- Email: [email protected]
P-343 Audit of data collection from lung cancer multidisciplinary team (MDT) meetings in South Western Sydney Area Health Service
$206
Posters t H e a f h services research
per week free of cost for Ant] Tobacoo campaign. They are groomed for health subjeot~secial aspects/counselling & rahabilItat]on by NGO staff Since August 2001 NCVM volunteers toured villages to conduct ant]-tobeoco programmes By ct,rrent rata we aim to cover 96 villages by 2010 target]ng tobacco consumers [Est]mated to be 4.30.000] from rural India Performa of this module with its operational methodology will be demonsb'ated to Barcalonal-lASLC200b conference participants Results: We did face hiccups in mobllising volunteers Dunng Phase-1 basic cost ware borne by donat]ons from local temples & well wlshors. In stat]stical analysis this method works outto be cost offeot]vo by margin of 60% compared to traclt]onal work cost of NGO campaigns [+ OR~% S.D.] This module conducts paint]ng competitions, kIte flying competitions among smokers & nor. smokers to achieve greater degree of motivation, we plan to integrate religious bodied & cultural community pregrammos to spread our Ant] Tobaoco message. NCVM sb'ategy has minimum maintenance cost & high acooptabdity among rural popolations Conclusion: Dunng developmental stages of tobacoo-induesd cancer campaigns gett]ng sponsors is obstacle After slogging for three years we recommend this approach for Cancer NGOs We need platform like Barcalona200b to interact with esperts in tobacco control
[P-~
The Cochrane Lung Cancer Review Group. An evldsnce-baesd resource for the management of lung cancer
S. TortI . F. Macbeth 2. M. Roque I . J. Garcia I . X. Bonfill ~. llberoametTcan
Cochrane Centre, Barcelona, Spain, 2Nationa/ Co/laborating Centre for Cancer, Caraiff, UK
Background: The Cochrane Collaboration is an internat]onal, not fo~profit and independent organisat]on, dedicated to making up~o date. accurate informat]on about the offoots of hoalthcaro reaclly evadable worldwide. The Cochrano Lung Canoor Review Group (LCG) (wwwcochrane.eslLCG) was set up in 1998 to prepare, update and clsseminate systemat]c rrevlews about the hoalthcare intorvent]ons for pat]ents with lung cancer which are published quarterly electronically as part of The Cochrane Library
( www update-software comlabstrectsiL UNGCAAbstractlndex htm) Methods: The LCG coordinates and gives methodological support to a network of people from all over the wodd who are interested in reviewing a specific intervention for lung cancer and assume responsibility for developing and maintaining a systematic review (SR) There are at present 40 authors in the group and the ecitorial team. based in Barcelona (Spain). is composed of two co~rdinat]ng edItors, one c(~ordinator, eight edItors, one thals search co<)rdinator, a few referees and one consumer. Results: S~teon SRs and ten protocols (a summary of the methods of a planned SR) are currently published in The Cochrene LJbrery. Published reviews cover prevent]on and oady detection (2). intervont]ons in NSCLC (6). interventions in SCLC (3) and other general intervont]ons in lung cancer (3). Conb'ovorsial topics reviewed are chemotherapy for NSCLC. screening for lung cancer and chest raciotherapy for SCLC. among others Besides its review work. the group is developing a Specialised Tnals Register. a database of all the RCTs in lung cancer ever published, which at present contains 137,5 records Conclusions: Tha work of the LCG is a very valuable and up-to,late source of high quality evidenoe~ased informat]on about the interventions for patients with lung cancer This tool can help researchers, dinicians and patients who need easy access to high quality and reliable informat]on on dinical effectiveness.
