Hospital-based multidisciplinary lung cancer care in Australia: a survey of the landscape in 2021

Brims, Fraser; Kumarasamy, Chellan; Nash, Jessica; Leong, Tracy L.; Marshall, Henry

doi:10.1136/bmjresp-2021-001157

Cited by 14 publications

(21 citation statements)

References 24 publications

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“…The indicator "presentation in the tumor board" is therefore part of the certification requirements in all certification systems. This counter-acts a tumor board that is regularly held in the absence of main treatment partners [29]. The certification commission has also determined that, in contrast to the guideline recommendation and the quality indicator based on it, not only patients in stage IV, but all patients with an initial diagnosis of lung cancer must be presented pretherapeutically in the tumor board, regardless of stage.…”

Section: Discussionmentioning

confidence: 99%

Development and Update of Guideline-based Quality Indicators in Lung Cancer

Utzig,

Hoffmann,

Reinmuth

et al. 2023

Pneumologie

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Background In 2022, an update of the German lung cancer guideline, first published in 2010 and revised in 2018, was released. This article aims to show the process of updating, developing, and implementing guideline-based quality indicators (QI) into the certification system for lung cancer centers (LCC). Methods A multidisciplinary and interprofessional working group revised the guideline QIs from 2018 using the strong recommendations of the guideline update, a systematic review for QIs, and the results of the implemented QIs from LCC. Results For 4 out of 8 indicators from the 2018 guideline, the LCC showed an improved implementation of the requirements in the last 3 years (2018–2020). For 3 indicators, the median of the results was constant at a very high level (≥96% or 100%). Only the “adjuvant cisplatin-based chemotherapy” indicator showed declining values between 2018 and 2020. The target values and plausibility limits were well achieved by LCC. After updating the guideline, one QI from 2018 was not included in the new QI set due to the small denominator population. Based on the new strong recommendations, 8 new QIs were defined. From the QI set of the guideline update, 13 of 15 indicators (7 since 2018 and 6 from 2022 on) were adopted into the certification program. Conclusions The guideline recommendations are implemented by LCC at a high level. The process presented confirms the successful implementation of the so-called quality cycle in oncology. The QIs developed by the German Guideline Program in Oncology (GGPO) are adopted by the certification program. The implementation of the QI is measured in LCC, evaluated by the German Cancer Society (DKG), and reflected back to the GGPO. The “real world” data have led to the deletion of one QI and show a high implementation of most QIs in LCC.

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Section: Discussionmentioning

confidence: 99%

Development and Update of Guideline-based Quality Indicators in Lung Cancer

Utzig,

Hoffmann,

Reinmuth

et al. 2023

Pneumologie

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“…Recent Australian data show that while most lung cancer centres run regular MDTs, important gaps jeopardize the quality of this care. 43 Of the 79 institutions surveyed (72% of all known lung cancer care centres), most had regular MDT meetings but only 57.5% achieved full core membership. Fewer than half had specialist nurses and fewer than a quarter had regular surgical representation.…”

Section: Mdt Variations In Carementioning

confidence: 98%

“…MDT care may lead to better lung cancer outcomes and comprises an essential component of LCS. Recent Australian data show that while most lung cancer centres run regular MDTs, important gaps jeopardize the quality of this care 43 . Of the 79 institutions surveyed (72% of all known lung cancer care centres), most had regular MDT meetings but only 57.5% achieved full core membership.…”

Section: Lung Cancer Updatementioning

confidence: 99%

Contemporary Concise Review 2021: Pulmonary nodules from detection to intervention

Leong

2022

Respirology

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The US Preventive Task Force (USPSTF) has updated screening criteria by expanding age range and reducing smoking history required for eligibility; the International Lung Screen Trial (ILST) data have shown that PLCOM2012 performs better for eligibility than USPSTF criteria.• Screening adherence is low (4%-6% of potential eligible candidates in the United States) and depends upon multiple system and patient/candidate-related factors.• Smoking cessation in lung cancer improves survival (past prospective trial data, updated meta-analysis data); smoking cessation is an essential component of lung cancer screening. • Circulating biomarkers are emerging to optimize screening and early diagnosis.• COVID-19 continues to affect lung cancer treatment and screening through delays and disruptions; specific operational challenges need to be met. • Over 70% of suspected malignant lesions develop in the periphery of the lungs.Bronchoscopic navigational techniques have been steadily improving to allow greater accuracy with target lesion approximation and therefore diagnostic yield. • Fibre-based imaging techniques provide real-time microscopic tumour visualization, with potential diagnostic benefits. • With significant advances in peripheral lung cancer localization, bronchoscopically delivered ablative therapies are an emerging field in limited stage primary and oligometastatic disease. • In advanced stage lung cancer, small-volume samples acquired through bronchoscopic techniques yield material of sufficient quantity and quality to support clinically relevant biomarker assessment.

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“…A recent national survey of lung cancer care in Australia has highlighted clear deficiencies in many institutions' staffing and infrastructure for treating this type of cancer. 8 Advances in understanding the molecular biology of lung cancer have transformed the care of many patients with NSCLC, with an array of novel therapies becoming available in the past 5 years. The number of targetable oncogenes, including mutations, rearrangements and amplifications, continues to expand rapidly, particularly in adenocarcinoma of the lung.…”

mentioning

confidence: 99%

“…Access to advanced diagnostics such as endobronchial ultrasound bronchoscopy, positron emission tomography, and access to a specialist multidisciplinary team are now critical for high quality care. A recent national survey of lung cancer care in Australia has highlighted clear deficiencies in many institutions’ staffing and infrastructure for treating this type of cancer 8 …”

mentioning

confidence: 99%