Article
Guideline adherence of sarcoma care in Germany – results from a nationwide cohort study (PROSa-study)
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Authors
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Martin Eichler
- Universitätsklinikum Carl Gustav Carus Dresden, MK 1, Dresden, Germany
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Stephan Richter
- University Hospital and Medical Faculty Carl Gustav Carus, Department of Internal Medicine I, Dresden, Germany
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Peter Hohenberger
- Mannheim University Medical Center, Div. of Surgical Oncology & Thoracic Surgery, Mannheim, Germany
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Bernd Kasper
- University Medical Centre Mannheim, Interdisciplinary Tumor Center Mannheim, Mannheim, Germany
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Dimosthenis Andreou
- University Hospital Munster, Clinic for General Orthopedics and Tumor Orthopedics, Münster, Germany
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Daniel Pink
- Helios Hospital Bad Saarow, Sarcoma Center, Bad Saarow, Germany
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Henriette Golcher
- University Hospital Erlangen, Surgical Clinic, Erlangen, Germany
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Stephen Fung
- University Hospital Düsseldorf, Clinic for General, Visceral and Pediatric Surgery, Düsseldorf, Germany
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Eva Wardelmann
- University Hospital Muenster, Gerhard-Domagk-Institute of Pathology, Münster, Germany
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Markus Wartenberg
- Das Lebenshaus e.V, Das Lebenshaus e.V, Bad Nauheim, Germany
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Leopold Hentschel
- University Hospital and Medical Faculty Carl Gustav Carus, University CancerCenter, Dresden, Germany
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Maria Eberlein-Gonska
- University Hospital and Medical Faculty Carl Gustav Carus, Department of quality- and medical risk management, Dresden, Germany
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Martin Bornhäuser
- University Hospital and Medical Faculty Carl Gustav Carus, University CancerCenter, Dresden, Germany
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Jochen Schmitt
- University Hospital and Medical Faculty Carl Gustav Carus, Center for Evidence-based Healthcare, Dresden, Germany
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Markus Schuler
- University Hospital and Medical Faculty Carl Gustav Carus, Department of Internal Medicine I, Dresden, Germany
| Published: | October 2, 2019 |
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Outline
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Introduction: Sarcomas challenge clinical and research standards because of a complex diagnostic and treatment algorithm and a high disease burden. There is scarce knowledge about the real-world situation of sarcoma care in Germany such as compliance to treatment guidelines and the quality of care.
Methods: We conducted a nationwide prospective cohort study. Approximately 1300 adult patients with incident or prevalent sarcoma were recruited between 09/2017 and 01/2019 in 60 participating institutions. Clinical data on patient- and institutional-level and patient reported outcomes via standardized and self-developed questionnaires were collected online or via pen&paper at 0, 6 and 12 months after patient consent. Study data were managed using REDCap electronic data capture tools.
Standards of care were identified through established guidelines and with the help of expert consultations. We examined the implementation of the following standards: Case review by multidisciplinary tumor-board pre- and post-treatment and after diagnosis of a local or systemic recurrence, biopsy before therapy, local CT or MRI scan, thoracic or abdominal CT scans before therapy, the quality of surgical margins, psycho-oncological care and social care.
Multivariable regressions with variables on patient level as well as on structural clinical data will be performed.
Results/Aims: Baseline clinical data collection closes in 05/2019. Final baseline results will be presented at the conference. We aim to identify potential factors associated with non-guideline adherence. On an institutional level those might for example include: numbers of patients treated per year, existing certifications and type of medical facility. On a patient level those might include: gender, socio-economic-status and age.
Conclusions: The PROSa Study will provide detailed information on the quality of care and guideline adherence in Germany. Furthermore, the study supports the identification of insufficient healthcare structures as well as potential vulnerable groups. Ultimately, it might contribute to an optimization of healthcare service for adult sarcoma patients.
