Current Issue : October - December Volume : 2018 Issue Number : 4 Articles : 6 Articles
Background: The high impact of a cancer diagnosis on patients and their families and the increasing costs of\ncancer treatment call for optimal and efficient oncological care. To improve the quality of care and to minimize\nhealthcare costs and its economic burden, many healthcare organizations introduce care pathways to improve\nefficiency across the continuum of cancer care. However, there is limited research on the effects of cancer care\npathways in different settings.\nMethods: The aim of this systematic review and meta-analysis described in this protocol is to synthesize existing\nliterature on the effects of oncological care pathways. We will conduct a systematic search strategy to identify all\nrelevant literature in several biomedical databases, including Cochrane library, MEDLINE, Embase, and CINAHL. We\nwill follow the methodology of Cochrane Effective Practice and Organisation of Care (EPOC), and we will include\nrandomized trials, non-randomized trials, controlled before-after studies, and interrupted time series studies. In\naddition, we will include full economic evaluations (cost-effectiveness analyses, cost-utility analyses, and costbenefit\nanalyses), cost analyses, and comparative resource utilization studies, if available. Two reviewers will\nindependently screen all studies and evaluate those included for risk of bias. From these studies, we will\nextract data regarding patient, professional, and health systems outcomes. Our systematic review will follow\nthe PRISMA set of items for reporting in systematic reviews and meta-analyses.\nDiscussion: Following the protocol outlined in this article, we aim to identify, assess, and synthesize all\navailable evidence in order to provide an evidence base on the effects of oncological care pathways as\nreported in the literature....
Some of themost significant advances in ovarian cancer treatment have been those that result in improvements in progression-free\nsurvival (PFS); however there is little research to understand the value that patients place on accessing therapies that result in PFS\nas a clinical outcome related to survivorship. This study therefore aimed to understand the experience and expectations of women\nwith ovarian cancer in Australia in relation to quality of life (QoL) and treatment options. An online survey collected demographic\ninformation and 13 investigator-derived structured interview questions were developed to understand the experience of women\nwith ovarian cancer, their understanding of terminology associated with their condition, and expectations of future treatment. This\nstudy demonstrated that ovarian cancer patients equate PFS with being in remission and that patients expect QoL during that time\nto be good to excellent.Women in this study described excellent QoL as feeling positive and happy and not worrying about cancer,\nfeeling fit and healthy without side effects, and being able to live life as they did before their diagnosis, including the absence of\nfear of progression or recurrence. It is therefore suggested that there is a positive relationship between PFS and QoL. While it is\ndifficult to quantify QoL and further research is needed, the results of this study suggest that the minimum time that women with\novarian cancer expect in relation to treatments that result in PFS is approximately six months. In the absence of this information,\ndecision-makers are left to make assumptions about the value women place on access to therapeutics that increase PFS, which for\nthis type of cancer is an important aspect of survivorship....
Background. Neoplasm, AKA cancer (Ca), is associated with majormorbidity and mortality. Aim. Measurement of health related\nquality of life (HRQoL) of Ca patients is uncommon in Ethiopia. The present study determined the HRQoL and its determinants\namong people living with Ca in north Ethiopia. Methods. A prospective hospital based study was conducted from 1 January 2017\nto 30 August 2017 on Ca patients attending cancer treatment center of University of Gondar Teaching Hospital. The European\nOrganization for Research and Treatment of Cancer Questionnaire version 3 was utilized to collect the data.The rate of QoL was\npresented using means with standard deviation (�±SD). Binary logistic regression was employed to determine factors associated\nwith HRQoL. Result. The present study is based on the findings from 150 subjects. The rate of QoL was 52.7 (20.1) (mean �± SD).\nThe highest functional status was emotional functioning 61 (25.5). Patients with no disease metastasis, 92.1 (5.1), had high QoL\nas compared to metastasis, 22.1 (18.9) (...
