The purpose of tumour staging for colorectal cancer (CRC) is to help define clinical management, facilitate communication between physicians, provide a basis for stratification and analysis of treatment results in prospective studies, and provide some prognostic information for patients and their families. The World Congresses of Gastroenterology, Digestive Endoscopy, and Coloproctology, Working Party on staging for CRC studied six commonly used systems to review their strengths and weaknesses. Although it was concluded that defining a new staging system was unnecessary, it was recognized that there is a need to define a terminology to describe the full anatomic extent of spread of CRC. Furthermore, we note that there are several additional features, derived from both clinical and pathology information, which have had prognostic significance shown by appropriately constructed multivariate analyses and which can be used to formulate a more accurate prognostic index than that provided by a description of anatomical tumour spread. Thus the Working Party came to two principal conclusions. First, a standard format should be adopted for the collection of the essential data required for prospective studies, and we recommend the 'International Documentation System (IDS) for CRC' for this purpose. Second, a nomenclature which describes the full anatomical extent of tumour spread and residual tumour status in CRC has been defined and should be adopted, from which all currently used staging systems can be derived. We have called this nomenclature the 'International Comprehensive Anatomical Terminology (ICAT) for CRC'. In the event that these recommendations are adopted, we envision that there will be improved clarity in the documentation of treatment outcome for patients with CRC and improved communication of results derived from prospective studies. Furthermore, an acceptance of IDS and ICAT would set the scene to develop a prognostic index for individual patients with CRC by the expansion of anatomical clinicopathology staging information to include additional factors which have independent prognostic significance.
Patient satisfaction is an integral part of assessing the quality of oral health care. As dental care becomes more impersonal, competitive, and expensive, the potential for patient complaints is on the rise. Dental school clinics may be more vulnerable to patient grievances due to inexperienced student providers, less eficient delivery of care, challenges related to continuity of care, and the complexity of adhering to institutional policies. Effective management of patient complaints can assist both individuals and institutions toward providing the highest quality of care achievable in the demanding dental education environment. Despite the obvious beneit, there is a dearth of recent studies that analyzed complaints in either the private practice setting or dental school clinics. The purpose of this study was to categorize and analyze the complaints received from patients seeking treatment at a large dental school clinic from 2005 to 2008. It was found that the combined complaints for all four years in descending order were regarding appointment, communication, money, quality, and other. No statistically signiicant association was found between the type of complaint and time of year. Most importantly, it was found that the system for recording complaints needed to be standardized in order to improve the quality of patient care. The indings from this study will not only facilitate adjustment of the school's current curricula and policies, but could also guide other institutions and private dental practitioners toward better patient care.
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