~-~
Dlagnoetlc succees rate of elngle day outpaUent evaluaUon of suspected lung cencer
The diagnesic sucooss rate of the single day evaluation was 60%. 68% of the pat]ents include for this prngramma a malignant cisease was found The mean pat]ent sat]sfaction score was 8. 5 Conclusions: Single day outpat]ent evaluat]on of pat]ents suspected of lung cancer has a high diagnesltc yield and is well tolerated by pat]ents [P-343] Audit of data collection from lung cancer multldlsclpllnary team (MDT) meetings in South Western Sydney Area Health Service S Vinod Collaborabon for Cancer Outcomes, Research and Education
(CCORE), Sydney, NSW, Austra/ia
Background: Patterns of care studios are an important tool in measuring the quality of pabont care. In SWSAHS, a lung cancer patterns of care study, based on rolzospeot]vo analysis of medical records has boon performed. (1) However. retTospective case review is limited by non-standardised recording of data and missing data Prospect3ve data collect]on enables more accurate recording and t]mely analysis A comprehensive data form was introduced at the SWSAHS Lung Cancer MDT meetings for this purpose The aim of this study was to assess completeness of data collection from these new data forms used for pat]ent presertat]on at the Lung Cancer MDT meet]rig Methods: In SWSAHS there are weekly Lung Cancer MDT meet]ngs where the management of newly diagnosed lung cancer pabonts is discussed. New patients are presented with the aid of a standard data form that was adopted for use in Juno 2003. In adclt]on the Lung Canoor Clinical Care Coordinator creates an agenda for each meeting and records the decisions made. A reb-espoctlve review was performed of collected data forms and the recorded agenda of MOT meetings from Juno 2003 May 2004. The data was analysed with SPSS v12. Results: Over this 12 month peded, there were. 184 cases presented at the MDT meet]ng These consisted of 142 were now patient presentat]ons and 42 follow-up presentations Of 142 new pat]ent presentations, only 85 (60%) ware presented using the new data form Data forms were filled in for 11/17 (6,5%) of cases presented by surgeons. 35/38. (92%) by radiation oncologists. 10/13 (77%) by medical oncologists. 29/65 (4,5%) by respiratory physicians and 0/2 (0%) by palliat]ve care physicians The pat]ent's height, weight, blood parameters and respiratory funot]on were the most poorly recorded Items. missing in 60% or greater of forms. Ago. gender, pathology grouping and b'eatmont plan were the best recorded Items missing in 2% or less of forms. The exact pathology was not recorded in 49% and date of diagnos~s was not recorded in 67%. Stage. performance status and weight loss data were missing in at least 10% of forms. Conclusions: Collection of patient data is vItal in imprrevlng qual~ of patient care This is best done prospa~vely to improve acouraot and minimise omissions The Lung MDT implemented a comprehensive data form for this porpose However the poor use of data forms for presentat]on and frequent missing data Items makes analysis ofpat]ent care difficult Limit]rig the number of data Items to those that directly impact on management and outcomes is suggested to improve completeness of data collection However all clinicians need to pa~cipate in such data collection to obtain benefits from It Only then can we begin to b'y and improve quality of patient care and outcomes.
[P-344] Patteme of care for lung cancer in New South Wales, Australia: Prellrnlnary results S. Mined~ D. O'Connell 2. D. King2 . B. Armstrong ~. ~Cancer Therapy Centre,
Uverpoot Hospital, Sydney, Australia, 2 Cancer Epiderniology Research Umt, The Cancer ~ c t l NSW, Sydney, Australta, 3School of Publtc Health, Umvereity ot Sydney, Australia
H van der Heilden. M van der Ddft. P Dekhuijzen Radboud University
Background: In 2002. there were 2627 new cases of lung cancer in New
Nijmegen Medical Centre, Nijmegan, Nelheffands
South Wales. represent]ng 9% of all cancers Although ranked only fourth in incidence, lung cancer is the leading cause of cancer death in NSW. account]ng for 2242 deaths or 16% of all cancer deaths in 2002. Survrval from lung canoor is poor and little is known about its clinical management in Ausb'alia. A study of lung cancer management in VIotorla. Australia in 1993 reported that the care of patients with lung cancer was sub optimal and inconsistent with published guidelines. The study found that 13% of patients had no histological confrmation of their disease and 25% of patients rooolvod no antitumour therapy: The aims of this study were to describe pattems of care for lung cancer and compare them to evidenco-pased gLidelines and other high quality evidence Methods: Pat]ants diagnosed with lung cancer between 1 November 2001 and 31 December 2002 ware identified from the NSW Central Cancer Registry (CCR) Informed consent was obtained to collect information about the clagnosis and treatment of their lung cancer from the tTeating doctor(s) Where consent could net be given because the pat]ant had died. specific ethics approval was obtained for data to be collected directly from clinioans. Data ware collected on diagnosis, staging and irlt]al treatment including surgery. chemotherapy, and radiotherapy. For each patient, h-eating doctors wore identified through CCR notifications and information about referrals obtained from other doctors.
