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10 ans de concertations oncologiques multidisciplinaires / France Vrijens / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2015)
ISSN : D/2015/10.273/19 : € 0,00
Etude n° 2013-16
Languages : French (fre)
Descriptors: Classification
QZ 200 Neoplasms. Cysts (General)
Indexation
2013-16 ; Clinical Medicine ; Clinical Protocols ; Disease Management ; Documents related to KCE reports ; Multidisciplinary meeting (MDM) ; Multidisciplinary team (MDT) ; Neoplasms ; Patient outcomes ; R239 ; Tumour boardsAbstract: Les Concertations Oncologiques Multidisciplinaires (COM) sont des réunions où les différents spécialistes concernés par le traitement d’un même patient se concertent pour élaborer ensemble un plan de diagnostic, de traitement et de suivi individuel. Depuis une dizaine d’années, une rémunération est prévue pour la participation à ces réunions. À la demande de l’INAMI, le Centre fédéral d’Expertise des Soins de santé (KCE) a dressé un bilan de leur activité mais a aussi exploré quelques pistes pour les rendre plus efficaces.
Le premier constat est très positif : la discussion d’un dossier en COM est (presque) devenue une étape de routine dans le parcours de tout nouveau patient atteint d’un cancer. Cela contribue à une amélioration globale de la qualité des soins. Mais l’organisation des COM pourrait être améliorée sur quelques points, notamment la difficulté à réunir au même endroit des spécialistes par ailleurs fort occupés. La faible participation des médecins généralistes est une autre ombre au tableau. Souvent, ils ne sont pas informés de la tenue des COM, sans parler d’autres problèmes pratiques (déplacements, horaire inadapté…). Pour ces différentes raisons, le KCE recommande d’encourager le recours aux moyens modernes de communication comme les vidéo-conférences.Contents note: PRÉFACE 2-- OBJET DE CE RAPPORT 3-- MESSAGES CLÉS. 3-- CONTEXTE 4-- PRINCIPAUX RÉSULTATS DE L’ÉTUDE. 5-- 1. Le nombre de patients dont le cas est présenté et discuté en COM augmente d’année en année. L’impact de ces concertations multidisciplinaires est globalement considéré comme très positif. 5-- 2. La multidisciplinarité est la condition principale de la qualité et de l’efficacité des COM ; il faut donc favoriser la participation de toutes les disciplines médicales nécessaires. À cet égard, le recours aux vidéo-conférences est une piste qui mérite d’être davantage explorée. 9-- 3. La présence des médecins généralistes (MG) aux COM reste très faible, principalement pour des raisons de manque de temps. Leur participation doit être facilitée, en particulier pour les patients dont la situation psycho-médico-sociale est complexe.14-- 4. La collaboration des équipes hospitalières avec le registre du cancer est indispensable au développement d’une politique de qualité des soins. Les COM sont un lien privilégié pour renforcer cette collaboration, mais il faut encore améliorer le processus d’enregistrement des données si l’on veut pouvoir optimaliser leur exploitation. Le rôle de data manager doit être redéfini et mieux circonscrit. 16-- 5. Les distinctions entre première COM, COM de suivi et COM supplémentaire ne sont pas claires. Un cadre cohérent et une adaptation des règles de financement sont impératifs .18-- 6. Les échanges de données administratives et les flux financiers avec les mutualités sont lents, lourds et complexes ; ils gagneraient à être simplifiés. Le remplacement du papier par des moyens de communication informatisés s’impose.21-- 7. Le Plan Cancer finance un certain nombre d’emplois supplémentaires pour les centres agréés d’oncologie, au prorata du nombre annuel de COM qu’ils déclarent. Mais les profils de fonction de ces postes supplémentaires sont mal définis, et il règne une incertitude dans le secteur quant à leur pérennité étant donné les possibles adaptations des règles d’attribution en 2015 21-- CONCLUSIONS 22-- RECOMMANDATIONS 23 Link for e-copy: https://doi.org/10.57598/R239BS Format of e-copy: PDF (638 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3505 Copies(0)
Status No copy
ISSN : D/2015/10.273/18 : € 0,00
Studie n° 2013-16
Languages : Dutch (nla)
Descriptors: Classification
QZ 200 Neoplasms. Cysts (General)
Indexation
2013-16 ; Clinical Medicine ; Clinical Protocols ; Disease Management ; Documents related to KCE reports ; Multidisciplinary meeting (MDM) ; Multidisciplinary team (MDT) ; Neoplasms ; Patient outcomes ; R239 ; Tumour boardsAbstract: Het Multidisciplinair Oncologisch Consult (MOC) is een overleg tussen verschillende specialisten, betrokken bij de behandeling van een patiënt met kanker, om samen een individueel diagnose-, behandel- en opvolgplan op te stellen. Sinds een tiental jaren worden de deelnemende artsen hiervoor ook vergoed door de ziekteverzekering. Op vraag van het RIZIV maakte het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) de balans op van de MOCs en ging het na hoe hun werking nog kan worden verbeterd.
