Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Disparities in Prostate Cancer Treatment Suggest Ways to Improve Care

05.08.2008
Quality of care varies greatly for the treatment of men with early-stage prostate cancer by region of the country and category of health care facility, suggesting the potential for improved patient outcomes with more standard treatment protocols, according to a new study that was published in the Aug. 1 issue of the Journal of Clinical Oncology (2008: Vol. 26, Issue 22).

The inconsistencies in care also suggest that there is much to do before quality improvement initiatives, such as pay-for-performance, can be instituted nationwide, according to Benjamin A. Spencer, M.D., M.P.H., the lead author of the study. Dr. Spencer is a urologic oncologist at NewYork-Presbyterian Hospital/Columbia University Medical Center and an assistant professor of urology at the Columbia University College of Physicians and Surgeons.

"We found significant variations for early-stage prostate cancer quality indicators. There were differences in care from community hospitals to cancer centers to teaching hospitals. There were also disparities in care from one region of the country to another. But there were no racial disparities, suggesting equity in care once a patient initiates treatment," says Dr. Spencer. "If these variations in care can be eliminated, thereby providing uniform quality, it may lead to improved outcomes for patients."

The study reviewed national databases and individual patient charts to identify gaps in care for prostate cancer using comprehensive quality measures developed by RAND.

All therapies for localized prostate cancer can significantly impact the patient's quality of life. Improving the quality of care throughout the health care system could greatly improve quality-of-life issues for men treated for the disease.

Compliance with structural measures, such as having more than one board-certified urologist and board-certified radiation oncologist on staff, was high at near or greater than 90 percent. In contrast, compliance with standards for pre-therapy assessments of sexual and bowel function was low, at less than 52 percent.

Comprehensive cancer centers and teaching/research hospitals had higher compliance rates than community cancer centers across the board on nearly all compliance measures. Compliance rates varied greatly throughout the country on several measures, including board-certified urologists and radiation oncologists, communication with primary care physician and conformal total radiation dose.

High-quality care is possible, as evidenced by the near or greater than 80 percent compliance with pre-therapy disease severity assessment and counseling indicators. However, compliance was substantially lower for pre-therapy functional assessment and post-treatment follow-up indicators.

Using the National Cancer Data Base, the study sampled early-state prostate cancer cases diagnosed in 2000 through 2001 and explicitly reviewed medical records from 2,775 men treated with radical prostatectomy or external-beam radiation therapy. The researchers determined compliance with 29 quality-of-care disease-specific structure and process indicators developed by RAND, stratified by race, geographic region and hospital type.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia's College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree and is now among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments -- more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service.

It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital's mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons.

Jennifer Homa | Newswise Science News
Further information:
http://www.nyp.org
http://www.columbia.edu

More articles from Health and Medicine:

nachricht Lung images of twins with asthma add to understanding of the disease
06.12.2019 | University of Western Ontario

nachricht Between Arousal and Inhibition
06.12.2019 | Albert-Ludwigs-Universität Freiburg im Breisgau

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Developing a digital twin

University of Texas and MIT researchers create virtual UAVs that can predict vehicle health, enable autonomous decision-making

In the not too distant future, we can expect to see our skies filled with unmanned aerial vehicles (UAVs) delivering packages, maybe even people, from location...

Im Focus: The coldest reaction

With ultracold chemistry, researchers get a first look at exactly what happens during a chemical reaction

The coldest chemical reaction in the known universe took place in what appears to be a chaotic mess of lasers. The appearance deceives: Deep within that...

Im Focus: How do scars form? Fascia function as a repository of mobile scar tissue

Abnormal scarring is a serious threat resulting in non-healing chronic wounds or fibrosis. Scars form when fibroblasts, a type of cell of connective tissue, reach wounded skin and deposit plugs of extracellular matrix. Until today, the question about the exact anatomical origin of these fibroblasts has not been answered. In order to find potential ways of influencing the scarring process, the team of Dr. Yuval Rinkevich, Group Leader for Regenerative Biology at the Institute of Lung Biology and Disease at Helmholtz Zentrum München, aimed to finally find an answer. As it was already known that all scars derive from a fibroblast lineage expressing the Engrailed-1 gene - a lineage not only present in skin, but also in fascia - the researchers intentionally tried to understand whether or not fascia might be the origin of fibroblasts.

Fibroblasts kit - ready to heal wounds

Im Focus: McMaster researcher warns plastic pollution in Great Lakes growing concern to ecosystem

Research from a leading international expert on the health of the Great Lakes suggests that the growing intensity and scale of pollution from plastics poses serious risks to human health and will continue to have profound consequences on the ecosystem.

In an article published this month in the Journal of Waste Resources and Recycling, Gail Krantzberg, a professor in the Booth School of Engineering Practice...

Im Focus: Machine learning microscope adapts lighting to improve diagnosis

Prototype microscope teaches itself the best illumination settings for diagnosing malaria

Engineers at Duke University have developed a microscope that adapts its lighting angles, colors and patterns while teaching itself the optimal...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

The Future of Work

03.12.2019 | Event News

First International Conference on Agrophotovoltaics in August 2020

15.11.2019 | Event News

Laser Symposium on Electromobility in Aachen: trends for the mobility revolution

15.11.2019 | Event News

 
Latest News

Solving the mystery of carbon on ocean floor

06.12.2019 | Earth Sciences

Chip-based optical sensor detects cancer biomarker in urine

06.12.2019 | Life Sciences

A platform for stable quantum computing, a playground for exotic physics

06.12.2019 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>