Bac~(ground: rapid evaluat]on of patients suspected of lung cancer can significantly reduce the t]mo needed for diagnosis. Since august 1999 we use a single day outpat]ent evaluat]on program for these pat]onts based on abnormalit]os on a chest roontgonogram. After clinical evaluat]on by a chest physician the patients are evaluated subsequently by a C~scan. pulmonary function test. bronchoscopy and PET scan. all performed on the same day. At the end of the day the results of those investigations are discussed with the pat]ent and a staging and treatment propcsal are made Methods: Diagnost]c success rate of the and of day diagnosis was evaluated in the first 67 pat]ants who have part]cipatad in this program Tolerability was evaluated by a questionnaire rat]ng tha ovarall pat]ent sat]sfaction on a 0 to 10 visual analog scale Reeulte: 8.7 pat]ents (age 38. 8.7. 66 males and 21 females) ware evaluated In ,52 (61%) patients a clagnosis was available at the end of the single day evaluation program based on cytological samples obtained by brenchescapy. After further evaluat]on a final diagnosis of NSCLC was found in 47 (54%) pat]onts and of SCLC in 3 pat]ents(3%). Metastases were found in 9 (10%) pat]onts and non malignant disease in 18 patients (21%). A total number of 45 pat]onts (52%) wore surgically b'oated after a mean waiting t]me of 11 days.
Posters t H e a f h services research
per week free of cost for Ant] Tobacoo campaign. They are groomed for health subjeot~secial aspects/counselling & rahabilItat]on by NGO staff Since August 2001 NCVM volunteers toured villages to conduct ant]-tobeoco programmes By ct,rrent rata we aim to cover 96 villages by 2010 target]ng tobacco consumers [Est]mated to be 4.30.000] from rural India Performa of this module with its operational methodology will be demonsb'ated to Barcalonal-lASLC200b conference participants Results: We did face hiccups in mobllising volunteers Dunng Phase-1 basic cost ware borne by donat]ons from local temples & well wlshors. In stat]stical analysis this method works outto be cost offeot]vo by margin of 60% compared to traclt]onal work cost of NGO campaigns [+ OR~% S.D.] This module conducts paint]ng competitions, kIte flying competitions among smokers & nor. smokers to achieve greater degree of motivation, we plan to integrate religious bodied & cultural community pregrammos to spread our Ant] Tobaoco message. NCVM sb'ategy has minimum maintenance cost & high acooptabdity among rural popolations Conclusion: Dunng developmental stages of tobacoo-induesd cancer campaigns gett]ng sponsors is obstacle After slogging for three years we recommend this approach for Cancer NGOs We need platform like Barcalona200b to interact with esperts in tobacco control
[P-~
The Cochrane Lung Cancer Review Group. An evldsnce-baesd resource for the management of lung cancer
S. TortI . F. Macbeth 2. M. Roque I . J. Garcia I . X. Bonfill ~. llberoametTcan
Cochrane Centre, Barcelona, Spain, 2Nationa/ Co/laborating Centre for Cancer, Caraiff, UK
Background: The Cochrane Collaboration is an internat]onal, not fo~profit and independent organisat]on, dedicated to making up~o date. accurate informat]on about the offoots of hoalthcaro reaclly evadable worldwide. The Cochrano Lung Canoor Review Group (LCG) (wwwcochrane.eslLCG) was set up in 1998 to prepare, update and clsseminate systemat]c rrevlews about the hoalthcare intorvent]ons for pat]ents with lung cancer which are published quarterly electronically as part of The Cochrane Library
( www update-software comlabstrectsiL UNGCAAbstractlndex htm) Methods: The LCG coordinates and gives methodological support to a network of people from all over the wodd who are interested in reviewing a specific intervention for lung cancer and assume responsibility for developing and maintaining a systematic review (SR) There are at present 40 authors in the group and the ecitorial team. based in Barcelona (Spain). is composed of two co~rdinat]ng edItors, one c(~ordinator, eight edItors, one thals search co<)rdinator, a few referees and one consumer. Results: S~teon SRs and ten protocols (a summary of the methods of a planned SR) are currently published in The Cochrene