De bevindingen zijn in de eerste plaats positief: de behandeling van een dossier in een MOC is (bijna) routine geworden in het zorgtraject van elke nieuwe kankerpatiënt, wat bijdraagt tot een verhoging van de zorgkwaliteit. Toch is er nog ruimte voor verbetering. Zo blijft het fysiek samenbrengen van de drukbezette specialisten een moeilijke zaak. Een ander minpunt is het kleine aantal huisartsen dat deelneemt. Vaak worden ze niet geïnformeerd over de organisatie van een MOC. Daarnaast zijn er ook praktische belemmeringen. Het KCE beveelt daarom het gebruik van moderne communicatiemiddelen, zoals videoconferenties, aan.Contents note: VOORWOORD 2 -- DOEL VAN DEZE STUDIE. 3 -- KERNBOODSCHAPPEN 3 -- BELANGRIJKSTE RESULTATEN VAN HET ONDERZOEK 5 -- 1. het aantal patiënten dat wordt voorgesteld en besproken in een moc stijgt jaar na jaar. De impact van deze multidisciplinaire consulten wordt algemeen als erg positief beschouwd 5 -- 2. de multidisciplinariteit is de belangrijkste voorwaarde voor de kwaliteit en de doeltreffendheid van de moc. de deelname van alle nodige medische disciplines moet dus worden aangemoedigd. daarom moet het gebruik van videoconferenties verder worden bekeken. 9 -- 3. de deelname van huisartsen aan de moc blijft laag, vooral door tijdsgebrek. hun deelname moet makkelijker worden gemaakt, vooral voor de patiënten met een complexe psychomedisch-sociale situatie. 14 -- 4. de samenwerking van de ziekenhuisteams met het kankerregister is essentieel voor de ontwikkeling van een zorgkwaliteitsbeleid. de MOC zijn de bevoorrechte overlegmomenten om deze samenwerking te versterken, maar voor een optimaal gebruik van de gegevens moet hun registratieproces verbeterd worden. de rol van de data manager moet worden geherdefinieerd en afgebakend. 16 -- 5. het onderscheid tussen de eerste moc, opvolgings-MOC en bijkomende moc is niet duidelijk. het is noodzakelijk om een samenhangend kader te creëren en de financieringsregels aan te passen. 18 -- 6. de uitwisseling van administratieve gegevens en de financiële stromen met de ziekenfondsen zijn traag, zwaar en complex; ze moeten worden vereenvoudigd. de vervanging van papier door elektronische communicatiemiddelen is nodig 21 -- 7. het kankerplan financiert een aantal extra jobs voor de erkende oncologiecentra, in verhouding tot hun jaarlijks aantal MOC. de functieprofielen van deze jobs zijn slecht gedefinieerd en door een mogelijke aanpassing van de toekenningsregels in 2015 heerst er in de sector onzekerheid over hun voortbestaan. 21 -- CONCLUSIE 22 -- AANBEVELINGEN 23 Link for e-copy: https://doi.org/10.57598/R239AS Format of e-copy: PDF (692 Kb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3506 Copies(0)
Status No copy 50 Years of Cancer Control in India / Indian Department of Health (2003)
Languages : English (eng)
Descriptors: Classification
QZ 200 Neoplasms. Cysts (General)
Indexation
History of Medicine ; India ; Neoplasms ; prevention and controlContents note: 1 History Of Medical Services And Cancer Treatment Facilities D P Punia -- 2 Addressing The Cancer Agenda : How Have We Measured Up ? K.A. Dinshaw -- 3 Cancer Registration In India Kishore Chaudhry & Usha K. Luthra -- 4 Cancer Genetics Subrata Sinha -- 5 Molecular Approaches To Cancer Management In The Postgenomic Era Alpana Saxena, Sarita Agarwal and Y. N. Rao -- 6 Cancer Prevention And Control In India Cherian Varghese -- 7 Role Of Tumor Markers And Recent Advances In Cancer Diagnosis Manisha Bhutani, Amish Vora and Vinod Kochupillai -- 8 Evolution Of Radiotherapy Machines And Changing Scenario In India A.V. Lakshmanan -- 9 Choice Of A Teletherapy Unit K.S. Reddy -- 10 Radiation Therapy In The Management Of Cancer G. K. Rath -- 11 Role Of BARC In Quality Assurance And Safety In Medical Applications Of Ionizing