A successful clinical pilot registry of four radiation oncology practices in Africa and Ontario.

T R Madzima, M Boshoff, D Abuidris, N Tsikai, G W Jones
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Abstract

Objective: Radiation Oncology practices can exhibit heterogeneities between and sometimes within institutions. Clinical registries with scope and detail could quantify consistency and distinctives that justify difference. Retrospective, isolated clinical audits are problematic, typically because not all data are captured in charts, while useful prospective clinical registries will have to be practical, efficient and accurate. We tested feasibility of a clinical registry at a critical time-point in the patient's clinical trajectory when treating physicians could have requisite data.

Design: This was a prospective and non-randomized observational study. Four centres used a 1-page form to acquire data during a 4-month period. Patients had curative breast, rectum or prostate cancers, or were palliative. Objectives were to demonstrate form completion and to delineate patterns of disease presentation and clinical practice.

Results: The 107 cases had 99% complete data, internally consistent within cases and centres. Similar practices were seen for 22 cases with curative rectal and prostate cancer, and 34 palliative cases, but of the 51 curative breast cancer cases those in Africa were with greater Stage, underwent more extensive surgery, were less likely to receive shorter radiation schedules, and were less exposed to Taxane-based chemotherapy regimens.

Conclusions: This study demonstrates the feasibility for a simple clinical registry requiring minimal effort by participants. A real-time pan-African registry, operating continually or in regular waves, could provide important knowledge at little cost.

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一个成功的临床试点注册四个放射肿瘤学实践在非洲和安大略省。
目的:放射肿瘤学实践在不同机构之间,有时在不同机构内部表现出异质性。具有范围和细节的临床登记可以量化一致性和证明差异的独特性。回顾性、孤立的临床审计是有问题的,通常是因为并非所有数据都以图表形式记录,而有用的前瞻性临床登记必须是实用、高效和准确的。我们测试了在患者临床轨迹的关键时间点进行临床登记的可行性,此时治疗医生可以获得必要的数据。设计:这是一项前瞻性、非随机观察性研究。四个中心使用一页表格在4个月期间获取数据。患者患有可治愈的乳腺癌、直肠癌或前列腺癌,或患有姑息性癌症。目的是证明形式完成和描述疾病表现和临床实践的模式。结果:107例病例资料完成率99%,病例和中心内部一致。在22例可治愈的直肠癌和前列腺癌患者以及34例姑息性乳腺癌患者中发现了类似的做法,但在51例可治愈的乳腺癌患者中,非洲患者的分期较长,接受了更广泛的手术,接受较短放疗计划的可能性较小,并且较少暴露于紫杉烷为基础的化疗方案。结论:本研究证明了一个简单的临床登记的可行性,需要最小的参与者的努力。一个持续或定期运作的实时泛非洲登记册可以以很少的成本提供重要的知识。
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