The Relationship Between Guideline-Recommended Initiation of Therapy, Outcomes, and Cost for Patients with Metastatic Non-Small Cell Lung Cancer

Casebeer, Adrianne Waldman; Antol, Dana Drzayich; DeClue, Richard W; Hopson, Sari; Li, Yong; Khoury, Raya; Michael, Todd P.; Sehman, Marina; Parikh, Aparna R.; Stemkowski, Stephen; Bunce, Mikele

doi:10.18553/jmcp.2018.24.6.554

Cited by 5 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical practice guidelines (CPGs) are statements that include recommendations based on “a systematic review of evidence and an assessment of the benefits and harms of alternative care options” for assisting “practitioner and patient decisions” [1, 2]. Additionally, CPGs have been shown to improve clinical outcomes [3–16].…”

Section: Introductionmentioning

confidence: 99%

The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

Hatakeyama

Seto

Amin

et al. 2019

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundThe Appraisal of Guidelines for Research & Evaluation (AGREE) II has been widely used to evaluate the quality of clinical practice guidelines (CPGs). While the relationship between the overall assessment of CPGs and scores of six domains were reported in previous studies, the relationship between items constituting these domains and the overall assessment has not been analyzed. This study aims to investigate the relationship between the score of each item and the overall assessment and identify items that could influence the overall assessment.MethodsAll Japanese CPGs developed using the evidence-based medicine method and published from 2011 to 2015 were used. They were independently evaluated by three appraisers using AGREE II. The evaluation results were analyzed using regression analysis to evaluate the influence of 6 domains and 23 items on the overall assessment.ResultsA total of 206 CPGs were obtained. All domains and all items except one were significantly correlated to the overall assessment. Regression analysis revealed that Domain 3 (Rigour of Development), Domain 4 (Clarity of Presentation), Domain 5 (Applicability), and Domain 6 (Editorial Independence) had influence on the overall assessment. Additionally, four items of AGREE II, clear selection of evidence (Item 8), specific/unambiguous recommendations (Item 15), advice/tools for implementing recommendations (Item 19), and conflicts of interest (Item 22), significantly influenced the overall assessment and explained 72.1% of the variance.ConclusionsThese four items may highlight the areas for improvement in developing CPGs.

show abstract

Section: Introductionmentioning

confidence: 99%

The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

Hatakeyama

Seto

Amin

et al. 2019

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…No increased costs after guideline implementation were detected by CASEBEER et al [126] after multivariate analysis. NEUBAUER et al [132] could even demonstrate lower costs for guideline-concordant care within a period of 1 year after initiation of first-line chemotherapy in NSCLC patients in a regional outpatient US oncology network (1409 patients; average 12-month on/off pathway costs: USD 18 042 versus USD 27 737; on/off cost ratio 0.71, 95% CI 0.64-0.80).…”

Section: Other Considerationsmentioning

confidence: 83%

“…Summary of evidence and overall quality of evidence 15 observational studies were finally selected out of the 754 initially identified abstracts [123][124][125][126][127][128][129][130][131][132][133][134][135][136][137]. To allow clinically meaningful rating of evidence, we defined six subgroups: guideline implementation: 1) all lung cancer, all stages, all therapies; guideline adherence: 2) NSCLC, all stages, surgical resection with or without neoadjuvant/adjuvant therapies; 3) all lung cancer, all stages, all treatment modalities; 4) NSCLC, unresectable stage III, chemo-and/or radiotherapy; 5) NSCLC, all stages, chemotherapy; and 6) SCLC, all stages, all treatment modalities.…”

Section: Problemmentioning

confidence: 99%

European Respiratory Society guideline on various aspects of quality in lung cancer care

Blum

Durieux

Chorostowska‐Wynimko³

et al. 2022

Eur Respir J

View full text Add to dashboard Cite

This ERS guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO questions. The evidence was appraised in compliance with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multi-disciplinary task force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results.In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) the integration of multi-disciplinary teams and multi-disciplinary consultations, 3) the implementation of and adherence to lung cancer guidelines, 4) the benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) the need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, histological subtyping and the molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) the added value of early integration of palliative care teams or specialists, 7) the advantage of integrating specific quality improvement measures, and 8) the benefit of using patient decision tools.These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.

show abstract

“…However, the performance status in this patient was poor, therefore palliative treatment is recommended with consideration of the age and patient's ability to tolerate toxicity of the treatment. 23 Yang et al reported that gastrointestinal metastatic was poor diagnosis with average time of death was 130 days. 3 This report also showed that lung cancer with intestinal metastatic had poor diagnosis which the patient died within 20 days of hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Total obstruction of small intestine due to metastatic lung adenocarcinoma

Widyanti

Putra²,

Yaniswari³

et al. 2023

Int J Res Med Sci

View full text Add to dashboard Cite

Lung cancer with symptomatic small intestinal metastasis is a rare case but potentially fatal with poor diagnosis in most advanced stages. A-82 years old male patient with chronic cough, chest pain, progressive dyspnea abdominal pain, obstipation, and distended abdomen. Chest computed tomography (CT)-scan revealed right inferior pulmonary lobe of lung tumor. Abdominal X-ray and abdominal ultrasound showed ileus obstruction features. The patient underwent emergency laparotomy under the diagnosis of total ileus obstruction. Surgical resection of two masses in the small intestinal were performed with ileo-ileal anastomosis. Histomorphology of the surgical specimen revealed poorly differentiated adenocarcinoma involving the small intestine without precursor lesions that suggested a metastasis. The patient underwent thoracentesis and pleural fluid cytology that reported seeding of non-small cell lung cancer (NSCLC) tend to adenocarcinoma type. A diagnosis of lung adenocarcinoma with small intestinal metastasis was concluded based on correlation of these anatomopathological examination. Clinicians should consider possibility of lung cancer with small intestinal metastasis in patient with abdominal symptoms.

show abstract

The Relationship Between Guideline-Recommended Initiation of Therapy, Outcomes, and Cost for Patients with Metastatic Non-Small Cell Lung Cancer

Cited by 5 publications

References 16 publications

The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

The structure of the quality of clinical practice guidelines with the items and overall assessment in AGREE II: a regression analysis

European Respiratory Society guideline on various aspects of quality in lung cancer care

Total obstruction of small intestine due to metastatic lung adenocarcinoma

Contact Info

Product

Resources

About