A Clinical Audit: Assessing the Diagnostic Delay of Primary Brain Tumors, Glioblastoma IDH-Wild Type and Primary CNS Lymphoma; Exploring the Use of CSF Liquid Biopsy

Sana J. Ghosheh
{"title":"A Clinical Audit: Assessing the Diagnostic Delay of Primary Brain Tumors, Glioblastoma IDH-Wild Type and Primary CNS Lymphoma; Exploring the Use of CSF Liquid Biopsy","authors":"Sana J. Ghosheh","doi":"10.58624/svoane.2023.04.0117","DOIUrl":null,"url":null,"abstract":"Background: Diagnostic delay is a critical issue in healthcare, often leading to delayed treatment and poor patient outcomes. Diagnostic errors contribute to about 10% of patient deaths annually. Delays are very prevalent in Glioblastoma and Primary CNS Lymphoma. Both have an aggressive nature and a short survival rate, which urges for early diagnosis to ensue treatment as quick as possible. The delayed diagnosis can be attributed to tumor-specific factors such as challenging differential diagnoses, inadequate methods in achieving optimal outcomes, and the presence of confounding factors like steroid usage. Aims and Objectives: The objective of this clinical audit is to analyse patient records within an oncology unit. The primary goal is to assess the quality of practice by evaluating the standards of diagnosis and treatment. Additionally, the audit aims to pinpoint areas that require improvement at every stage of patient management, encompassing administration, symptom evaluation, and post-therapeutic measures. Based on these findings, a comprehensive plan of action will be proposed to address the identified issues effectively. Standards and Methods: In this Clinical Audit, we assessed the adherence of 10 Glioblastoma and PCNSL patients in a neuro oncology unit, to standards and guidelines set by professional medical associations. Which include World Health Organisation (WHO), National Health Service England (NHS), and European Association of Neuro-oncology (EANO). Results: Our cohort showed long diagnostic delays, minimum and maximum values of 30 and 1825 days. The sample did not show significantly longer delays compared to other PCNSL or HGG patients, all collected from the literature, with p values of 0.174 and 0.637, respectively. Conclusions: In Conclusion, Diagnostic Delay attributed to PCNSL and Glioblastoma can be pinpointed to the inadequacy of existing standards in relying solely on stereotactic biopsies for definite diagnosis when it may not be ideal for all patients at all tumor stages. A plan of action encouraging large clinical trials of CSF Liquid Biopsy is recommended with an employment of recent advances and focusing on detecting circular tumor DNA for the diagnostic insight it provides. As well as exploring its use during or post therapy to monitor the lesion and pathology. To also adhere strictly to the discouragement of steroid use for the negative prognostic factors it causes.","PeriodicalId":505846,"journal":{"name":"SVOA Neurology","volume":"112 4","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"SVOA Neurology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.58624/svoane.2023.04.0117","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Diagnostic delay is a critical issue in healthcare, often leading to delayed treatment and poor patient outcomes. Diagnostic errors contribute to about 10% of patient deaths annually. Delays are very prevalent in Glioblastoma and Primary CNS Lymphoma. Both have an aggressive nature and a short survival rate, which urges for early diagnosis to ensue treatment as quick as possible. The delayed diagnosis can be attributed to tumor-specific factors such as challenging differential diagnoses, inadequate methods in achieving optimal outcomes, and the presence of confounding factors like steroid usage. Aims and Objectives: The objective of this clinical audit is to analyse patient records within an oncology unit. The primary goal is to assess the quality of practice by evaluating the standards of diagnosis and treatment. Additionally, the audit aims to pinpoint areas that require improvement at every stage of patient management, encompassing administration, symptom evaluation, and post-therapeutic measures. Based on these findings, a comprehensive plan of action will be proposed to address the identified issues effectively. Standards and Methods: In this Clinical Audit, we assessed the adherence of 10 Glioblastoma and PCNSL patients in a neuro oncology unit, to standards and guidelines set by professional medical associations. Which include World Health Organisation (WHO), National Health Service England (NHS), and European Association of Neuro-oncology (EANO). Results: Our cohort showed long diagnostic delays, minimum and maximum values of 30 and 1825 days. The sample did not show significantly longer delays compared to other PCNSL or HGG patients, all collected from the literature, with p values of 0.174 and 0.637, respectively. Conclusions: In Conclusion, Diagnostic Delay attributed to PCNSL and Glioblastoma can be pinpointed to the inadequacy of existing standards in relying solely on stereotactic biopsies for definite diagnosis when it may not be ideal for all patients at all tumor stages. A plan of action encouraging large clinical trials of CSF Liquid Biopsy is recommended with an employment of recent advances and focusing on detecting circular tumor DNA for the diagnostic insight it provides. As well as exploring its use during or post therapy to monitor the lesion and pathology. To also adhere strictly to the discouragement of steroid use for the negative prognostic factors it causes.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
临床审计:评估原发性脑肿瘤、IDH-野生型胶质母细胞瘤和原发性中枢神经系统淋巴瘤的诊断延迟;探索脑脊液液体活检的应用
背景:诊断延误是医疗保健中的一个关键问题,通常会导致治疗延误和不良的患者预后。每年约有 10% 的患者因诊断错误而死亡。诊断延误在胶质母细胞瘤和原发性中枢神经系统淋巴瘤中非常普遍。这两种疾病都具有侵袭性,存活率较低,因此需要尽早诊断,尽快治疗。延迟诊断可归因于肿瘤特异性因素,如具有挑战性的鉴别诊断、实现最佳疗效的方法不足,以及存在类固醇使用等混杂因素。目的和目标:本次临床审核的目的是分析肿瘤科的病历。主要目的是通过评估诊断和治疗标准来评估实践质量。此外,审核还旨在找出在患者管理的各个阶段(包括用药、症状评估和治疗后措施)需要改进的地方。根据这些发现,将提出一项全面的行动计划,以有效解决发现的问题。标准和方法:在本次临床审计中,我们评估了神经肿瘤科 10 名胶质母细胞瘤和 PCNSL 患者对专业医学协会制定的标准和指南的遵守情况。其中包括世界卫生组织 (WHO)、英国国家医疗服务体系 (NHS) 和欧洲神经肿瘤协会 (EANO)。结果:我们的样本显示诊断延误时间较长,最短和最长分别为 30 天和 1825 天。与其他 PCNSL 或 HGG 患者相比,样本的延误时间并没有明显延长,P 值分别为 0.174 和 0.637。结论总之,PCNSL 和胶质母细胞瘤的诊断延迟可归咎于现有标准的不足,即仅依靠立体定向活检来明确诊断,而这一方法并不适合所有肿瘤阶段的所有患者。建议制定一项行动计划,鼓励对 CSF 液体活检进行大规模临床试验,利用最新进展,重点检测环状肿瘤 DNA,以提供诊断依据。同时探索其在治疗期间或治疗后的应用,以监测病变和病理情况。还要严格遵守不鼓励使用类固醇的规定,因为这会导致不良预后因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
A 66-Year-Old Woman Presented with Sudden Onset Eye Pain and Loss of Vision: Do Not Miss MOGAD Neurosciences and Nobel Prizes in Medicine and Physiology, A Brief Historical Sketch Hyperglycemic Hemicoreorea/Hemiballism A Clinical Audit: Assessing the Diagnostic Delay of Primary Brain Tumors, Glioblastoma IDH-Wild Type and Primary CNS Lymphoma; Exploring the Use of CSF Liquid Biopsy The Delayed Diagnosis of Juvenile Myoclonic Epilepsy in Young Adults: A Scoping Review
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1