LJbrery. Published reviews cover prevent]on and oady detection (2). intervont]ons in NSCLC (6). interventions in SCLC (3) and other general intervont]ons in lung cancer (3). Conb'ovorsial topics reviewed are chemotherapy for NSCLC. screening for lung cancer and chest raciotherapy for SCLC. among others Besides its review work. the group is developing a Specialised Tnals Register. a database of all the RCTs in lung cancer ever published, which at present contains 137,5 records Conclusions: Tha work of the LCG is a very valuable and up-to,late source of high quality evidenoe~ased informat]on about the interventions for patients with lung cancer This tool can help researchers, dinicians and patients who need easy access to high quality and reliable informat]on on dinical effectiveness.
~-~
Dlagnoetlc succees rate of elngle day outpaUent evaluaUon of suspected lung cencer
The diagnesic sucooss rate of the single day evaluation was 60%. 68% of the pat]ents include for this prngramma a malignant cisease was found The mean pat]ent sat]sfaction score was 8. 5 Conclusions: Single day outpat]ent evaluat]on of pat]ents suspected of lung cancer has a high diagnesltc yield and is well tolerated by pat]ents [P-343] Audit of data collection from lung cancer multldlsclpllnary team (MDT) meetings in South Western Sydney Area Health Service S Vinod Collaborabon for Cancer Outcomes, Research and Education
(CCORE), Sydney, NSW, Austra/ia
Background: Patterns of care studios are an important tool in measuring the quality of pabont care. In SWSAHS, a lung cancer patterns of care study, based on rolzospeot]vo analysis of medical records has boon performed. (1) However. retTospective case review is limited by non-standardised recording of data and missing data Prospect3ve data collect]on enables more accurate recording and t]mely analysis A comprehensive data form was introduced at the SWSAHS Lung Cancer MDT meetings for this purpose The aim of this study was to assess completeness of data collection from these new data forms used for pat]ent presertat]on at the Lung Cancer MDT meet]rig Methods: In SWSAHS there are weekly Lung Cancer MDT meet]ngs where the management of newly diagnosed lung cancer pabonts is discussed. New patients are presented with the aid of a standard data form that was adopted for use in Juno 2003. In adclt]on the Lung Canoor Clinical Care Coordinator creates an agenda for each meeting and records the decisions made. A reb-espoctlve review was performed of collected data forms and the recorded agenda of MOT meetings from Juno 2003 May 2004. The data was analysed with SPSS v12. Results: Over this 12 month peded, there were. 184 cases presented at the MDT meet]ng These consisted of 142 were now patient presentat]ons and 42 follow-up presentations Of 142 new pat]ent presentations, only 85 (60%) ware presented using the new data form Data forms were filled in for 11/17 (6,5%) of cases presented by surgeons. 35/38. (92%) by radiation oncologists. 10/13 (77%) by medical oncologists. 29/65 (4,5%) by respiratory physicians and 0/2 (0%) by palliat]ve care physicians The pat]ent's height, weight, blood parameters and respiratory funot]on were the most poorly recorded Items. missing in 60% or greater of forms. Ago. gender, pathology grouping and b'eatmont plan were the best recorded Items missing in 2% or less of forms. The exact pathology was not recorded in 49% and date of diagnos~s was not recorded in 67%. Stage. performance status and weight loss data were missing in at least 10% of forms. Conclusions: Collection of patient data is vItal in imprrevlng qual~ of patient care This is best done prospa~vely to improve acouraot and minimise omissions The Lung MDT implemented a comprehensive data form for this porpose However the poor use of data forms for presentat]on and frequent missing data Items makes analysis ofpat]ent care difficult Limit]rig the number of data Items to those that directly impact on management and outcomes is suggested to improve completeness of data collection However all clinicians need to pa~cipate in such data collection to obtain benefits from It Only then can we begin to b'y and improve quality of patient care and outcomes.