Background: Screening programs for cervical neoplasm among women in the\nKingdom of Saudi Arabia (KSA) are very limited. Objective: To investigate\nthe prevalence and risk factors of cervical epithelial abnormalities among patients\nattending a health care specialty center (HCSC) of King Abdulaziz\nMedical City, Riyadh, KSA. Design: A questionnaire was developed to collect\ninformation about socio-demographic variables followed by cytopathological\nanalysis of Papanicolaou (Pap) smear. Settings: Female patients attending the\ngynecology clinic in the HCSC for cervical abnormalities during 2006 and\n2008 were selected for the study. Subjects and Methods: Pap smear was collected\nand subjected to cytopathological analysis, which was further classified according\nto the revised Bethesda 2001 system. Information on socio-demographic variables,\ntype and duration of oral contraceptives usage, active or passive smoking, history\nof sexually transmitted disease, or cervical cancer was collected by trained\nhealthcare professionals. Results were analyzed using chi-square test and\nt-test. Main outcome measures: Lower frequency of cervical lesions among\nKSA females in comparison with the western countries. Results: A total of 495\nPap smears were studied, out of which 31 Pap smears were found to be unsatisfactory\nand therefore excluded. Among the remaining Pap smears, 6.5%\nwere found to be abnormal; however, this was not statistically significant.\nNone of the studied socio-demographic factors were found to be significantly\ncorrelated with the appearance of abnormal Pap smears, except for passive\nsmoking. Conclusion: Saudi Arabia had a lower frequency of cervical lesions\nin comparison with the western countries. Further, this study can serve as a pilot study for a larger national screening program for the identification of\nprevalence and risk factors of cervical lesions in the women of KSA. Limitations:\nCases included in the study belong to the particular period, and patients\nwith abnormal Pap smears were not followed up. In-extension, the included\ndata were not restricted for a particular community....
Theaimis to summarize current knowledge on bothQoL and depressive/anxious symptoms in patients with UM, including studies\non the effect on QoL and psychological status of genetic testing related to the risk of metastatic disease. A review from the last 25\nyears by using the databases ââ?¬Å?PsycInfo,ââ?¬Â ââ?¬Å?Medline,ââ?¬Â and ââ?¬Å?Science Directââ?¬Â was performed. As a total result, eighteen papers were\nretrieved. Eight studies (44.4%) used a prospective design methodology: two were retrospective observations (11.1%), three were\ncross-sectional observational studies (16.6%), and three (16.6%) were naturalistic follow-up studies. One trial was conducted with\na case-control design (5.5%), and one was a methodological paper (5.5%). The number of subjects included in the studies ranged\nwidely, between 7 and 842 (mean: 152.1 Ã?± 201.3), for a total of 2587 patients, 1306 males (50.5%) and 1281 females (49.5%).Themean\nage of subject enrolled was 61.3 Ã?± 4.1 years. Twenty-six different scales, questionnaires, or interviews were utilized. No significant\ndifferences inQoL between radiotherapy and enucleation emerged.Genetic testing did not significantly affectQoL or psychological\nstatus....
Purpose. To analyze the current physician clinical oncological workforce within the CARICOM full member states with an\naim to make recommendations for building capacity. Methods. A questionnaire was prepared and emailed to professionals\nworking in oncology in 14 CARICOM full member countries. It was designed to identify the number of specialists providing\nhematology, medical oncology, and radiotherapy services. Results. Ten countries (71.4%) supplied information. Oncology services\nwere insufficient in the majority of countries. Hematology proved to be the most adequately staffed with six countries (60%) having\nthe recommended number of specialists. Medical oncology services were deficient in five countries (50%). Radiation oncology\nservices were the most limited with nine countries (90%) unable to provide the required quota of specialists. The majority of the\nworkforce consisted of nonnationals (55%). The remaining practitioners were nationals, and of these 50% were regionally trained.\nOncological care was primarily offered within the public sector. Conclusion.Oncological staffingwithin theCARICOMfullmember\nstates is insufficient to meet the demands of the current population. Encouraging training through locoregional or international\nprograms is key to obtaining the numbers required. Cancer registries will help provide data to influence public policy and improve\nthe oncological healthcare system....
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