Benefits Of Timely Care In Pancreatic Cancer: A Systematic Review To Navigate Through The Contradictory Evidence

被引:25
作者
Lukacs, Gabor [1 ,2 ]
Kovacs, Arpad [1 ,2 ]
Csanadi, Marcell [3 ]
Moizs, Mariann [1 ]
Repa, Imre [1 ,2 ]
Kalo, Zoltan [3 ,4 ]
Voko, Zoltan [3 ,4 ]
Pitter, Janos Gyorgy [3 ]
机构
[1] Moritz Kaposi Gen Hosp, Kaposvar, Hungary
[2] Univ Pecs, Doctoral Sch, Fac Hlth Sci, Pecs, Hungary
[3] Syreon Res Inst, 65-A Mexikoi Ut, H-1142 Budapest, Hungary
[4] Eotvos Lorand Univ, Dept Hlth Policy & Hlth Econ, Budapest, Hungary
基金
欧盟地平线“2020”;
关键词
pancreatic cancer; delay; wait time; prognosis; bias; systematic review; WAIT REFERRAL PATHWAY; TREATMENT DELAY; SURVIVAL; DIAGNOSIS; INTERVAL; SURGERY; IMPACT; ADENOCARCINOMA; OUTCOMES; BIAS;
D O I
10.2147/CMAR.S221427
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The evidence base of policies that improve the timeliness of cancer care is under ongoing debate. Pancreatic cancer is frequently diagnosed in a stage when curative therapy is not feasible; hence, it is an important target for timelier healthcare interventions. The objectives of our research were to identify all clinical studies on pancreatic cancer care delays via a systematic literature review, to assess the study methodologies for possible biases, to conclude on the available evidence, and to formulate research recommendations on evidence gaps. Nineteen studies were identified and eight reported multivariate analyses. Although many sources of bias shifted the results towards negative or paradoxical findings, a statistically significant association of shorter delays with better clinical outcomes was demonstrated in the majority of studies reporting multivariate analyses. Noninferiority analyses were not published. Further efforts to provide timely care for pancreatic cancer patients are encouraged, and studies on the associations of delay with patient experience and healthcare resource utilization are warranted.
引用
收藏
页码:9849 / 9861
页数:13
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