- Email: [email protected]
112 Spreading the word – using consumers effectively
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Poster abstracts of the 14th Annual British Thoracic Oncology Group Conference 2016 / Lung Cancer 91, Suppl. 1 (2016) S1–S71
Some direct outcomes included: • Developing an active and successful working party on symptom management. • A controversial proposal for surgery in advanced lung cancer thought to be a step too far by many clinicians was welcomed as being probably a popular proposal by the PPI member.
Figure 1. Ways in which NCRI Clinical Studies Groups (CSGs) involve consumers in their work.
Conclusion: Consumer contribution to cancer research is vital to ensure the patient voice is considered at all stages. Disclosure: All authors have declared no conflicts of interest. 112
Spreading the word – using consumers effectively
J. Rawlinson. Clinical Studies Group (lung), NCRI, Tipton, United Kingdom Introduction: Putting the patient at the heart of health and social care decisions, treatment design and research have long been suggested by Policy makers within different health and social care departments. How can this be achieved or enhanced within Cancer Research and care? Contributing to a variety of healthcare bodies and committees means networked patients and carers can often reach targeted markets more effectively and bring new ideas for consideration. Drawing on consumer involvement experience within different healthcare settings, enabled cross fertilisation of ideas, new ideas and developments to be communicated more quickly than through more conventional or traditional routes. Methods: Several examples were explored where consumer contribution or communication had impacted on different aspects of cancer services to provide qualitative findings. These included primary care involvement, secondary care exploration of potential future collaborations and input to professionals’ Continuous Professional Development workshops or conferences. Results: Consumers are not just patients or carers – many have or have had distinguished careers in their own areas of expertise. They bring skills, networks and experience that can contribute meaningfully to subjects being considered for cancer research. Skills are often transferable and may differ from others involved. Consumers often belong to several networks so can provide additional or novel connections for often disparate or disconnected parties. Their contribution can create added value to often stretched resources. Experience, enthusiasm and energy from a patient perspective can bring valuable synergies to enhance clinical and scientific findings. Conclusion: It is important to consider the wider impact consumer involvement can have on all aspects of cancer research and care design. Researchers and clinicians should make best use of this valuable and sometimes under utilised and underestimated resource. Disclosure: All authors have declared no conflicts of interest.
113
Barriers to surgery in early stage lung cancer – the East Sussex experience
L. Parker 1 , G. Butcher 1 , O. Kankam 2 . 1 Respiratory Medicine, East Sussex Healthcare Trust, St Leonards on Sea, United Kingdom; 2 Respiratory Medicine, East Sussex Healthcare NHS Trust, St Leonards on Sea, United Kingdom Introduction: NICE guidelines (2011) reccommend surgery with curative intent for fit patients diagnosed with early stage lung cancer. The UK national lung cancer audit 2013 (LUCADA) shows that the resection rate in stage I–II NSCLC varies between 46%-66%. We reviewed all stage IA-IIB lung cancer discussed at our lung cancer multi-disciplinary meeting over a 24 month period ascertain the barriers to surgery in our local population. Methods: Using our lung cancer database we conducted a retrospective analysis of all patients diagnosed between January 2012 to December 2013 within East Sussex Healthcare NHS Trust with stage IA to IIB disease. We examined the reasons why surgery was not offered. Results: 582 patients were diagnosed with lung cancer during this period of which 99 (17%) were staged as early disease (IA-IIB). 39 patients with early stage did not undergo curative surgery. Further analysis focused on this cohort. The mean age of this cohort was 80 years with a median WHO-ECOG performance status of 2. 47% (n=21) had a radiological diagnosis only as biopsy was not deemed safe or appropriate to perform. 13% had NSCLC (n=6). The major barriers to surgery were cardiovascular morbidty (n=13) (33%), chronic lung disease (n=11) (28%), dementia (n=5) (13%) and patient choice (n=1 (2%). Treatment offered in leiu of curative surgery was 2 (5%) SABR, 4 (10%) radiotherapy and the majority were referred for specialist palliative care. The median survival of those not offered surgery was 362 days. Conclusion: Our study shows that patients not offered surgery were elderly and frail with significant respiratory or cardiovascular morbidity making surgical resection risky. For those not offered surgery median survival was approximately 12 months indicating that best supportive care with optimum medical management can be beneficial in this group of patients. Disclosure: All authors have declared no conflicts of interest. 114
Use of routine healthcare data for the estimation of disease outcomes in locally advanced non-small cell lung cancer (LA NSCLC)
S. Wong 1 , K. Ricketts 2 , G. Royle 3 , R. Mendes 1 . 1 Oncology, University College London Hospital, London, United Kingdom; 2 Interventional Science, University College London, London, United Kingdom; 3 Medical Physics and Biomedical Engineering, University College London, London, United Kingdom Introduction: Outcomes for patients in UK with LA NSCLC are amongst the lowest in Europe. Assessing outcomes is important for analysing the effectiveness of current trends in practice. However, data quality is inconsistent and regular large scale analysis is laboriously challenging. This project will investigate the use of routine healthcare datasets to determine progression free survival (PFS) and overall survival (OS) of patients treated with radical radiotherapy for LA NSCLC. Methods: All LA NSCLC patients treated in the last 2 years are identified and paired manual and routine data generated for an initial pilot study of 20 patients. Manual data is extracted information from hospital records and considered the gold standard. Key time points are date of diagnosis, recurrence, and death or last follow-up appointment. Routine data is collected from various data sources including, Hospital Episode Statistics, chemotherapy data, and radiotherapy dataset. Relevant event dates are defined by proxy time points and refined using backdating and time interval optimization. Correlation of these datasets are then tested on the key clinical outcome
Poster abstracts of the 14th Annual British Thoracic Oncology Group Conference 2016 / Lung Cancer 91, Suppl. 1 (2016) S1–S71
Some direct outcomes included: • Developing an active and successful working party on symptom management. • A controversial proposal for surgery in advanced lung cancer thought to be a step too far by many clinicians was welcomed as being probably a popular proposal by the PPI member.
