Self-reported practice patterns and knowledge of rectal cancer care among Canadian general surgeons

Richardson, D; Porter, Geoff; Johnson, Paul M.

doi:10.1503/cjs.001814

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…This nationwide survey of providers is strengthened by its favorable response rate of 59%, leading to a better representation of the population of interest and a decrease in nonresponse bias. This response rate is similar to other surveys of Canadian surgeons and anesthesiologists and is slightly higher than the mean physician response rate reported in a systematic review of surveys . The sample size of 114 is a good representation of care providers across the country.…”

Section: Discussionsupporting

confidence: 78%

Current practices in perioperative blood management for patients undergoing liver resection: a survey of surgeons and anesthesiologists

et al. 2018

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Section: Discussionsupporting

confidence: 78%

Current practices in perioperative blood management for patients undergoing liver resection: a survey of surgeons and anesthesiologists

et al. 2018

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“…of national and provincial surveys, suggesting that this may be the case. 9,10,32 These differences are attributed to factors such as level of training (i.e., subspecialty v. nonfellowship), participation in continuing professional development, length of time in practice, location of practice, and access to clinical resources (e.g., MRI, ERUS). Whether or not these self-reported differences in practice patterns translate to variability in patient-level outcomes is unclear at this time.…”

Section: E33mentioning

confidence: 99%

“…Previous Canadian studies have highlighted such differences among surgeons managing rectal cancer across the country. 9,10 Clinical practice guidelines (CPGs) are systematically developed statements that are meant to inform decisionmaking regarding specific clinical situations. 11,12 They have the ability to improve the quality and consistency of care provided by bridging the gap between clinicians' knowledge/practices and what is supported in the literature.…”

mentioning

confidence: 99%

Management of rectal cancer in Canada: an evidence-based comparison of clinical practice guidelines

Mir

Merchant³

et al. 2020

CJS

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Background: Rectal cancer requires a multidisciplinary and multimodality treatment approach. Clinical practice guidelines (CPGs) provide a framework for delivering consistent, evidence-based health care. We compared provincial/territorial CPGs across Canada to identify areas of variability and evaluate their quality. Methods: We retrieved CPGs from Canadian organizations responsible for cancer care oversight and evaluated their quality and developmental methodology using the AGREE-II instrument. Recommendations for diagnostic and staging investigations, treatment by stage, and post-treatment surveillance of stage I-III rectal cancers were abstracted and compared. Results: We identified 7 sets of CPGs for analysis, varying in content, presentation, quality, and year last updated. Differences were noted in locoregional staging: 4 recommended magnetic resonance imaging over endorectal ultrasonography, 2 recommended either modality, and 3 specified scenarios for one over the other. Recommendations also varied for use of staging computed tomography of the chest versus chest radiography and for surgical management and indications for transanal excision. Recommendations for neoadjuvant therapy in stage II/III disease also differed: 3 guidelines recommended long-course chemoradiation over short-course radiation therapy alone, while 3 others recommended short-course radiation in specific clinical scenarios. Adjuvant chemotherapy for stage II/III disease was uniformly recommended, with variable protocols. The use of proctosigmoidoscopy and interval/duration of endoscopic post-treatment surveillance varied among guidelines. Conclusion: Canadian CPGs vary in their recommendations for staging, treatment, and surveillance of rectal cancer. Some of these differences reflect areas with limited definitive evidence. Consistent guidelines with uniform implementation across provinces/territories may lead to more equitable care to patients. Contexte : Le cancer rectal requiert une approche thérapeutique multidisciplinaire et multimodalité. Les guides de pratique clinique (GPC) procurent un cadre pour assurer la prestation de soins de santé constants reposant sur des données probantes. Nous avons comparé les GPC des provinces et des territoires canadiens pour identifier les secteurs où ils varient et pour en évaluer la qualité. Méthodes : Nous avons obtenu les GPC des organisations canadiennes responsables des soins oncologiques et nous avons évalué leur qualité et la méthodologie de leur élaboration au moyen de l'outil AGREE II (Appraisal of Guidelines for Research & Evaluation). Nous avons extrait et comparé les recommandations en ce qui concerne les épreuves diagnostiques et la stadification, les traitements en fonction du stade et la surveillance post-thérapeutique du cancer rectal de stade I à III. Résultats : Nous avons recensé 7 GPC aux fins de cette analyse; leur contenu, leur présentation, leur qualité et l'année de leur plus récente mise à jour variaient. Des différences ont été observées au plan de la stadification locorégi...

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“…The majority of rectal cancer patients in North America are treated by surgeons who perform 10 or fewer cases annually. 5 Moreover, the disease routinely requires coordination between surgeons, radiation and medical oncologists, and other clinical personnel such as radiologists, pathologists and wound-ostomy nurses. Decision-making is highly patient-centric and management often individualized, based on both tumor and patient characteristics.…”

Section: Introductionmentioning

confidence: 99%

Development of The American Society of Colon and Rectal Surgeons’ Rectal Cancer Surgery Checklist

Glasgow

Morris

Baxter

et al. 2016

Diseases of the Colon &Amp; Rectum

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Background There is excellent evidence that surgical safety checklists contribute to decreased morbidity and mortality. Objective To develop a surgical checklist comprising the key phases of care for rectal cancer patients. Design Consensus-oriented decision-making model involving iterative input from subject matter experts under the auspices of the American Society of Colon and Rectal Surgeons. Results The process generated a 25-item checklist covering the spectrum of care for rectal cancer patients undergoing surgery. Limitations Lack of prospective validation. Conclusions The American Society of Colon and Rectal Surgeons Rectal Cancer Surgery checklist comprises the essential elements of pre-, intra- and postoperative care that must be addressed during the surgical treatment of patients with rectal cancer.

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Self-reported practice patterns and knowledge of rectal cancer care among Canadian general surgeons

Cited by 3 publications

References 24 publications

Current practices in perioperative blood management for patients undergoing liver resection: a survey of surgeons and anesthesiologists

Current practices in perioperative blood management for patients undergoing liver resection: a survey of surgeons and anesthesiologists

Management of rectal cancer in Canada: an evidence-based comparison of clinical practice guidelines

Development of The American Society of Colon and Rectal Surgeons’ Rectal Cancer Surgery Checklist

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