Factors influencing the delivery of cancer pathways: a summary of the literature

Brice, Syaribah Noor; Harper, Paul Robert; Crosby, Tom; Gärtner, Daniel; Arruda, Edilson F.; England, Tracey; Aspland, Emma; Foley, Kieran

doi:10.1108/jhom-05-2020-0192

Cited by 8 publications

(6 citation statements)

References 73 publications

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“…Insufficient samples in a lung cancer diagnosis not only affect patients' well‐being and outcomes but also strain the resources, the efficiency, and the reputation of healthcare institutions. Delays in treatment and missed opportunities for clinical trials increase workload and reduce efficiency 39–42 . Therefore, it is crucial for the healthcare providers to continuously work on improving the diagnostic techniques to minimize the occurrence of insufficient samples and ensure timely and accurate diagnoses.…”

Section: Discussionmentioning

confidence: 99%

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Insufficient endobronchial ultrasound‐guided transbronchial needle aspiration specimens. When and why? The analysis of criteria and reasons behind the insufficient specimens

Vuorisalo,

Huhtala,

Paavonen

et al. 2024

Diagnostic Cytopathology

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BackgroundThe classification terminology systems for pulmonary cytology specimens have recently emerged. Inadequate samples, classified as "nondiagnostic," raise challenges in determining the threshold of cell numbers and the risk of malignancy (ROM).MethodsThe study retrospectively reviewed 248 endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) samples: 46 insufficient samples, 60 low cellularity samples, and 142 adequate samples. Characteristics as cellularity, number of benign and malignant cells, and background features were assessed. Receiver operating characteristic curve analysis was performed to establish cell sufficiency thresholds for the diagnosis.ResultsOut of the 248 samples analyzed, 108 were classified as benign, 94 as malignant, and 46 as insufficient. The study found that the cellularity thresholds for diagnosis in cell blocks and cytological samples were ≥50 cells and ≥100 cells, respectively. The thresholds for tumor cell counts were ≥1 − 10 cells for both types of cells, respectively. Considerably, some low cellularity samples were initially classified as insufficient despite meeting the diagnostic thresholds upon revision. The ROM varied across sample categories, with insufficient samples having a ROM of 10.9%, benign samples 15.7%, suspicious samples 92.0%, and malignant samples 100%.ConclusionInsufficient EBUS‐TBNA samples raise challenges in diagnosis and management. This study identified the root cause of insufficient samples, including factors related to humans, diagnostic methods, sampling, and laboratory processing. By understanding the root causes, diagnostic recommendations can be developed to improve the diagnostic process. The findings emphasize the importance of standardized classification and terminology systems for clear communication among healthcare professionals and institutions, ultimately improving patient care and enabling quality assurance measures.

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Section: Discussionmentioning

confidence: 99%

“…Delays in treatment and missed opportunities for clinical trials increase workload and reduce efficiency. [39][40][41][42] Therefore, it is crucial for the healthcare providers to continuously work on improving the diagnostic techniques to minimize the occurrence of insufficient samples and ensure timely and accurate diagnoses.…”

Section: Laboratory Processingmentioning

confidence: 99%

Insufficient endobronchial ultrasound‐guided transbronchial needle aspiration specimens. When and why? The analysis of criteria and reasons behind the insufficient specimens

Vuorisalo,

Huhtala,

Paavonen

et al. 2024

Diagnostic Cytopathology

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“…Some studies used system dynamics modeling as part of a mixed methods study in conjunction with other methods, such as mixed integer programming [33] or qualitative interviews and surveys [34]. People were the primary unit being modeled in 50% of the studies (n = 16) [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49], while 16% modeled patient experience or behavior (n = 5) [50][51][52][53][54]. Other primary units modeled include cells (n = 4; 13%) [33, [55][56][57], environmental contaminants (n = 4; 13%) [58][59][60][61], currency (n = 2; 6%) [62,63], and web search queries (n = 1; 3%) [64].…”

Section: Plos Onementioning

confidence: 99%

“…Most studies of both types indicated more than one purpose. [34,35,49,[52][53][54], publicly available data from cancer registries or federal statistics (n = 7; 22%) [40,41,43,44,46,47,61], patient or health system data (n = 5; 16%) [34,37,45,51,53], literature review (n = 4; 13%) [36,48,50,62], and expert interviews (n = 4; 13%) [41,42,50,51]. One study used search engine data [64] and another used unpublished data from a previously conducted clinical trial [46].…”

