教育干预和新冠肺炎大流行对原发性中枢神经系统肿瘤儿科患者诊断时间的影响。

IF 2.4 Q2 CLINICAL NEUROLOGY Neuro-oncology practice Pub Date : 2023-05-14 eCollection Date: 2023-10-01 DOI:10.1093/nop/npad024
Tyler Canova, Neil McNinch, Alexis Judd, Sarah Rush, Erin Wright
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引用次数: 0

摘要

背景:原发性中枢神经系统肿瘤是癌症儿童患者死亡和致残的主要原因。阿克伦儿童医院于2018年公布了脑肿瘤诊断反应时间的数据,并实施了一项既定计划的组成部分,以减少诊断延迟,从而减少肿瘤和治疗相关的疾病。本研究评估提供者教育后的总诊断间隔(TDI,从症状出现到诊断的时间)是否有所改善。在研究期间,新冠肺炎大流行迫使护理服务发生变化。还评估了这对TDI的影响。方法:进行回顾性图表回顾,将患者分为2008-2017年(历史)组和2018-2021年(教育后)组,以评估教育干预对TDI的影响。对教育后队列进行单独分析,以评估新冠肺炎大流行的影响。结果:85名受试者的TDI中位数为31天。尽管没有统计学意义(P=.939),但与历史组(42天)相比,这意味着TDI中位数下降了11天。此外教育后组的医疗保健提供者平均就诊次数有所增加(HCP,2.4次,教育后3.2次,P=.009)。COVID-19前组(TDI中位数43.5天)与COVID-19后组(TDI中值30天)在统计学上没有差异。结论:实施教育后TDI无显著下降,同时HCP就诊次数增加提示提供者在治疗原发性中枢神经系统肿瘤方面存在潜在差距。这些结果将影响教育的扩展,以进一步提高TDI。
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The effects of educational interventions and the COVID-19 pandemic on the time to diagnosis in pediatric patients with primary central nervous system tumors.

Background: Primary central nervous system tumors are a leading cause of death and disability amongst pediatric cancer patients. Akron Children's Hospital published data in 2018 on response time for brain tumor diagnosis and implemented components of an established program to decrease diagnostic delays and thereby reduce tumor- and treatment-related morbidities. This study evaluates if there was an improvement in the total diagnostic interval (TDI, time from symptom onset to diagnosis) after provider education. During the study, the COVID-19 pandemic forced alterations in care delivery. The impact this had on the TDI was also assessed.

Methods: A retrospective chart review was performed, and patients were separated into 2008-2017 (historical) and 2018-2021 (posteducation) groups to assess the effect of educational interventions on TDI. The posteducation cohort was analyzed separately to assess the impact of COVID-19 pandemic.

Results: The 85 patients studied in the post-education group showed a median TDI of 31 days. Though not statistically significant (P = .939), this represents an 11-day decrease in median TDI compared to the historical group (42 days). In addition, the posteducation group showed an increase in the average number of healthcare provider visits (HCP, 2.4 historical to 3.2 posteducation, P = .009). The pre-COVID-19 group (median TDI 43.5 days) did not differ statistically from the post-COVID-19 group (30-day median TDI).

Conclusion: The nonsignificant decrease in TDI and concurrent increase in HCP visits after implementation of education suggests a potential gap amongst providers in working-up primary CNS tumors. These results will influence expansion of education to further improve TDI.

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来源期刊
Neuro-oncology practice
Neuro-oncology practice CLINICAL NEUROLOGY-
CiteScore
5.30
自引率
11.10%
发文量
92
期刊介绍: Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving
期刊最新文献
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