Radiation B.C. Bhatt -- 12 Cancer Control Programme In Kerala, India M. K. Nair -- 13 A Novel Comprehensive Integrated Model For Cancer Control P.S.Prabhakaran, P.P.Bapsy, Aruna E.Prasad, U.D.Bafna and Kunwraswamy -- 14 Hematopoietic Stem Cell Transplantation In India Parikh Purvish M, Shah Pankaj M, Easow Jose Kumar Lalit -- 15 Technological Advances In Surgical Management Of Cancer Relevance To Indian Scenario R. K. Karwasara and Sanjeev Prashad -- 16 Supportive Care In Oncology : Historical Perspectives And Future Options B. B. Rewari, Sudhir Gupta -- 17 Emerging Strategies For Cancer Control In Women Of India Sudhir Gupta, Y. N. Rao and S. P. Agarwal -- 18 Tobacco Control In India Kishore Chaudhry -- 19 The Joy Of Cancer Anup Kumar -- 20 Radiation Accidents: Guidance To The Handling Of Overexposed Individuals Kumar T. Bhowmik -- 21 New Horizons In Oncology- The Years To Come... Santanu Chaudhuri -- 22 Contributors -- 23 Addresses Of Regional Cancer Centres -- 24 List Of Radiotherapy Centres In India Link for e-copy: http://mohfw.nic.in/cancer.html Format of e-copy: Webpage Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1260
Mise à jour continue
Languages : Dutch (dut) English (eng) French (fre)
Descriptors: Classification
WA 900 Public health statistics (including narrative reports on health conditions and health surveys)
Indexation
Belgium ; Neoplasms ; statistics and numerical data [Subheading]Abstract: The Belgian Cancer Registry Foundation is an institution which collects data concerning new cancer cases in Belgium and makes up statistics from these data.
This information is essential for:
* the study of the geographical spreading of cancer cases
* the follow-up of the evolution in the course of time
* the planning and evaluation of treatment and care equipment
* the contribution to the research on the causes of cancer
* the elaboration and the follow up of the prevention and screening campaigns (e.g. screening for breast cancer)
* the training of the medical and the paramedical staff
* informing the general public.
Statistic tables are published on this internet site.
For each complementary question concerning the numbers, the tables and the graphs please address to the Belgian Cancer Registry FoundationLink for e-copy: http://www.kankerregister.org/ Format of e-copy: Website Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=1298
ISBN : 978-3-540-64030-1
Languages : English (eng)
Descriptors: Classification
QZ 266 Neoplasms. Cysts -- Therapy
Indexation
Antineoplastic Agents ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Economic Evaluation ; Health Care Costs ; NeoplasmsAbstract: BOOK REVIEW Kevin B. Knopf, JNCI, 1999, 91(14), 1248-1249
The need for accurate economic analysis to guide health care delivery is irrefutable, since health care costs continue to rise in parallel with a growing demand in value for our spending. Cancer care accounts for 5%-10% of all health care dollars spent in the United States, and although breakthroughs in cancer research will provide much needed improvements in the treatment of cancer, they will also come at a cost. Dr. Neymark speaks in his preface of the "aura of sanctity" surrounding cancer so that "everything possible" is done for the patients. This aura derives partly from the seriousness of the disease and the fear surrounding a diagnosis of cancer. However, a need for high-quality economic research in cancer care is still necessary to guide rational resource allocation, and this text succeeds in succinctly and thoughtfully summarizing the state of the art of economic analysis of cancer therapies. By exploring the literature related to economic evaluation of cancer therapies over a 10-year period, Dr. Neymark has provided a great deal of food for thought for research in this area.