Section: Plos Onementioning

confidence: 99%

System dynamics modeling for cancer prevention and control: A systematic review

Kenzie,

Seater,

Wakeland

et al. 2023

PLoS ONE

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Cancer prevention and control requires consideration of complex interactions between multilevel factors. System dynamics modeling, which consists of diagramming and simulation approaches for understanding and managing such complexity, is being increasingly applied to cancer prevention and control, but the breadth, characteristics, and quality of these studies is not known. We searched PubMed, Scopus, APA PsycInfo, and eight peer-reviewed journals to identify cancer-related studies that used system dynamics modeling. A dual review process was used to determine eligibility. Included studies were assessed using quality criteria adapted from prior literature and mapped onto the cancer control continuum. Characteristics of studies and models were abstracted and qualitatively synthesized. 32 studies met our inclusion criteria. A mix of simulation and diagramming approaches were used to address diverse topics, including chemotherapy treatments (16%), interventions to reduce tobacco or e-cigarettes use (16%), and cancer risk from environmental contamination (13%). Models spanned all focus areas of the cancer control continuum, with treatment (44%), prevention (34%), and detection (31%) being the most common. The quality assessment of studies was low, particularly for simulation approaches. Diagramming-only studies more often used participatory approaches. Involvement of participants, description of model development processes, and proper calibration and validation of models showed the greatest room for improvement. System dynamics modeling can illustrate complex interactions and help identify potential interventions across the cancer control continuum. Prior efforts have been hampered by a lack of rigor and transparency regarding model development and testing. Supportive infrastructure for increasing awareness, accessibility, and further development of best practices of system dynamics for multidisciplinary cancer research is needed.

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“…However, gaps and biases within each system have been identified that undoubtedly affect the management of potentially curable patients. 17 There is a current lack of internationally agreed recommendations for improving care of lung cancer patients, with the purpose of being interpreted at a policy level to align efforts to empower those in positions to instigate change.…”

Section: Introductionmentioning

confidence: 99%

An International Consensus on Actions to Improve Lung Cancer Survival: A Modified Delphi Method Among Clinical Experts in the International Cancer Benchmarking Partnership

et al. 2022

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Background Research from the International Cancer Benchmarking Partnership (ICBP) demonstrates that international variation in lung cancer survival persists, particularly within early stage disease. There is a lack of international consensus on the critical contributing components to variation in lung cancer outcomes and the steps needed to optimise lung cancer services. These are needed to improve the quality of options for and equitable access to treatment, and ultimately improve survival. Methods Semi-structured interviews were conducted with 9 key informants from ICBP countries. An international clinical network representing 6 ICBP countries (Australia, Canada, Denmark, England, Ireland, New Zealand, Northern Ireland, Scotland & Wales) was established to share local clinical insights and examples of best practice. Using a modified Delphi consensus model, network members suggested and rated recommendations to optimise the management of lung cancer. Calls to Action were developed via Delphi voting as the most crucial recommendations, with Good Practice Points included to support their implementation. Results Five Calls to Action and thirteen Good Practice Points applicable to high income, comparable countries were developed and achieved 100% consensus. Calls to Action include (1) Implement cost-effective, clinically efficacious, and equitable lung cancer screening initiatives; (2) Ensure diagnosis of lung cancer within 30 days of referral; (3) Develop Thoracic Centres of Excellence; (4) Undertake an international audit of lung cancer care; and (5) Recognise improvements in lung cancer care and outcomes as a priority in cancer policy. Conclusion The recommendations presented are the voice of an expert international lung cancer clinical network, and signpost key considerations for policymakers in countries within the ICBP but also in other comparable high-income countries. These define a roadmap to help align and focus efforts in improving outcomes and management of lung cancer patients globally.

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Factors influencing the delivery of cancer pathways: a summary of the literature

Cited by 8 publications

References 73 publications

Insufficient endobronchial ultrasound‐guided transbronchial needle aspiration specimens. When and why? The analysis of criteria and reasons behind the insufficient specimens

Insufficient endobronchial ultrasound‐guided transbronchial needle aspiration specimens. When and why? The analysis of criteria and reasons behind the insufficient specimens

System dynamics modeling for cancer prevention and control: A systematic review

An International Consensus on Actions to Improve Lung Cancer Survival: A Modified Delphi Method Among Clinical Experts in the International Cancer Benchmarking Partnership

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