Matthew D F McInnes1,2, Sulaiman Nanji3,4,5, William J Mackillop3,4,6, Jennifer A Flemming7, Xuejiao Wei3, D Blair Macdonald1,2, Nicola Scheida1,2, Christopher M Booth3,4,6. 1. Department of Radiology, University of Ottawa, Ottawa, ON, Canada. 2. Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada. 3. Division of Cancer Care and Epidemiology, Queen's University Cancer Research Institute, Queen's University, Kingston, ON, Canada. 4. Department of Oncology, Queen's University, Kingston, ON, Canada. 5. Department of Surgery, Queen's University, Kingston, ON, Canada. 6. Department of Public Health Sciences, Queen's University, Kingston, ON, Canada. 7. Department of Gastroenterology, Queen's University, Kingston, ON, Canada.
Abstract
OBJECTIVE: To assess the use of pre-operative imaging for colon cancer and to identify factors associated with utilization in routine clinical practice. METHODS: This population-based, retrospective cohort study used a random sample of 25% of colon cancer patients treated with surgery in the province of Ontario (2002-2008). Pre-operative imaging (<16 weeks from surgery) of the chest, abdomen-pelvis was identified. Modified poisson regression was used to analyze factors associated with practice patterns. RESULTS: Of the 7,249 included patients, 48% had pre-operative imaging (CT abdomen and imaging of the chest) in keeping with guideline recommendations. The rate of guideline concordant pre-operative imaging increased over time: 64% in the most recent study period (2006-2008) versus 31% (2002-2004); P < 0.001. Variables associated with use of chest imaging: Age, co-morbidity, surgeon volume, and geographic region; no association with gender, hospital volume, or socio-economic status. Variables associated with use of abdomen imaging: Hospital volume and geographic region; no association with age, gender, comorbidity, socio-economic status, or surgeon volume. CONCLUSION: In clinical practice, the majority of patients were not receiving pre-operative imaging that was in line with clinical practice guidelines; however, use increased over time indicating a possible association with dissemination of clinical practice guidelines. J. Surg. Oncol. 2017;115:202-207.
RCT Entities:
OBJECTIVE: To assess the use of pre-operative imaging for colon cancer and to identify factors associated with utilization in routine clinical practice. METHODS: This population-based, retrospective cohort study used a random sample of 25% of colon cancerpatients treated with surgery in the province of Ontario (2002-2008). Pre-operative imaging (<16 weeks from surgery) of the chest, abdomen-pelvis was identified. Modified poisson regression was used to analyze factors associated with practice patterns. RESULTS: Of the 7,249 included patients, 48% had pre-operative imaging (CT abdomen and imaging of the chest) in keeping with guideline recommendations. The rate of guideline concordant pre-operative imaging increased over time: 64% in the most recent study period (2006-2008) versus 31% (2002-2004); P < 0.001. Variables associated with use of chest imaging: Age, co-morbidity, surgeon volume, and geographic region; no association with gender, hospital volume, or socio-economic status. Variables associated with use of abdomen imaging: Hospital volume and geographic region; no association with age, gender, comorbidity, socio-economic status, or surgeon volume. CONCLUSION: In clinical practice, the majority of patients were not receiving pre-operative imaging that was in line with clinical practice guidelines; however, use increased over time indicating a possible association with dissemination of clinical practice guidelines. J. Surg. Oncol. 2017;115:202-207.