The general nature of economic evaluation is defined in the introduction:
"Economic evaluation is a widely applicable economic method concerned with the comparison of two or more alternatives with respect to both their positive and negative impacts or benefits and costs, respectively, as these impacts are generally termed. It is the presence of alternative methods of treatments that create an economic problem."
It is the presence of choices that makes economic evaluation a valuable tool. In the past, the treatment of cancer, particularly metastatic disease, was limited in the number of options available, as the author notes. However, new treatments are continually being developed, which come with a cost versus benefit trade-off, and thus economic evaluations will assume a greater importance as our therapeutic choices increase.
The very brief chapter on the epidemiology of cancer could have been made more substantial, and the addition of graphs to interpret trends would have been useful. The following chapter provides an excellent overview of the nature of cancer and its major treatment modalities, which will be of interest to the nonclinician.
The chapters on economic evaluation and the economic burden of cancer are well written and serve as solid introductions for the novice to these areas and a good review for others. He describes the rationale and methods behind the cost-of-illness studies, which he treats with a healthy skepticism. A lengthy section on economic evaluation covers important concepts and describes, in turn, the four major types of studies: cost-minimization, cost-benefit, cost-effectiveness, and cost-utility, the latter two being the most appropriate type of study for most cancer therapeutics. Discussion about methodology involved in collecting data for cost and outcomes, perspective of the analysis, valuation, and presentation and interpretation of results of economic evaluations are also well written.
The heart of the text is a thorough discussion of the major economic studies of cancer treatment published from 1985 to 1996. The author reviews the relevant literature pertaining to costs and treatment of most of the major malignancies, including relevant supportive care areas. Topics covered include the following: breast cancer (14 studies), lung cancers (eight studies), colorectal cancer (eight studies), prostate cancer (10 studies), genitourinary and gynecologic malignancies (11 studies), leukemias and lymphomas (10 studies), therapies for emesis and infections (nine studies), hematologic support and transplantation (18 studies), and palliative care (five studies). Every section is preceded by an overview of treatment options that are fairly accurate—although not without occasional omissions and errors; these sections will be invaluable for the nonclinician.
Each study is described concisely, including rationale, type of analysis, perspective, techniques, data sources, and results, when stated by the original authors. Dr. Neymark justly criticizes studies with conceptual or methodologic flaws, erroneous assumptions, or clear oversights in the evaluation, and as a critical reviewer, he certainly holds no punches. This lengthy and in-depth review of a body of work makes his text a compelling read and enables the reader to gain a great deal of insight into how to, and often how not to, evaluate the economics of cancer therapeutics. Through reading his summation of the body of literature, one obtains an appreciation of not only what studies have been performed and which studies should be performed but also a sense of the "state of the art of the methodology" currently in use. Each chapter closes with a concise table of the articles reviewed and concluding comments that highlight the strengths and weaknesses in the studies, comparing studies when appropriate, and pointing out possible future directions.
A concluding chapter discusses some of the broader controversies, which have been hinted at throughout the review, in an insightful manner. The use of "league tables" to compare cost-effectiveness ratios is justly criticized, due to the implicit assumption of comparability of studies. The issue of costs versus charges is briefly discussed, and a lengthy discussion of the merits of collecting economic data in clinical trials points to the complementary benefit of modeling. The nature of outcomes used, e.g., the inapplicability of life-years saved as an outcome to evaluate antiemetic therapies, is also explored.
By design, this review cannot serve as a complete "how to" guide for economic evaluations, although there are many pearls to be gained from a thorough reading. The economics of cancer prevention and screening, which are in many ways more difficult to study from an economic perspective, were not explored in this text, but there are other sources for this information.
Many of the reviewed studies are excellent and may serve as an aide to treatment choices for a specific situation. In a broader sense, this book will be extremely valuable for both the health service researcher who wishes to learn about cancer economics and the cancer researcher interested in the economic aspects of their field. By reviewing 9 years of the literature in a systematic, thoughtful, and critical manner, there is much to be gained for the interested reader who invests a small amount of time reading this excellent work.Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=244 Hold
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Barcode Call number Media type Location Section Status 10273-00306 QZ 266/NEY Book KCE Library (10.124) Available Assessment of High Intensity Focused Ultrasound for the Treatment of Prostate Cancer / Caroline Obyn in Acta Chirurgica Belgica, 109(2009)05 ([10/01/2009])
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