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Across-province standardization and comparative analysis of time-to-care intervals for cancer.

Winget M, Turner D, Tonita J, King C, Nugent Z, Alvi R, Barss R - BMC Cancer (2007)

Bottom Line: We identified criteria important for selecting time-to-care intervals and appropriate inclusion criteria that were robust across the agencies that did not result in an overly selective sample of patients to be compared.Comparisons of data across three provinces of the selected time-to-care intervals identified several important differences related to treatment and access that require further attention.Expanding this collaboration across Canada would facilitate improvement of and equitable access to quality cancer care at a national level.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Affairs and Community Oncology, Alberta Cancer Board, 10123-99 Street, Edmonton, Alberta, T5J 3H1, Canada. marcywin@cancerboard.ab.ca

ABSTRACT

Background: A set of consistent, standardized definitions of intervals and populations on which to report across provinces is needed to inform the Provincial/Territorial Deputy Ministries of Health on progress of the Ten-Year Plan to Strengthen Health Care. The objectives of this project were to: 1) identify a set of criteria and variables needed to create comparable measures of important time-to-cancer-care intervals that could be applied across provinces and 2) use the measures to compare time-to-care across participating provinces for lung and colorectal cancer patients diagnosed in 2004.

Methods: A broad-based group of stakeholders from each of the three participating cancer agencies was assembled to identify criteria for time-to-care intervals to standardize, evaluate possible intervals and their corresponding start and end time points, and finalize the selection of intervals to pursue. Inclusion/exclusion criteria were identified for the patient population and the selected time points to reduce potential selection bias. The provincial 2004 colorectal and lung cancer data were used to illustrate across-province comparisons for the selected time-to-care intervals.

Results: Criteria identified as critical for time-to-care intervals and corresponding start and end points were: 1) relevant to patients, 2) relevant to clinical care, 3) unequivocally defined, and 4) currently captured consistently across cancer agencies. Time from diagnosis to first radiation or chemotherapy treatment and the smaller components, time from diagnosis to first consult with an oncologist and time from first consult to first radiation or chemotherapy treatment, were the only intervals that met all four criteria. Timeliness of care for the intervals evaluated was similar between the provinces for lung cancer patients but significant differences were found for colorectal cancer patients.

Conclusion: We identified criteria important for selecting time-to-care intervals and appropriate inclusion criteria that were robust across the agencies that did not result in an overly selective sample of patients to be compared. Comparisons of data across three provinces of the selected time-to-care intervals identified several important differences related to treatment and access that require further attention. Expanding this collaboration across Canada would facilitate improvement of and equitable access to quality cancer care at a national level.

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Cumulative time from diagnosis to first consult visit with an oncologist by tumor site and province.
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Figure 2: Cumulative time from diagnosis to first consult visit with an oncologist by tumor site and province.

Mentions: The curves shown in Figures 2 and 3 present the time from diagnosis to first consult with an oncologist and time from first consult to first radiation/chemotherapy, respectively. From Figure 2 it can be seen that the time from diagnosis to first consult was much shorter for lung cancer patients than for colorectal cancer patients. In Figure 3, however, the difference between tumor sites is negligible indicating a similarity in speed of processing and treating patients once they are seen at a cancer facility by an oncologist. The time intervals from diagnosis to consult and consult to radiation/chemotherapy for colorectal cancer patients were both significantly different across provinces (P < 0.001 for both intervals). Colorectal cancer patients in AB experienced a shorter time from diagnosis to consult with an oncologist but a longer interval from consult to radiation/chemotherapy than in SK or MB. No differences were found in either interval for lung cancer, (P = 0.29 and P = 0.17, respectively).


Across-province standardization and comparative analysis of time-to-care intervals for cancer.

Winget M, Turner D, Tonita J, King C, Nugent Z, Alvi R, Barss R - BMC Cancer (2007)

Cumulative time from diagnosis to first consult visit with an oncologist by tumor site and province.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2089079&req=5

Figure 2: Cumulative time from diagnosis to first consult visit with an oncologist by tumor site and province.
Mentions: The curves shown in Figures 2 and 3 present the time from diagnosis to first consult with an oncologist and time from first consult to first radiation/chemotherapy, respectively. From Figure 2 it can be seen that the time from diagnosis to first consult was much shorter for lung cancer patients than for colorectal cancer patients. In Figure 3, however, the difference between tumor sites is negligible indicating a similarity in speed of processing and treating patients once they are seen at a cancer facility by an oncologist. The time intervals from diagnosis to consult and consult to radiation/chemotherapy for colorectal cancer patients were both significantly different across provinces (P < 0.001 for both intervals). Colorectal cancer patients in AB experienced a shorter time from diagnosis to consult with an oncologist but a longer interval from consult to radiation/chemotherapy than in SK or MB. No differences were found in either interval for lung cancer, (P = 0.29 and P = 0.17, respectively).

Bottom Line: We identified criteria important for selecting time-to-care intervals and appropriate inclusion criteria that were robust across the agencies that did not result in an overly selective sample of patients to be compared.Comparisons of data across three provinces of the selected time-to-care intervals identified several important differences related to treatment and access that require further attention.Expanding this collaboration across Canada would facilitate improvement of and equitable access to quality cancer care at a national level.

View Article: PubMed Central - HTML - PubMed

Affiliation: Medical Affairs and Community Oncology, Alberta Cancer Board, 10123-99 Street, Edmonton, Alberta, T5J 3H1, Canada. marcywin@cancerboard.ab.ca

ABSTRACT

Background: A set of consistent, standardized definitions of intervals and populations on which to report across provinces is needed to inform the Provincial/Territorial Deputy Ministries of Health on progress of the Ten-Year Plan to Strengthen Health Care. The objectives of this project were to: 1) identify a set of criteria and variables needed to create comparable measures of important time-to-cancer-care intervals that could be applied across provinces and 2) use the measures to compare time-to-care across participating provinces for lung and colorectal cancer patients diagnosed in 2004.

Methods: A broad-based group of stakeholders from each of the three participating cancer agencies was assembled to identify criteria for time-to-care intervals to standardize, evaluate possible intervals and their corresponding start and end time points, and finalize the selection of intervals to pursue. Inclusion/exclusion criteria were identified for the patient population and the selected time points to reduce potential selection bias. The provincial 2004 colorectal and lung cancer data were used to illustrate across-province comparisons for the selected time-to-care intervals.

Results: Criteria identified as critical for time-to-care intervals and corresponding start and end points were: 1) relevant to patients, 2) relevant to clinical care, 3) unequivocally defined, and 4) currently captured consistently across cancer agencies. Time from diagnosis to first radiation or chemotherapy treatment and the smaller components, time from diagnosis to first consult with an oncologist and time from first consult to first radiation or chemotherapy treatment, were the only intervals that met all four criteria. Timeliness of care for the intervals evaluated was similar between the provinces for lung cancer patients but significant differences were found for colorectal cancer patients.

Conclusion: We identified criteria important for selecting time-to-care intervals and appropriate inclusion criteria that were robust across the agencies that did not result in an overly selective sample of patients to be compared. Comparisons of data across three provinces of the selected time-to-care intervals identified several important differences related to treatment and access that require further attention. Expanding this collaboration across Canada would facilitate improvement of and equitable access to quality cancer care at a national level.

Show MeSH
Related in: MedlinePlus