Figure 1. Ways in which NCRI Clinical Studies Groups (CSGs) involve consumers in their work.
Conclusion: Consumer contribution to cancer research is vital to ensure the patient voice is considered at all stages. Disclosure: All authors have declared no conflicts of interest. 112
Spreading the word – using consumers effectively
J. Rawlinson. Clinical Studies Group (lung), NCRI, Tipton, United Kingdom Introduction: Putting the patient at the heart of health and social care decisions, treatment design and research have long been suggested by Policy makers within different health and social care departments. How can this be achieved or enhanced within Cancer Research and care? Contributing to a variety of healthcare bodies and committees means networked patients and carers can often reach targeted markets more effectively and bring new ideas for consideration. Drawing on consumer involvement experience within different healthcare settings, enabled cross fertilisation of ideas, new ideas and developments to be communicated more quickly than through more conventional or traditional routes. Methods: Several examples were explored where consumer contribution or communication had impacted on different aspects of cancer services to provide qualitative findings. These included primary care involvement, secondary care exploration of potential future collaborations and input to professionals’ Continuous Professional Development workshops or conferences. Results: Consumers are not just patients or carers – many have or have had distinguished careers in their own areas of expertise. They bring skills, networks and experience that can contribute meaningfully to subjects being considered for cancer research. Skills are often transferable and may differ from others involved. Consumers often belong to several networks so can provide additional or novel connections for often disparate or disconnected parties. Their contribution can create added value to often stretched resources. Experience, enthusiasm and energy from a patient perspective can bring valuable synergies to enhance clinical and scientific findings. Conclusion: It is important to consider the wider impact consumer involvement can have on all aspects of cancer research and care design. Researchers and clinicians should make best use of this valuable and sometimes under utilised and underestimated resource. Disclosure: All authors have declared no conflicts of interest.
113
Barriers to surgery in early stage lung cancer – the East Sussex experience
L. Parker 1 , G. Butcher 1 , O. Kankam 2 . 1 Respiratory Medicine, East Sussex Healthcare Trust, St Leonards on Sea, United Kingdom; 2 Respiratory Medicine, East Sussex Healthcare NHS Trust, St Leonards on Sea, United Kingdom Introduction: NICE guidelines (2011) reccommend surgery with curative intent for fit patients diagnosed with early stage lung cancer. The UK national lung cancer audit 2013 (LUCADA) shows that the resection rate in stage I–II NSCLC varies between 46%-66%. We reviewed all stage IA-IIB lung cancer discussed at our lung cancer multi-disciplinary meeting over a 24 month period ascertain the barriers to surgery in our local population. Methods: Using our lung cancer database we conducted a retrospective analysis of all patients diagnosed between January 2012 to December 2013 within East Sussex Healthcare NHS Trust with stage IA to IIB disease. We examined the reasons why surgery was not offered. Results: 582 patients were diagnosed with lung cancer during this period of which 99 (17%) were staged as early disease (IA-IIB). 39 patients with early stage did not undergo curative surgery. Further analysis focused on this cohort. The mean age of this cohort was 80 years with a median WHO-ECOG performance status of 2. 47% (n=21) had a radiological diagnosis only as biopsy was not deemed safe or appropriate to perform. 13% had NSCLC (n=6). The major barriers to surgery were cardiovascular morbidty (n=13) (33%), chronic lung disease (n=11) (28%), dementia (n=5) (13%) and patient choice (n=1 (2%). Treatment offered in leiu of curative surgery was 2 (5%) SABR, 4 (10%) radiotherapy and the majority were referred for specialist palliative care. The median survival of those not offered surgery was 362 days. Conclusion: Our study shows that patients not offered surgery were elderly and frail with significant respiratory or cardiovascular morbidity making surgical resection risky. For those not offered surgery median survival was approximately 12 months indicating that best supportive care with optimum medical management can be beneficial in this group of patients. Disclosure: All authors have declared no conflicts of interest. 114
Use of routine healthcare data for the estimation of disease outcomes in locally advanced non-small cell lung cancer (LA NSCLC)
S. Wong 1 , K. Ricketts 2 , G. Royle 3 , R. Mendes 1 . 1 Oncology, University College London Hospital, London, United Kingdom; 2 Interventional Science, University College London, London, United Kingdom; 3 Medical Physics and Biomedical Engineering, University College London, London, United Kingdom Introduction: Outcomes for patients in UK with LA NSCLC are amongst the lowest in Europe. Assessing outcomes is important for analysing the effectiveness of current trends in practice. However, data quality is inconsistent and regular large scale analysis is laboriously challenging. This project will investigate the use of routine healthcare datasets to determine progression free survival (PFS) and overall survival (OS) of patients treated with radical radiotherapy for LA NSCLC. Methods: All LA NSCLC patients treated in the last 2 years are identified and paired manual and routine data generated for an initial pilot study of 20 patients. Manual data is extracted information from hospital records and considered the gold standard. Key time points are date of diagnosis, recurrence, and death or last follow-up appointment. Routine data is collected from various data sources including, Hospital Episode Statistics, chemotherapy data, and radiotherapy dataset. Relevant event dates are defined by proxy time points and refined using backdating and time interval optimization. Correlation of these datasets are then tested on the key clinical outcome