Sandro Barni1, Evaristo Maiello2, Massimo Di Maio3, Andrea Ardizzoni4, Federico Cappuzzo5, Ernesto Maranzano6, Silvia Novello7, Chiara Bennati8, Alessandra Ori9, Sara Rizzoli9, Lucio Crinò8. 1. Azienda Ospedaliera di Treviglio-Caravaggio, Piazzale Ospedale 1, 24047, Treviglio, Bergamo, Italy. 2. IRCCS Casa Sollievo della Sofferenza, Via Cappuccini, 71013 San Giovanni Rotondo, Foggia, Italy. 3. Dipartimento di Oncologia, Università di Torino, AOU San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Torino, Italy. Electronic address: massimo.dimaio@unito.it. 4. Policlinico S Orsola-Malpighi, Via Albertoni 15,40138 Bologna, Italy. 5. Istituto Toscano Tumori, Viale Alfieri 36, 57100 Livorno, Italy. 6. Azienda Ospedaliera Santa Maria di Terni, Via Tristano di Joannuccio 1, 05100 Terni, Italy. 7. Dipartimento di Oncologia, Università di Torino, AOU San Luigi Gonzaga, Regione Gonzole 10, 10043 Orbassano, Torino, Italy. 8. Azienda Ospedaliera di Perugia, Via S. Andrea Delle Fratte, 06156 Perugia, Italy. 9. MediData srl, Viale Virgilio 54/U, 41123 Modena, Italy.
Abstract
OBJECTIVES: Clinical practice guidelines represent a key tool to improve quality and reduce variability of cancer care. In 2004, Italian Association of Medical Oncology (AIOM) launched the RIGHT (research for the identification of the most effective and highly accepted clinical guidelines for cancer treatment) program. The third step, RIGHT-3, evaluated the concordance between AIOM lung cancer guidelines and Italian clinical practice. MATERIALS AND METHODS: RIGHT-3 was a retrospective observational study, conducted in 53 Italian centers treating lung cancer. Sampling from AIOM database of 230 centers was stratified by presence of thoracic surgery and geographic distribution. To describe the adherence to AIOM guidelines (2009 edition), 11 indicators regarding diagnostic and treatment procedures were identified. Patients with non-small-cell lung cancer (NSCLC) diagnosis who had first visit in 2010 were divided into 3 groups, based on TNM stage: I-II-IIIA (5 indicators), IIIB (3 indicators) and IV (3 indicators). RESULTS: 708 patients were enrolled; 680 were eligible: 225 patients in stage I-II-IIIA; 156 patients in stage IIIB; 299 patients in stage IV. Cyto-histological diagnosis was available in 96%, 97%, 96% of stage I-II-IIIA, IIIB, IV respectively. Positron-emission tomography was performed in 64% of stage I-II-IIIA and 46% of stage IIIB. 88% of stage I-II patients eligible for surgery underwent lobectomy; after surgery, 61% of stage II and 57% of stage IIIA patients received adjuvant chemotherapy. Among stage IIIB patients who received combined chemo- radiotherapy, sequential approach was more common than concomitant treatment (86% vs. 14%). Among stage IV patients, 87% received platinum-based first-line treatment, and 70% received second-line. CONCLUSION: The RIGHT-3 study showed that, in 2010, adherence to Italian NSCLC guidelines was high for many indicators (including those related to treatment of stage IV patients), but lower for some diagnostic procedures. Guidelines adherence monitoring can be useful to reduce variability in cancer care.
OBJECTIVES: Clinical practice guidelines represent a key tool to improve quality and reduce variability of cancer care. In 2004, Italian Association of Medical Oncology (AIOM) launched the RIGHT (research for the identification of the most effective and highly accepted clinical guidelines for cancer treatment) program. The third step, RIGHT-3, evaluated the concordance between AIOM lung cancer guidelines and Italian clinical practice. MATERIALS AND METHODS: RIGHT-3 was a retrospective observational study, conducted in 53 Italian centers treating lung cancer. Sampling from AIOM database of 230 centers was stratified by presence of thoracic surgery and geographic distribution. To describe the adherence to AIOM guidelines (2009 edition), 11 indicators regarding diagnostic and treatment procedures were identified. Patients with non-small-cell lung cancer (NSCLC) diagnosis who had first visit in 2010 were divided into 3 groups, based on TNM stage: I-II-IIIA (5 indicators), IIIB (3 indicators) and IV (3 indicators). RESULTS: 708 patients were enrolled; 680 were eligible: 225 patients in stage I-II-IIIA; 156 patients in stage IIIB; 299 patients in stage IV. Cyto-histological diagnosis was available in 96%, 97%, 96% of stage I-II-IIIA, IIIB, IV respectively. Positron-emission tomography was performed in 64% of stage I-II-IIIA and 46% of stage IIIB. 88% of stage I-II patients eligible for surgery underwent lobectomy; after surgery, 61% of stage II and 57% of stage IIIA patients received adjuvant chemotherapy. Among stage IIIB patients who received combined chemo- radiotherapy, sequential approach was more common than concomitant treatment (86% vs. 14%). Among stage IV patients, 87% received platinum-based first-line treatment, and 70% received second-line. CONCLUSION: The RIGHT-3 study showed that, in 2010, adherence to Italian NSCLC guidelines was high for many indicators (including those related to treatment of stage IV patients), but lower for some diagnostic procedures. Guidelines adherence monitoring can be useful to reduce variability in cancer care.
Authors: Shrujal S Baxi; Minal Kale; Salomeh Keyhani; Benjamin R Roman; Annie Yang; Antonio P Derosa; Deborah Korenstein Journal: Med Care Date: 2017-07 Impact factor: 2.983
Authors: Namrata Kewalramani; Carlos Machahua; Venerino Poletti; Jacques Cadranel; Athol U Wells; Manuela Funke-Chambour Journal: ERJ Open Res Date: 2022-06-20