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M. MANSUETO msc A. GRIMALDI msc G. MANGILI md M. PICCHIO md G. GIOVACCHINI md R. VIGANÒ md C. MESSA md & F. FAZIO md 《European journal of cancer care》2009,18(6):612-619
Aim of this study was to evaluate the economic impact of the introduction of positron emission tomography/computed tomography (PET/CT) in the early detection of recurrent ovarian cancer through a cost-effectiveness analysis of different diagnostic strategies. Thirty-two consecutive patients with suspected ovarian cancer recurrence, studied by both contrast enhanced abdominal CT and PET/CT, were retrospectively included in the study. Three different diagnostic strategies were evaluated and compared: (1) CT only or baseline strategy; (2) PET/CT for negative CT or strategy A; (3) PET/CT for All or strategy B. For each one, expected costs, avoided surgery and incremental cost-effectiveness ratio (ICER) were calculated to identify the most cost-effective strategy. The number of positive patients increased from baseline strategy (20/32) to strategy A and B (30/32 and 29/32 respectively). Positron emission tomography/computed tomography reoriented physician choice in 31% and 62% of patients (strategies A and B respectively). Strategy A is dominated by strategy B, which is more expensive (2909€ vs. 2958€), but also more effective (3 cases of surgery avoided) and presents an ICER of 226.77€ per surgery avoided (range: 49.50–433.00€). Positron emission tomography/computed tomography introduction in this population is cost-effective and allowed to redirect the clinical management of patients towards more appropriate therapeutic choices. 相似文献
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ANDREW BOTTOMLEY phd CHANTAL QUINTEN msc CORNEEL COENS msc FRANCESCA MARTINELLI msc MURIELLE MAUER phd JOHN MARINGWA phd CHARLES S. CLEELAND phd HENNING FLECHTNER phd CAROLYN GOTAY phd EVA GREIMEL phd MADELEINE KING phd DAVID OSOBA md MARTIN J.B. TAPHOORN phd BRYCE B. REEVE phd JOLIE RINGASH phd JOSEPH SCHMUCKER-VON KOCH phd & JOACHIM WEIS phd 《European journal of cancer care》2009,18(2):105-107
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S. BROWN mb bs director A. BELGAUMI md consultant A. KOFIDE md consultant R. SABBAH md consultant A. EZZAT md executive director medical clinical operations consultant B. LITTLECHILD team leader M. SHOUKRI phd principal scientist R. BARR md A. LEVIN md 《European journal of cancer care》2009,18(3):313-317
Failure to attend medical appointments (No Show) and loss to follow-up (LTFU) among patients with cancer can adversely affect their treatment and eventual outcome. In a 3-year prospective study of 199 patients with malignant lymphoma, all of those with No Shows were contacted, and reasons given for No Shows were categorized. Of the 340 No Shows, 34.1% were due to hospital-based communication problems, 17.6% to errors in patient communication with the hospital, 7.4% to transportation problems and 16.5% to other personal reasons. Almost one quarter (24.4%) of the patients were not contactable. Reasons for No Show in all categories were instructive as to patients' attitudes to treatment. Nineteen (12.2%) of the 156 patients who had not died in the 3-year follow-up period were identified as LTFU. These 19 LTFU patients accounted for 77 (22.6%) of all No Shows. The data indicate that LTFU in this cohort is significantly less frequent than in a prior cohort followed up for 3 years from 1997 to 1998. These findings suggest that some causes of No Show can be addressed, and individuals are identified as at particular risk for No Show and ultimately LTFU. This study points out that pre-emptive strategies to reduce No Shows may be feasible and efficacious. 相似文献
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L. LETRILLIART md phd general practitioner L. MILLIAT-GUITTARD phd research fellow P. ROMESTAING md radio-oncologist A.M. SCHOTT md phd epidemiologist N. BERTHOUX nurse research assistant & C. COLIN md phd professor of epidemiology health economics 《European journal of cancer care》2009,18(2):131-139
Before electronic records become operational, patient-held records provide an opportunity to improve communication between patients and healthcare professionals. Our aim was to design the appropriate organization, layout and content for such a shared record for breast cancer management, based on a consensus between the various stakeholders. We therefore conducted a Delphi study within a working group of 48 members, including patients, oncologists, general practitioners, nurses and other professionals. The procedure featured three rounds during which participants' judgements were collected via mailed questionnaires and quantitative and qualitative feedback was provided on a regular basis. These three rounds were followed by an evaluation phase. Forty members (83%) participated in the three rounds. According to the agreement reached, the shared record was expected to include a front summary card, four sections for groups of users authorized to write down or insert information in the record (patient, physicians, medical auxiliaries and other healthcare professionals), and one section for medical imaging files. In addition, the record was to include specific categories of information as subsections within each of the various user sections. The participant satisfaction rate was over 90% for all aspects of the procedure, with the exception of interaction within the working group (79%). 相似文献