, Jacob Y.
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h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Shin, Jacob Y.
Husain, Amreen
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Husain, Amreen
Teng, Nelson N.
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Teng, Nelson N.
Berek, Jonathan S.
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Berek, Jonathan S.
Osann, Kathryn
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Osann, Kathryn
Leiserowitz, Gary S.
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Leiserowitz, Gary S.
Cress, Rosemary D.
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Cress, Rosemary D.
O'Malley, Cynthia
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机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
机构:
Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Bankhead, C. R.
Collins, C.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Birmingham, Dept Obstet & Gynaecol, Birmingham, W Midlands, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Collins, C.
Stokes-Lampard, H.
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h-index: 0
机构:
Univ Birmingham, Dept Obstet & Gynaecol, Birmingham, W Midlands, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Stokes-Lampard, H.
Rose, P.
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h-index: 0
机构:Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Rose, P.
Wilson, S.
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h-index: 0
机构:
Univ Birmingham, Dept Primary Care, Birmingham, W Midlands, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Wilson, S.
Clements, A.
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机构:
Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Clements, A.
Mant, D.
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h-index: 0
机构:Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Mant, D.
Kehoe, S. T.
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h-index: 0
机构:
Univ Oxford, Nuffield Acad Dept Obstet & Gynaecol, Womens Ctr, John Radcliffe Hosp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
Kehoe, S. T.
Austoker, J.
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h-index: 0
机构:
Univ Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, EnglandUniv Oxford, Dept Primary Care, Canc Res UK Primary Care Educ Res Grp, Oxford OX3 7LF, England
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Chan, John K.
Kapp, Daniel S.
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h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Kapp, Daniel S.
Shin, Jacob Y.
论文数: 0引用数: 0
h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Shin, Jacob Y.
Husain, Amreen
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h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Husain, Amreen
Teng, Nelson N.
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h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Teng, Nelson N.
Berek, Jonathan S.
论文数: 0引用数: 0
h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Berek, Jonathan S.
Osann, Kathryn
论文数: 0引用数: 0
h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Osann, Kathryn
Leiserowitz, Gary S.
论文数: 0引用数: 0
h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Leiserowitz, Gary S.
Cress, Rosemary D.
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h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA
Cress, Rosemary D.
O'Malley, Cynthia
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h-index: 0
机构:Univ Calif San Francisco, Div Gynecol Oncol, Dept Obstet Gynecol & Reprod Sci, Sch Med,San Francisco Comprehens Canc Ctr, San Francisco, CA 94143 USA