[P-344] Patteme of care for lung cancer in New South Wales, Australia: Prellrnlnary results S. Mined~ D. O'Connell 2. D. King2 . B. Armstrong ~. ~Cancer Therapy Centre,
Uverpoot Hospital, Sydney, Australia, 2 Cancer Epiderniology Research Umt, The Cancer ~ c t l NSW, Sydney, Australta, 3School of Publtc Health, Umvereity ot Sydney, Australia
H van der Heilden. M van der Ddft. P Dekhuijzen Radboud University
Background: In 2002. there were 2627 new cases of lung cancer in New
Nijmegen Medical Centre, Nijmegan, Nelheffands
South Wales. represent]ng 9% of all cancers Although ranked only fourth in incidence, lung cancer is the leading cause of cancer death in NSW. account]ng for 2242 deaths or 16% of all cancer deaths in 2002. Survrval from lung canoor is poor and little is known about its clinical management in Ausb'alia. A study of lung cancer management in VIotorla. Australia in 1993 reported that the care of patients with lung cancer was sub optimal and inconsistent with published guidelines. The study found that 13% of patients had no histological confrmation of their disease and 25% of patients rooolvod no antitumour therapy: The aims of this study were to describe pattems of care for lung cancer and compare them to evidenco-pased gLidelines and other high quality evidence Methods: Pat]ants diagnosed with lung cancer between 1 November 2001 and 31 December 2002 ware identified from the NSW Central Cancer Registry (CCR) Informed consent was obtained to collect information about the clagnosis and treatment of their lung cancer from the tTeating doctor(s) Where consent could net be given because the pat]ant had died. specific ethics approval was obtained for data to be collected directly from clinioans. Data ware collected on diagnosis, staging and irlt]al treatment including surgery. chemotherapy, and radiotherapy. For each patient, h-eating doctors wore identified through CCR notifications and information about referrals obtained from other doctors.
Bac~(ground: rapid evaluat]on of patients suspected of lung cancer can significantly reduce the t]mo needed for diagnosis. Since august 1999 we use a single day outpat]ent evaluat]on program for these pat]onts based on abnormalit]os on a chest roontgonogram. After clinical evaluat]on by a chest physician the patients are evaluated subsequently by a C~scan. pulmonary function test. bronchoscopy and PET scan. all performed on the same day. At the end of the day the results of those investigations are discussed with the pat]ent and a staging and treatment propcsal are made Methods: Diagnost]c success rate of the and of day diagnosis was evaluated in the first 67 pat]ants who have part]cipatad in this program Tolerability was evaluated by a questionnaire rat]ng tha ovarall pat]ent sat]sfaction on a 0 to 10 visual analog scale Reeulte: 8.7 pat]ents (age 38. 8.7. 66 males and 21 females) ware evaluated In ,52 (61%) patients a clagnosis was available at the end of the single day evaluation program based on cytological samples obtained by brenchescapy. After further evaluat]on a final diagnosis of NSCLC was found in 47 (54%) pat]onts and of SCLC in 3 pat]ents(3%). Metastases were found in 9 (10%) pat]onts and non malignant disease in 18 patients (21%). A total number of 45 pat]onts (52%) wore surgically b'oated after a mean waiting t]me of 11 days.