1 / 16

THE MANAGEMENT OF PATIENTS WITH THYROID CANCER

THE MANAGEMENT OF PATIENTS WITH THYROID CANCER. Cathy Bennett Information Projects Manager. UPDATE. Second steering group meeting PROTOCOL development (Miss Durning, Mr England, Dr Mallick, Dr Watson + others). TO DISCUSS. Protocol under development - still some issues to resolve

masao
Download Presentation

THE MANAGEMENT OF PATIENTS WITH THYROID CANCER

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. THE MANAGEMENT OF PATIENTS WITH THYROID CANCER Cathy Bennett Information Projects Manager

  2. UPDATE • Second steering group meeting • PROTOCOL development (Miss Durning, Mr England, Dr Mallick, Dr Watson + others)

  3. TO DISCUSS • Protocol under development - still some issues to resolve • Background • Aims and objectives • Exclusions • Patient issues? • Pathology review? • Study design and Pilot

  4. KEY QUESTIONS • What really makes a difference to outcome and/or the decisions made about management? • What are the outcomes? • recurrence • laryngeal nerve damage, other • death

  5. AIMS AND OBJECTIVES - 1 • To publish the anonymised results of the audit in a form which is freely accessible and to encourage participating hospital Trusts and health care professionals to use the findings to adopt best practice.

  6. AIMS AND OBJECTIVES - 2 • To determine whether patients diagnosed with thyroid cancer in the Northern and Yorkshire Region in 1998 received appropriate care, including diagnosis and assessment, as compared with the NCN/BAES guidelines. Determine practice before the introduction of guidelines in 2000? • To assess the specialties, workload, and extent of multi-disciplinary team working of clinicians who managed thyroid cancer patients in the Northern and Yorkshire Region in recent years.Who does surgery and who else is involved? • To determine the outcomes of patients diagnosed with thyroid cancer (Northern and Yorkshire).What affects outcomes?

  7. OVERVIEW • BASELINE - 1998/99 - Assessment, diagnosis and care by case note review against key features in the guidelines and surgeon questionnaire • 1998 to PRESENT - Overall patterns of management and outcomes

  8. 1. DIAGNOSIS, PRE-TREATMENT ASSESSMENT and CARE • Is it appropriate and up to guidelines standard? • Case note review in 1998/99 patients - registrations are incomplete for 2000 and 2001- against key features in the guidelines • Proforma - disciplined about data items collected

  9. 2. SURGICAL MANAGEMENT • Who, speciality, and workload - registry data • Questionnaire for surgeons in 1998 - Speciality and Sub-group, MDT?

  10. 3. INVOLVEMENT OF OTHER HEALTH CARE PROFESSIONALS • Retrospective - how can we find out who was involved - named specialist? • Prospective - who is now involved in the follow up of a patient What questions would we ask? • Is there a team and how is it defined? • Who is in the team? • How does the team work? • At what point are they involved? • Methodology - questionnaire, interview

  11. 4.1 PATIENT ISSUES: Possible Topics • Experiences of receiving I131 therapy (Stajduhar et al, 2000) • care, education • Experiences of thyroid hormone withdrawal for cancer recurrence evaluation (Dow et al, 1997) • QOL, use of recombinant TSH to avoid hypo • Psychosocial impact of genetic testing in familial medullary TC (Freyer et al, 1999) • care, education

  12. 4.2 PATIENT ISSUES: Methodology • Identification of patients • retrospective via cancer registry (ethical problems?) • prospective in liaison with clinical nurse specialists in N & Y region • combination of above • Regional study vs. single hospital • enlarge patient numbers, increase study viability • Interview/postal questionnaires/QOL • expertise in NYCRIS Can we do it? Is this research?

  13. 5.1 PATHOLOGY: Subtypes Subtypes Lymphomas - in or out?

  14. 5.2 PATHOLOGY: Review • Pathology review - advantages/disadvantages - review a subset where mis-reporting may lead to inappropriate care • Who would review and how to obtain the materials • Concurrent with audit? • Who would lead the process?

  15. 6.STUDY DESIGN • TITLE: FACTORS AFFECTING ADVERSE OUTCOMES IN THYROID CANCER • Patients in 1998/9 • Build up a detailed profile of each case: diagnosis, types, management and follow up against key features in the guidelines • Outcomes • Recurrence • Death • Other • Management of recurrence and other outcomes

  16. 7. PILOT • Review case notes of a sample of patients in 1998 (all hospitals) for diagnosis, assessment and care - devise proforma with protocol working group. • Pilot information gathering about teams/involvement of other healthcare professionals

More Related