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Shalini K Vinod



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    MA18 - Modelling, Decision-Making and Population-Based Outcomes (ID 920)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Treatment in the Real World - Support, Survivorship, Systems Research
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 13:30 - 15:00, Room 201 F
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      MA18.04 - Discussant - MA 18.01, MA 18.03 (ID 14651)

      13:40 - 13:55  |  Presenting Author(s): Shalini K Vinod

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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    P1.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 947)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.15-25 - Has Lung Cancer Radiotherapy Utilisation Changed over Time in New South Wales, Australia? (ID 13549)

      16:45 - 18:00  |  Presenting Author(s): Shalini K Vinod

      • Abstract
      • Slides

      Background

      Evidence based indications suggest that 73% of all Australian lung cancer patients would benefit from radiotherapy at diagnosis. In 2001-2002, the radiotherapy utilisation (RTU) rate in NSW for lung cancer was 39%. Since then a number of new radiation oncology centres have opened and the number of linear accelerators increasing from 29 to 46. There has also been an increase in the number of lung cancer multidisciplinary teams. We aimed to evaluate whether there had been any change in RTU for lung cancer in NSW from 2001-2002 to 2009-2011.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      All patients diagnosed with lung cancer in NSW between 1/1/2009 and 31/12/2011 were identified from the NSW Central Cancer Registry (NSWCCR). Data linkage with the Admitted Patients Data Collection, Retrospective Radiotherapy Data and Clinical Cancer Registry was performed to ascertain radiotherapy treatment within 1 year of diagnosis. Patients with non-lung cancer pathologies and those who lived closer to interstate radiotherapy centres were excluded. Patients with a clinical diagnosis of lung cancer (no pathological confirmation (NPC)) were included.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 10,712 patients were identified through NSWCCR of which 947 patients were excluded leaving 9,765 patients for analysis. The median age was 71 years and 60% were males. Histopathology was NSCLC, SCLC and NPC in 76%, 12% and 13% respectively. Stage was I&II in 12%, III in 12%, IV in 28% and unknown in 47%. The overall RTU for lung cancer was 40%. RTU was 43% for NSCLC, 56% for SCLC and 8% for NPC. RTU by stage compared to previous figures is shown in Table 1.

      Table-1 Radiotherapy utilisation rate by stage of lung cancer, NSW 2001-2002 and 2009-2011

      Histology

      Stage

      RTU N (%) (2001-2002)

      RTU (%) (2009-2011)

      NSCLC

      I

      76(26)

      201(27)

      II

      35(39)

      164(41)

      III

      170(55)

      753(72)

      IV

      258(49)

      1,497(66)

      Unknown

      17(22)

      544(18)

      Total

      556(43)

      3,159(43)

      SCLC

      I-III

      39(47)

      157(80)

      IV

      61(32)

      280(61)

      Unknown

      1(17)

      202(41)

      Total

      101(36)

      639(56)

      NPC

      I

      12(22)

      12(43)

      II

      4(33)

      3(50)

      III

      11(35)

      17(71)

      IV

      20(27)

      37(60)

      Unknown

      5(8)

      25(2)

      Total

      52(23)

      94(8)

      OVERALL

      Total

      709(39)

      3,892(40)

      8eea62084ca7e541d918e823422bd82e Conclusion

      Increased RTU was seen in some groups of patients including Stage III-IV NSCLC, Stage I-IV SCLC and Stage I-IV NPC. Despite an increase in resources, overall RTU for lung cancer has remained unchanged over the last decade.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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    P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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      P3.15-07 - A Literature Review and Assessment of Lung Cancer Quality Indicators (ID 12837)

      12:00 - 13:30  |  Author(s): Shalini K Vinod

      • Abstract
      • Slides

      Background

      Quality indicators (QIs) are used to assess various aspects of the quality of healthcare services received by patients in the “real-world”. They provide a measurement tool to be utilised in care settings to develop standards or benchmarks, identify variations in care, guide performance improvement, monitor changes over time and promote accountability. The management of lung cancer is complex and rapidly evolving. Care often involves multidisciplinary assessment and management with multimodality treatment that requires a comprehensive and co-ordinated approach. Evaluating the quality of care received in “real-world” everyday care is crucial for optimising health outcomes for lung cancer patients. We reviewed quality indicators in lung cancer and assessed their utility.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      A medline search was conducted using the search terms “quality indicators” and “lung neoplasms” and grey literature using a web search of government and relevant health organisations. Full-text review was performed to include only articles that fulfilled inclusion criteria of original research that developed or applied specific QIs related to the care of lung cancer patients. Data was collected on the characteristics, frequency, use and testing for each indicator.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of 43 articles or reports were analysed. These included 293 distinct QIs, the most frequently reported indicators were related to surgery (n=66), then symptom assessment and management (n=43) and diagnosis and staging (n=38). There were fewer indicators related to systemic therapy (n=30), radiotherapy (n=17) or combined treatments (n=10). Analysis of the characteristics of process and structure QIs was undertaken and classified as meeting all ideal or a minimum set of desirable characteristics for QIs. Of these 60 met the minimum set and only five the ideal characteristics. These included 12 related to diagnosis and staging, four to pre-treatment assessment, five to surgery, 12 to systemic treatment, six to radiotherapy, three to combined treatment, three non-specific to treatment, three to symptom assessment, 11 to supportive care and one to palliative care.

      8eea62084ca7e541d918e823422bd82e Conclusion

      A wide range of quality indicators have been developed and used in lung cancer. The most frequent are treatment related and surgical based, which only reflects a small proportion of all lung cancer patients. In order to assess their usefulness, we classified QIs according to fulfilling accepted desirable characteristics. We present these as the most useful for implementation as quality metrics. QIs must also be feasible and relevant, which must be tailored to the health service for application.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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